Review Question - QID 100530

Nitrate drugs (nitroglycerin and isosorbide), often used to treat angina, commonly cause headaches. The mechanism of the headaches is believed to be vasodilation of the cerebral arteries.

Nitrate drugs cause direct relaxation of arterial and venous smooth muscle. Venodilation predominates at therapeutic doses, which reduces preload (at higher doses, it reduces afterload). Arteriodilation begins at high doses and can produce hypotension and a reflex tachycardia. Nitrates may be given lingually (spray pump), sublingually, intrabuccally, orally, topically, or by IV infusion.

Incorrect Answers:
Answer 1: Transient ischemic attacks generally present with aphasia, vision changes, hemiparesis, or parasthesias. Headaches are an unusual presenting sign.
Answer 2: An elevated creatinine kinase is not associated with treatment of angina or headache. It is associated with use of statin therapy.
Answer 3: Beta adrenergic inactivation is not associated with headache.
Answer 4: An acute intracranial hemorrhage may present with headache but this would not be related to treatment of angina.