beta blockers contraindicated in prinzmetal's angina?

[soxman]

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I came across this during step II prep and cant really pinpoint why. One source also mentioned that aspirin is contraindicated in prinzmetal's angina which I find it very hard to believe. Can anyone shed some light onto this?
Thanks!

 

[Jonari]

beta-blockers leave the alpha1 receptors available for binding by various endogenous hormones (ie think NE)...hence the DoC for prinzmetal's angina is CCB...specifically a dihydropyridine CCB, the ones which end in -dipine (ie nimodipine - which is commonly used to prevent the vasospasm seen from a subarachnoid hemorrhage of a berry aneurysm).

 

[soxman]

beta-blockers leave the alpha1 receptors available for binding by various endogenous hormones (ie think NE)...hence the DoC for prinzmetal's angina is CCB...specifically a dihydropyridine CCB, the ones which end in -dipine (ie nimodipine - which is commonly used to prevent the vasospasm seen from a subarachnoid hemorrhage of a berry aneurysm).

crap why didn't I think of that. Like how Beta blockers are contraindicated in cocaine overdose...unopposed alpha agonism. Thanks a lot!

 

[Transposony]

One source also mentioned that aspirin is contraindicated in prinzmetal's angina which I find it very hard to believe. Can anyone shed some light onto this?
Thanks!

In prinzmetal's angina the pathophysiology is coronary spasm and not clot formation/propagation. Therefore, there is nothing Aspirin can do but to mess up the vasodilator mechanisms in the endothelium since it is an inhibitor of prostacyclin production as well as nitric oxide.

 

[Ronin786]

crap why didn't I think of that. Like how Beta blockers are contraindicated in cocaine overdose...unopposed alpha agonism. Thanks a lot!

Also why you dont give them in pheochromocytoma until you give Phenoxybenzamine or an alpha blocker.

 

[Jonari]

Also why you dont give them in pheochromocytoma until you give Phenoxybenzamine or an alpha blocker.

nice!! completely forgot about this application....keep up the good work brah! 👍

ps: house > harvey