Chapter 29 Angina Q&A (1 of 13) Sample Questions
1. JMP is a 60 year old man with stable angina using metoprolol succinate 50 mg twice daily and he also suffers from chronic obstructive pulmonary disease. He presents with his family doctor with COPD exacerbations. His physician believes his COPD exacerbations are associated with use of high dose metoprolol succinate. In the past he was on isosorbide dinitrate but discontinued because occasionally he wants to use sildenafil as needed. What other therapies can consider for JMP for the treatment of angina?
- A. Lisinopril
- B. Telmisartan
- C. Amlodipine
- D. Nitrates transdermal patch
Tips: Beta blockers are the first line therapy for the treatment of angina. Many patient with respiratory disease asthma, COPD cannot tolerate. In JMP case his COPD was exacerbated thus switching to Calcium channel blockers amlodipine is appropriate alternate. Guidelines suggest the use of beta blockers is contraindicated or side effects are not tolerated, or in addition to a beta blocker additional angina relief is needed calcium channel blocker are alternate option. Patient also using sildenafil so nitrates are not suitable option.