Antianginal Drugs

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Spacer, Paragraph, HRFlowable
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT
from reportlab.platypus import KeepTogether

OUTPUT = "/home/daytona/workspace/antianginal-flashcards/Antianginal_Drugs_Flashcards.pdf"

# ── Colour palette ────────────────────────────────────────────────────────────
DARK_BLUE   = colors.HexColor("#1B3A5C")
MID_BLUE    = colors.HexColor("#2E6DA4")
LIGHT_BLUE  = colors.HexColor("#D6E8F7")
ACCENT      = colors.HexColor("#E8F4FD")
GREEN       = colors.HexColor("#1A7A4A")
GREEN_LIGHT = colors.HexColor("#D4EDDA")
ORANGE      = colors.HexColor("#C05A00")
ORANGE_LIGHT= colors.HexColor("#FFF0D9")
PURPLE      = colors.HexColor("#5B2D8E")
PURPLE_LIGHT= colors.HexColor("#EDE3F7")
RED         = colors.HexColor("#B22222")
RED_LIGHT   = colors.HexColor("#FDECEA")
GREY_LIGHT  = colors.HexColor("#F5F5F5")
WHITE       = colors.white

styles = getSampleStyleSheet()

# Custom paragraph styles
Q_style = ParagraphStyle(
    "Question",
    parent=styles["Normal"],
    fontSize=10.5,
    leading=14,
    textColor=DARK_BLUE,
    fontName="Helvetica-Bold",
)
A_style = ParagraphStyle(
    "Answer",
    parent=styles["Normal"],
    fontSize=10,
    leading=14,
    textColor=colors.HexColor("#1A1A1A"),
    fontName="Helvetica",
)
LABEL_style = ParagraphStyle(
    "Label",
    parent=styles["Normal"],
    fontSize=7.5,
    textColor=WHITE,
    fontName="Helvetica-Bold",
    alignment=TA_CENTER,
)
TITLE_style = ParagraphStyle(
    "Title",
    parent=styles["Normal"],
    fontSize=20,
    leading=26,
    textColor=WHITE,
    fontName="Helvetica-Bold",
    alignment=TA_CENTER,
)
SUBTITLE_style = ParagraphStyle(
    "Subtitle",
    parent=styles["Normal"],
    fontSize=12,
    leading=16,
    textColor=LIGHT_BLUE,
    fontName="Helvetica",
    alignment=TA_CENTER,
)
SECTION_style = ParagraphStyle(
    "Section",
    parent=styles["Normal"],
    fontSize=13,
    leading=18,
    textColor=WHITE,
    fontName="Helvetica-Bold",
    alignment=TA_CENTER,
)

# ── Flashcard data ────────────────────────────────────────────────────────────
# Each card: (category, label_color, q_bg, question, answer)
CARDS = [
    # ── BASICS ────────────────────────────────────────────────────────────────
    ("BASICS", MID_BLUE, ACCENT,
     "What is the core problem in angina pectoris?",
     "Mismatch between myocardial O₂ supply and demand.\n"
     "Demand > Supply → ischaemia → chest pain."),

    ("BASICS", MID_BLUE, ACCENT,
     "What are the 4 determinants of myocardial O₂ demand?",
     "1. Heart rate (chronotropy)\n"
     "2. Contractility (inotropy)\n"
     "3. Preload (ventricular filling pressure / wall stress)\n"
     "4. Afterload (arterial resistance)"),

    ("BASICS", MID_BLUE, ACCENT,
     "Name the 3 types of angina and their main cause.",
     "1. Stable (exertional) — fixed atherosclerotic stenosis; demand ↑\n"
     "2. Vasospastic (Prinzmetal's) — coronary vasospasm; supply ↓\n"
     "3. Unstable angina (ACS) — plaque rupture + thrombosis; supply ↓"),

    ("BASICS", MID_BLUE, ACCENT,
     "What is the first-line drug for an ACUTE angina attack?",
     "Sublingual nitroglycerin (GTN) — onset 1–3 min.\n"
     "All CAD patients should carry it as standby medication."),

    # ── NITRATES ──────────────────────────────────────────────────────────────
    ("NITRATES", GREEN, GREEN_LIGHT,
     "Mechanism of organic nitrates.",
     "Bioconverted → Nitric Oxide (NO)\n"
     "→ activates soluble guanylyl cyclase\n"
     "→ ↑ cGMP → myosin light-chain dephosphorylation\n"
     "→ smooth muscle relaxation & vasodilation"),

    ("NITRATES", GREEN, GREEN_LIGHT,
     "Primary vs. secondary haemodynamic effect of nitrates.",
     "Primary: VENODILATION → ↓ preload → ↓ wall stress → ↓ O₂ demand\n"
     "Secondary (higher doses): Arterial dilation → ↓ afterload\n"
     "Also: Direct coronary vasodilation → relieves vasospasm"),

    ("NITRATES", GREEN, GREEN_LIGHT,
     "Examples of organic nitrates and their duration.",
     "• Nitroglycerin (GTN) sublingual — 30–60 min\n"
     "• GTN patch / spray — 4–8 h\n"
     "• Isosorbide dinitrate (ISDN) — 4–6 h\n"
     "• Isosorbide mononitrate (ISMN) — 6–10 h"),

    ("NITRATES", GREEN, GREEN_LIGHT,
     "What is nitrate tolerance? How is it prevented?",
     "Continuous exposure → loss of efficacy (tolerance).\n"
     "Prevention: nitrate-free interval of 8–12 h daily\n"
     "(e.g., remove transdermal patch at night)."),

    ("NITRATES", GREEN, GREEN_LIGHT,
     "Key adverse effects of nitrates.",
     "• Headache (most common — meningeal vasodilation)\n"
     "• Postural hypotension\n"
     "• Reflex tachycardia\n"
     "• Flushing\n"
     "⚠ Contraindicated within 24 h of PDE5 inhibitors → profound hypotension"),

    # ── BETA-BLOCKERS ─────────────────────────────────────────────────────────
    ("β-BLOCKERS", ORANGE, ORANGE_LIGHT,
     "Mechanism of beta-blockers in angina.",
     "Block β₁ receptors in the heart:\n"
     "→ ↓ Heart rate (chronotropy)\n"
     "→ ↓ Contractility (inotropy)\n"
     "→ ↓ AV conduction velocity\n"
     "Net: ↓ myocardial O₂ consumption (especially on exertion)"),

    ("β-BLOCKERS", ORANGE, ORANGE_LIGHT,
     "Which type of angina are β-blockers FIRST-LINE for?",
     "Chronic STABLE (exertional) angina.\n"
     "Also: Post-MI, angina + HF, angina + hypertension.\n"
     "⚠ AVOID in vasospastic angina — unopposed α-activity worsens spasm."),

    ("β-BLOCKERS", ORANGE, ORANGE_LIGHT,
     "Examples of β-blockers used in angina.",
     "Cardioselective (β₁): Metoprolol, Atenolol, Bisoprolol\n"
     "Non-selective: Propranolol\n"
     "α+β blocker: Carvedilol (useful in angina + HF)"),

    ("β-BLOCKERS", ORANGE, ORANGE_LIGHT,
     "Why are β-blockers + nitrates a good combination?",
     "Complementary actions:\n"
     "• β-blockers block reflex tachycardia from nitrates\n"
     "• Nitrates counteract ↑ preload from β-blockade\n"
     "• Nitrates alleviate ↑ coronary vascular resistance from β-blockade\n"
     "→ Synergistic reduction of O₂ demand"),

    ("β-BLOCKERS", ORANGE, ORANGE_LIGHT,
     "Key adverse effects and contraindications of β-blockers.",
     "Side effects: Bradycardia, fatigue, cold extremities,\n"
     "  bronchoconstriction (non-selective), masks hypoglycaemia\n"
     "Contraindications: Severe asthma/COPD, significant bradycardia,\n"
     "  high-degree AV block, vasospastic angina, decompensated HF"),

    # ── CALCIUM CHANNEL BLOCKERS ──────────────────────────────────────────────
    ("CALCIUM CHANNEL BLOCKERS", PURPLE, PURPLE_LIGHT,
     "Mechanism of calcium channel blockers (CCBs).",
     "Block voltage-gated L-type Ca²⁺ channels (bind open/inactivated state)\n"
     "→ ↓ Ca²⁺ influx into smooth muscle → vasodilation\n"
     "→ ↓ Ca²⁺ in cardiac muscle → ↓ contractility, HR, AV conduction"),

    ("CALCIUM CHANNEL BLOCKERS", PURPLE, PURPLE_LIGHT,
     "Difference between DHP and non-DHP CCBs.",
     "Dihydropyridines (nifedipine, amlodipine): mainly vascular\n"
     "  → vasodilation ↑↑, reflex tachycardia, minimal cardiac effect\n\n"
     "Non-DHPs (verapamil, diltiazem): cardiac + vascular\n"
     "  → ↓ HR, ↓ contractility, ↓ AV conduction + vasodilation"),

    ("CALCIUM CHANNEL BLOCKERS", PURPLE, PURPLE_LIGHT,
     "Which CCB sub-class is used for vasospastic angina?",
     "BOTH DHPs and non-DHPs are first-line for vasospastic angina.\n"
     "They relax coronary smooth muscle and prevent vasospasm.\n"
     "Long-acting nitrates are also first-line; β-blockers are avoided."),

    ("CALCIUM CHANNEL BLOCKERS", PURPLE, PURPLE_LIGHT,
     "When do guidelines prefer DHPs over non-DHPs in stable angina?",
     "• When heart rate is already LOW\n"
     "• When β-blockers are not tolerated or contraindicated\n"
     "• DHP + β-blocker combination → for PERSISTENT angina\n"
     "⚠ Non-DHPs + β-blockers → risk of severe bradycardia / heart block"),

    ("CALCIUM CHANNEL BLOCKERS", PURPLE, PURPLE_LIGHT,
     "Adverse effects of verapamil vs. nifedipine.",
     "Verapamil: Constipation, bradycardia, heart block, ↓ contractility\n"
     "  ⚠ Avoid in HFrEF\n\n"
     "Nifedipine: Peripheral oedema, flushing, reflex tachycardia\n\n"
     "Both: Hypotension"),

    # ── SECOND-LINE AGENTS ─────────────────────────────────────────────────────
    ("SECOND-LINE", RED, RED_LIGHT,
     "Mechanism of ranolazine.",
     "Inhibits late inward Na⁺ current (late Iₙₐ)\n"
     "→ ↓ intracellular Na⁺ → ↓ Na⁺/Ca²⁺ exchanger activity\n"
     "→ ↓ intracellular Ca²⁺ overload → ↓ diastolic wall tension\n"
     "✓ No significant effect on BP or HR"),

    ("SECOND-LINE", RED, RED_LIGHT,
     "Mechanism and advantage of ivabradine.",
     "Selectively inhibits HCN (If 'funny') channels in SA node\n"
     "→ ↓ heart rate WITHOUT affecting contractility or BP\n"
     "Use: Alternative to β-blockers in normal sinus rhythm\n"
     "⚠ Avoid combining with β-blockers, verapamil, or diltiazem"),

    ("SECOND-LINE", RED, RED_LIGHT,
     "Mechanism of nicorandil.",
     "Dual mechanism:\n"
     "1. K⁺-channel opener → arteriolar dilation → ↓ afterload\n"
     "2. Nitrate-like action → venodilation → ↓ preload\n"
     "Add-on therapy; not available in the US"),

    ("SECOND-LINE", RED, RED_LIGHT,
     "Mechanism of trimetazidine.",
     "Metabolic agent — inhibits fatty acid β-oxidation\n"
     "→ shifts myocardial fuel to glucose (more O₂-efficient per ATP)\n"
     "✓ No haemodynamic effects → safe to combine with all antianginals\n"
     "Available mainly in Europe"),

    # ── GUIDELINES ────────────────────────────────────────────────────────────
    ("GUIDELINES", MID_BLUE, ACCENT,
     "First-line antianginal treatment per ACC/AHA & ESC guidelines.",
     "All CAD patients:\n"
     "  • Sublingual nitrate (standby) + Aspirin + Statin\n\n"
     "Chronic stable angina:\n"
     "  • β-Blocker (preferred) OR diltiazem/verapamil\n"
     "  • DHP if HR is low or β-blockers not tolerated\n"
     "  • β-Blocker + DHP for persistent angina"),

    ("GUIDELINES", MID_BLUE, ACCENT,
     "Second-line antianginal options per ESC guidelines.",
     "Add or switch to:\n"
     "• Ivabradine\n"
     "• Long-acting nitrates\n"
     "• Nicorandil\n"
     "• Ranolazine\n"
     "• Trimetazidine (Europe only)\n\n"
     "Ranolazine & trimetazidine can combine with ALL first-line agents."),

    ("GUIDELINES", MID_BLUE, ACCENT,
     "Meta-analysis comparison of the 3 main antianginal classes.",
     "β-Blockers > nifedipine: fewer angina episodes/week, fewer withdrawals.\n"
     "No significant difference: long-acting nitrates vs. CCBs vs. β-blockers in outcomes.\n"
     "→ β-Blockers remain guideline-preferred first-line."),

    ("GUIDELINES", MID_BLUE, ACCENT,
     "Antianginal drug to AVOID in vasospastic angina and why?",
     "β-BLOCKERS — avoid!\n"
     "β-blockade leaves α-adrenoceptors unopposed\n"
     "→ vasoconstriction → worsens coronary vasospasm\n\n"
     "Use CCBs and/or long-acting nitrates instead."),
]

CATEGORY_COLORS = {
    "BASICS": MID_BLUE,
    "NITRATES": GREEN,
    "β-BLOCKERS": ORANGE,
    "CALCIUM CHANNEL BLOCKERS": PURPLE,
    "SECOND-LINE": RED,
    "GUIDELINES": MID_BLUE,
}

SECTION_ORDER = [
    ("BASICS", "Basics of Angina"),
    ("NITRATES", "Class 1 — Organic Nitrates"),
    ("β-BLOCKERS", "Class 2 — Beta-Blockers"),
    ("CALCIUM CHANNEL BLOCKERS", "Class 3 — Calcium Channel Blockers"),
    ("SECOND-LINE", "Class 4 — Second-Line Agents"),
    ("GUIDELINES", "Clinical Guidelines"),
]

# ── Build PDF ─────────────────────────────────────────────────────────────────
def build_pdf():
    doc = SimpleDocTemplate(
        OUTPUT,
        pagesize=A4,
        leftMargin=1.5*cm,
        rightMargin=1.5*cm,
        topMargin=1.5*cm,
        bottomMargin=1.5*cm,
    )
    W = A4[0] - 3*cm  # usable width

    story = []

    # ── Cover block ────────────────────────────────────────────────────────
    cover_data = [[Paragraph("💊 Antianginal Drugs", TITLE_style)],
                  [Paragraph("Pharmacology Flashcards", SUBTITLE_style)],
                  [Paragraph("Based on Katzung's Basic & Clinical Pharmacology, 16th Ed.\n"
                             "Goodman & Gilman's Pharmacological Basis of Therapeutics", SUBTITLE_style)]]
    cover = Table(cover_data, colWidths=[W])
    cover.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), DARK_BLUE),
        ("ROUNDEDCORNERS", [12]),
        ("TOPPADDING", (0,0), (-1,-1), 18),
        ("BOTTOMPADDING", (0,0), (-1,-1), 18),
        ("LEFTPADDING", (0,0), (-1,-1), 20),
        ("RIGHTPADDING", (0,0), (-1,-1), 20),
    ]))
    story.append(cover)
    story.append(Spacer(1, 0.6*cm))

    # ── Cards grouped by section ───────────────────────────────────────────
    cards_by_cat = {cat: [] for cat, _ in SECTION_ORDER}
    for cat, label_color, q_bg, q, a in CARDS:
        cards_by_cat[cat].append((label_color, q_bg, q, a))

    card_num = 0
    for cat_key, cat_title in SECTION_ORDER:
        if not cards_by_cat[cat_key]:
            continue
        # Section header
        sect_color = CATEGORY_COLORS[cat_key]
        sect_data = [[Paragraph(cat_title, SECTION_style)]]
        sect_tbl = Table(sect_data, colWidths=[W])
        sect_tbl.setStyle(TableStyle([
            ("BACKGROUND", (0,0), (-1,-1), sect_color),
            ("ROUNDEDCORNERS", [8]),
            ("TOPPADDING", (0,0), (-1,-1), 8),
            ("BOTTOMPADDING", (0,0), (-1,-1), 8),
            ("LEFTPADDING", (0,0), (-1,-1), 12),
            ("RIGHTPADDING", (0,0), (-1,-1), 12),
        ]))
        story.append(KeepTogether([sect_tbl, Spacer(1, 0.3*cm)]))

        for label_color, q_bg, q_text, a_text in cards_by_cat[cat_key]:
            card_num += 1

            # Q label pill
            label_pill_data = [[Paragraph(f"Q{card_num}", LABEL_style)]]
            label_pill = Table(label_pill_data, colWidths=[1.4*cm])
            label_pill.setStyle(TableStyle([
                ("BACKGROUND", (0,0), (-1,-1), label_color),
                ("ROUNDEDCORNERS", [6]),
                ("TOPPADDING", (0,0), (-1,-1), 2),
                ("BOTTOMPADDING", (0,0), (-1,-1), 2),
                ("LEFTPADDING", (0,0), (-1,-1), 4),
                ("RIGHTPADDING", (0,0), (-1,-1), 4),
            ]))

            # Question row
            q_para = Paragraph(q_text, Q_style)
            q_row_data = [[label_pill, q_para]]
            q_row = Table(q_row_data, colWidths=[1.6*cm, W - 1.6*cm])
            q_row.setStyle(TableStyle([
                ("BACKGROUND", (0,0), (-1,-1), q_bg),
                ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
                ("TOPPADDING", (0,0), (-1,-1), 10),
                ("BOTTOMPADDING", (0,0), (-1,-1), 10),
                ("LEFTPADDING", (0,0), (-1,-1), 10),
                ("RIGHTPADDING", (0,0), (-1,-1), 10),
                ("ROUNDEDCORNERS", [8]),
            ]))

            # Answer
            a_label_data = [[Paragraph("ANSWER", LABEL_style)]]
            a_label = Table(a_label_data, colWidths=[1.8*cm])
            a_label.setStyle(TableStyle([
                ("BACKGROUND", (0,0), (-1,-1), colors.HexColor("#999999")),
                ("ROUNDEDCORNERS", [4]),
                ("TOPPADDING", (0,0), (-1,-1), 1),
                ("BOTTOMPADDING", (0,0), (-1,-1), 1),
                ("LEFTPADDING", (0,0), (-1,-1), 4),
                ("RIGHTPADDING", (0,0), (-1,-1), 4),
            ]))

            a_para = Paragraph(a_text.replace("\n", "<br/>"), A_style)
            a_row_data = [[a_label, a_para]]
            a_row = Table(a_row_data, colWidths=[2.0*cm, W - 2.0*cm])
            a_row.setStyle(TableStyle([
                ("BACKGROUND", (0,0), (-1,-1), GREY_LIGHT),
                ("VALIGN", (0,0), (-1,-1), "TOP"),
                ("TOPPADDING", (0,0), (-1,-1), 10),
                ("BOTTOMPADDING", (0,0), (-1,-1), 10),
                ("LEFTPADDING", (0,0), (-1,-1), 10),
                ("RIGHTPADDING", (0,0), (-1,-1), 10),
            ]))

            # Outer card container
            card_data = [[q_row], [a_row]]
            card = Table(card_data, colWidths=[W])
            card.setStyle(TableStyle([
                ("BOX", (0,0), (-1,-1), 1, colors.HexColor("#CCCCCC")),
                ("ROUNDEDCORNERS", [10]),
                ("TOPPADDING", (0,0), (-1,-1), 0),
                ("BOTTOMPADDING", (0,0), (-1,-1), 0),
                ("LEFTPADDING", (0,0), (-1,-1), 0),
                ("RIGHTPADDING", (0,0), (-1,-1), 0),
                ("LINEBELOW", (0,0), (-1,0), 1, colors.HexColor("#CCCCCC")),
            ]))

            story.append(KeepTogether([card, Spacer(1, 0.35*cm)]))

        story.append(Spacer(1, 0.2*cm))

    # ── Footer note ────────────────────────────────────────────────────────
    footer_data = [[Paragraph(
        "Sources: Katzung's Basic & Clinical Pharmacology 16th Ed. | "
        "Goodman & Gilman's 13th Ed. | Fuster & Hurst's The Heart 15th Ed.",
        ParagraphStyle("footer", parent=styles["Normal"], fontSize=7.5,
                       textColor=colors.HexColor("#888888"), alignment=TA_CENTER))]]
    footer = Table(footer_data, colWidths=[W])
    story.append(footer)

    doc.build(story)
    print(f"PDF saved to: {OUTPUT}")

build_pdf()