ACS and Stable Angina Drugs

Question 1

Nitrates

Answer 1

• STABLE ANGINA DRUG
• Release NO and activate guanylyl cyclase, this makes GMP and causes vasodilation
• Significant first pass metabolism (Given by sublingual etc…)
• Risk of developing a tolerance (thiol def., increased superoxide, activation of RAAS…)
• Adverse effects: headaches, ortho hypotension, increased renal Na+ and H2O absorption
• DO NOT COMBINE WITH ED DRUGS

Question 2

Nitroglycerin

Answer 2

• STABLE ANGINA DRUG

- type of nitrate

Question 3

Isosorbide dinitrate

Answer 3

• STABLE ANGINA DRUG

- type of nitrate

Question 4

Isosorbide mononitrate

Answer 4

• STABLE ANGINA DRUG

- type of nitrate

Question 5

Calcium Channel Blockers

Answer 5

• STABLE ANGINA DRUG
• prevent myosin light chain function
• 2 types: dihydropyridines and cardioactive CCBs
• Dihydropyridines: work on vascular smooth muscle
• Cardioactive CCBs: work on vascular smooth muscle, cardiac muscle, and cardiac pacemaker cells

Question 6

Amlodipine

Answer 6

• STABLE ANGINA DRUG
• dihydropyridine CCB
• long acting

Question 7

Nifedipine

Answer 7

• STABLE ANGINA DRUG
• dihydropyridine CCB
• short acting

Question 8

Nicardipine

Answer 8

• STABLE ANGINA DRUG
• dihydropyridine CCB
• short acting

Question 9

Diltiazem

Answer 9

• STABLE ANGINA DRUG

- Cardioactive CCB

Question 10

Varapamil

Answer 10

• STABLE ANGINA DRUG

- Cardioactive CCB

Question 11

β-Blockers

Answer 11

• STABLE ANGINA DRUG

- Decrease adrenergic stimulation to heart, and also decrease BP leading to reduced afterload

Question 12

Propranolol

Answer 12

• STABLE ANGINA DRUG

- β-Blocker

Question 13

Nadolol

Answer 13

• STABLE ANGINA DRUG

- β-Blocker

Question 14

Metoprolol

Answer 14

• STABLE ANGINA DRUG

- β-Blocker

Question 15

Atenolol

Answer 15

• STABLE ANGINA DRUG

- β-Blocker

Question 16

Ranolazine

Answer 16

• STABLE ANGINA DRUG
• Blocks the late Na+ current
• Normalizes the repolarization of cardiac myocytes
• May reduce diastolic tension and compression of coronary vessels in diastole
• Used in stable angina that is refractory to standard meds

Question 17

Antiplatelet drugs

Answer 17

• ACS DRUG
• inhibit platelet function
• used to prevent white thrombi in arteries

Question 18

Anticoagulants

Answer 18

• ACS DRUG
• regulate functions and synthesis of clotting factors
• prevent red thrombi from forming in veins

Question 19

Thrombolytics

Answer 19

• ACS DRUG
• destroy blood clots after they have formed
• re-establish blood flow

Question 20

Aspirin

Answer 20

• ACS DRUG (antiplatelet)

- irreversible inhibition of COX to prevent production of TxA2

Question 21

Clopidogrel

Answer 21

• ACS DRUG (antiplatelet)
• P2Y12 (ADP) receptor blocker
• inhibits a Gi and therefore increases levels of cAMP, which prevents platelet aggregation
• nonfunctional CYP2C19 allele renders drug inactive (50% chinese, 34%AA, 25% cauc.)

Question 22

Prasugrel

Answer 22

• ACS DRUG (antiplatelet)
• P2Y12 (ADP) receptor blocker
• inhibits a Gi and therefore increases levels of cAMP, which prevents platelet aggregation

Question 23

Ticagrelor

Answer 23

• ACS DRUG (antiplatelet)
• P2Y12 (ADP) receptor blocker
• inhibits a Gi and therefore increases levels of cAMP, which prevents platelet aggregation

Question 24

Abciximab

Answer 24

• ACS DRUG (antiplatelet)
• GP IIB/IIIA inhibitor
• risk of thrombocytopenia

Question 25

Eptifibatide

Answer 25

• ACS DRUG (antiplatelet)

- GP IIB/IIIA inhibitor

Question 26

Tirofiban

Answer 26

• ACS DRUG (antiplatelet)

- GP IIB/IIIA inhibitor

Question 27

Alteplase

Answer 27

• ACS DRUG (thrombolytic)

- Tissue Plasminogen Activator

Question 28

Reteplase

Answer 28

• ACS DRUG (thrombolytic)

- Tissue Plasminogen Activator

Question 29

Tenecteplase

Answer 29

• ACS DRUG (thrombolytic)

- Tissue Plasminogen Activator

Question 30

Streptokinase

Answer 30

-ACS DRUG (thrombolytic)