ACS Drugs Flashcards
What is Vasospastic Angina?
Episodes of vasoconstriction of coronary arteries
What is the 1st choice of drugs to treat Vasospastic Angina?
CCBs
– ex. amlodipine or diltiazem
What is the 1st choice of drug to treat Vasospastic Angina?
CCBs
– Amlodipine or Diltiazem
If CCBs are not available for Vasospastic Angina, what should be used?
Long acting Nitrates
What 3 drug classes are used for Anti-platelets with ACS?
- Thromboxane A2 synthesis (-)
- ADP receptor blockers
- Glycoprotein receptor blockers
What 2 drug classes are used as thrombolytics in treating ACS?
- Tissue type plasminogen (+)
- Streptokinase
What drug (-) Thromboxane A2 synthesis?
Aspirin
What directly, does Aspirin (-)?
Cyclooxygenase – this inhibits synthesis of Thromboxane A2
Why does Aspirin want to (-) Thromboxane A2 synthesis?
It causes platelet aggregation
Adverse effects of Aspirin?
GI bleeding and aspirin allergy
What are 3 ADP (p2y12) receptor blockers?
Clopidogrel
Prasugrel
Ticagrelor
What are 3 ADP (p2y12) receptor blockers?
Clopidogrel
Prasugrel
Ticagrelor
What do ADP (p2y12) receptor blockers cause to happen?
- Increased adenylyl cyclase
- Increases cAMP
= (-) platelet activation
What do ADP (p2y12) receptor blockers cause to happen?
- Increased adenylyl cyclase
- Increases cAMP
= (-) platelet activation
Side effect of ADP (p2y12) receptor blockers?
Bleeding
With ACS, what should be started ASAP?
Aspirin and an ADP receptor blocker!
With ACS, what should be started ASAP?
Aspirin and an ADP receptor blocker!
What are 3 Glycoprotein receptor blockers?
Abciximab
Eptifibatide
Tirofoban
What are 3 Glycoprotein receptor blockers?
Abciximab
Eptifibatide
Tirofoban
MOA for Glycoprotein receptor blockers?
Prevent binding of ligands to GP2b/3a receptor on platelets to (-) platelet aggregation
Adverse effect of Glycoprotein receptor blockers, especially Abciximab?
Bleeding
- Abciximab = Thrombocytopenia
When are Glycoprotein receptor blockers used?
High risk PCIs
MOA for tissue type plasminogen (+) and Streptokinase?
Activate plasminogen to plasmin = degrades fibrin
What are 3 tissue type plasminogen (+)s?
Alteplase
Reteplase
Tenecteplase
What are 3 Tissue Type Plasminogen (+)’s?
Alteplase
Reteplase
Tenecteplase
Adverse effects of Streptokinase?
Allergic reactions and bleeding due to systemic fibrinolysis
When are Thrombolytic agents used?
If PCI cannot be performed in time
Clopidogrel resistance is due to metabolism by?
CYP2C19
Clopidogrel resistance is due to metabolism by?
CYP2C19
