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BDS2 Diseases of Human Systems > Acute Coronary Syndromes > Flashcards

Acute Coronary Syndromes Flashcards

1
Q

name three reversible risks for cardiovascular disease

A

hypertension, hyperlipidaemia, diabetes

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2
Q

give the four steps to prevention of cardiovascular diseases

A

lifestyle changes
control of cholesterol
control hypertension
antiplatelet drugs

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3
Q

give three types of antiplatelet drugs

A

aspirin
clopidogrel
dipyridamole

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4
Q

what is the mechanism of action of aspirin

A

inhibits platelet aggregation by altering balance of thromboxane A2

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5
Q

how does clopidogrel work

A

inhibits ADP platelet aggregation

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6
Q

how does dipyridamole work

A

inhibits platelet phosphodiesterase

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7
Q

what would you be concerned about if a patient is on more than one antiplatelet drug

A

it increases bleeding time
patient is at higher risk of CVD

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8
Q

how do anticoagulants work

A

inhibit clotting cascade - the platelet clot forms as normal but will not be stabilised as fibrin will not be deposited - has no effect on immediate bleeding but clot will break down hours later

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9
Q

what does warfarin work on

A

inhibits synthesis of vitamin K dependent clotting factors

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10
Q

what are the four vitamin K dependent clotting factors

A

2, 7, 9, 10

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11
Q

what is INR

A

a prothrombin ratio

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12
Q

what is an ideal INR for a patient

A

2-4

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13
Q

what are DOACs

A

similar to warfarin but do not require same testing as their bioavailability is predictable

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14
Q

what factors do most DOACs work on (accept dabigatran)

A

factor X inhibitors

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15
Q

what does dabigatran have an effect on

A

direct thrombin inhibitor

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16
Q

what DOACs are taken twice daily

A

dabigatran
apixaban

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17
Q

what DOACs are taken once daily

A

rivaroxaban
edoxaban

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18
Q

give three examples of advantages of DOACs

A

short half life
may only be a short course
no significant interactions in dentistry

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19
Q

what are statins

A

lipid lowering drugs - inhibit cholesterol synthesis in liver

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20
Q

what drug do statins especially interact with

A

fluconazole

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21
Q

what must happen with statins during antifungal treatment

A

they need to be stopped

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22
Q

what is the function of beta blockers

A

reduce heart muscle excitability which reduces risk of ventricular fibrillation and death by preventing increase in heart rate

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23
Q

give two examples of beta blockers

A

propanolol
atenolol

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24
Q

what is the action of antidiuretics

A

increase water and salt loss which reduces plasma volume

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25
Q

what are antidiuretics used for

A

anti-hypertensive
heart failure

26
Q

what is an example of a loop diuretic

A

frusemide

27
Q

what oral effect can diuretics cause

A

dry mouth

28
Q

what are the two type of nitrate medications available

A

short acting
long acting

29
Q

what is an example of short acting nitrates

A

GTN - emergency management of angina

30
Q

what is an example of long acting nitrates

A

isosorbide mononitrate - prevention of angina

31
Q

how do nitrates work

A

dilate veins returning blood to the heart so reduce the filling pressure (preload) of the heart

32
Q

what are three actions of nitrates

A

dilate veins - reduce preload
dilate arteries - reduce afterload
dilate coronary arteries

33
Q

what are calcium channel blockers used to treat

A

used to treat hypertension and migraines

34
Q

what is an oral side effect of calcium channel blockers

A

gingival hyperplasia

35
Q

what are the five common types of medication used in cardiac medicine

A

ACE inhibitors
Beta blockers
Calcium channel blockers
Diuretics
Nitrates

36
Q

how do calcium channel blockers work

A

block calcium channels in smooth muscles - causing relaxation and dilation

37
Q

give examples of ACE inhibitors

A

enalapril
ramapril
lisinopril

38
Q

what two things do ACE inhibitors act on

A

inhibits conversion of angiotensin I to angiotensin II which is a potent vasoconstrictor
prevents aldosterone dependent resorption of salt and water

39
Q

what are two potential side effects of ACE inhibitors

A

cough
hypotension

40
Q

what is losartan

A

angiotensin II blocker - similar to ACE inhibitor but doesnt have same side effects

41
Q

what are three potential oral reactions to ACE inhibitors

A

lichenoid reaction
sudden swelling due to increase in tissue fluid
swelling of tongue/ lips

42
Q

what are the two pathological processes involved in acute coronary syndromes

A

blood vessel narrowing
blood vessel occlusion

43
Q

what are the three main heart arteries

A

right coronary artery
left coronary artery
circumflex coronary artery

44
Q

when does blood flow into the coronary arteries

A

during diastole

45
Q

what are three forms of acute ischaemic events

A

atherosclerosis with blood clot
atherosclerosis itself
spasm of artery

46
Q

what is stable angina

A

atherosclerotic plaque narrows artery and restricts blood flow - causes pain on exertion - effects reversed if O2 requirements are reduced

47
Q

what drugs are avoided when patient is taking warfarin

A

NSAIDs - can cause internal bleeding

48
Q

what are the two types of diuretics

A

loop and thiazide diuretics

49
Q

give two examples of calcium channel blockers

A

amlodipine and nifedipine

50
Q

what is the aspirin dose per day

A

75mg

51
Q

up until which time is ischaemia reversible

A

20 mins

52
Q

what are the troponin levels like in stable angina

A

normal as little cardiac muscle death

53
Q

what is unstable angina

A

atherosclerotic plaque develops plaque on surface but doesn’t occlude the lumen - can happen at any time

54
Q

what is seen on and ECG of unstable angina

A

depression of ST segment and T wave inversion

55
Q

what is an NSETMI

A

non-ST elevation MI

56
Q

what is a STEMI

A

no blood and oxygen delivered to heart muscle - ST elevation

57
Q

what is peripheral vascular disease

A

angina of tissues (usually lower limb)

58
Q

give two side effects of peripheral vascular disease

A

poor wound healing
areas of necrosis and gangrene

59
Q

give four symptoms of an MI

A

pain
nausea
sweating
pale

60
Q

what is thrombolysis

A

chemical used to dissolve any blood clot

BDS2 Diseases of Human Systems (7 decks)

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