angina

Question 1

1st line for typical angina if no C/I

Answer 1

beta blockers “olol”

B1 specific-metoprolol

Question 2

when to use CCBs?

Answer 2

• use non-DHPs (verapamil/diltiazem) when BB are C/I

- use DHPs (dipine) as add on to BBs

Question 3

organic nitrates/nitrites

Answer 3

tolerance develops!
DDI w/PDE 5 inhibitors
nitro-replace after 3-6 months
isosorbide-maintenance

Question 4

Ranolazine

Answer 4

MOA – sodium current inhibitor

Indications – Used for chronic stable angina in combination with CCB, beta-blockers or nitrates.

Contraindications – pre-existing QT prolongation, uncorrected hypokalemia,

Question 5

how to treat a STEMI

Answer 5

• aspirin
• nitro
• analgesics
• BBs

Question 6

absolute C/I to fibrinolytics

Answer 6

• Any prior ICH
• Known structural cerebral vascular lesion (eg, AVM)
• Known malignant intracranial neoplasm (primary or metastatic)
• Ischemic stroke within 3 months EXCEPT acute ischemic stroke within 3 hours
• Suspected aortic dissection
• Active bleeding or bleeding diathesis (excluding menses)
• Significant closed head or facial trauma within 3 months

Question 7

examples of fibrinolytics

Answer 7

-streptokinase

“plase”

Question 8

PCI – stent placement (some pts require CABG therapy. If CABG therapy indicated, antiplatelets should be held for 5 days)

Answer 8

NOTE – A major difference in therapy between STEMI and NSTEMI is that fibrinolytics are NOT used in NSTEMI patients