Angina/ACS/MI Flashcards
What is the first line for chronic stable angina?
Unstable angina?
Vasospastic angina?
NTG
Beta blockers
CCB
Ranolazine
NTG and BB (metoprolol and atenolol)
NTG and CCB - NEVER give BB
When would you use isosorbide?
For chronic angina and NEVER for acute attacks
Isosorbide dinitrate
What are the two formulations and dosing?
Isordil Titradose - BID-TID : 7am, 12pm, and 5pm
Oral SR (dilatrate) - 40mg QD-BID - 8am and 2pm
Isosorbide mononitrate
What are the two formulations and dosing?
Monoket/ISMO - 8am and 3pm
Imdur (ER) - Daily
What is nitrobid?
Nitroglycerin ointment for prevention of angina and is given BID
What are the NTG TD brand names, indication, and doses?
Minitran, Nitro-dur
0.1 to 0.8mg/hr - 1 patch Q12H
For angina PPX
What are the FDA-approved DHP CCB’s for angina?
Amlodipine, nifedipine ER, and nicardipine
When would you use ranolazine?
Dosing?
ADE?
As a sub for BB or as an add on therapy if initial treatment with BB/CCB/nitrate is not effective
500mg BID , max 1000mgBID
Prolong QT
What are the basic treatments for NSTEMI and STEMI?
NSTEMI - antiplatelets, parenteral anticoagulants, and possibly PCI
STEMI - PCI, antiplatelets, parenteral anticoagulants, or CABG/thrombolytics
What are the ACS initial measures?
Morphine - PRN for severe pain
Oxygen - keep O2 >90%
Nitrates - SL NTG 3x every 5 min then IV
Aspirin or DAPT
BB - Metoprolol 25mg PO if not HTN ; use IV if HTN
High-Intensity Statin
Serial ECG’s and Troponins
When do you avoid giving a nitrate? 4
SBP <90
HR <50
Extreme Tachycardia
PDE-5 inhibitor
What BB’s are used in ACS?
Metoprolol and atenolol
What is the purpose of ACEi in heart attacks?
When to start?
Which one to start?
To prevent adverse ventricle remodeling , decrease sudden death and recurrent MI
Within 24 hours but 6 hours after BP is stable
Lisinopril and captopril
What to do and prevent in cocaine-induced MI?
Prevent BB and use Benzo instead
