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Pharmacology semester 3 Test 1 > Angina And MI > Flashcards

Angina And MI Flashcards

1
Q

Rationale for treatment of angina

A

Increase O2 supply by vasodilation with nitrates and CCBs

Decrease O2 demand with beta blockers and CCBs

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2
Q

1st line for typical angina

A

Beta blockers

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3
Q

Cardioselective beta blockers

A

Metoprolol
Atenolol
Nebivolol

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4
Q

Non selective beta blockers

A

Propranolol

Nadolol

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5
Q

Alpha and beta blockers

A

Carvedilol

Labetalol

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6
Q

Initial therapy for angina if beta blockers are contraindicated

A

Non-DHP CCBs

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7
Q

CCBs preferred for variant angina

A

Non DHPs

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8
Q

Add on therapy to beta blockers

A

DHP CCBs

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9
Q

DHP CCBs used in angina

A

Amlodipine
Felodipine
Nifedipine

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10
Q

MOA for organic nitrates

A

Release NO that diffuses into vascular smooth muscle and dilates veins to decrease preload and ventricular pressure to decrease myocardial O2 demand

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11
Q

CI for nitrates

A

Aortic valve stenosis, use of Viagara, Levitra, Cialis; angle closure glaucoma, head trauma, cerebral hemorrhage, anemia, severe hypotension

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12
Q

ADRs of nitrates

A

H/a dizzy weakness postural hypotension rash anxiety

TOLERANCE

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13
Q

Monitoring parameters for nitrates

A

BP

HR

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14
Q

Role of nitrates in managing angina

A

SL to relieve acute symptoms of myocardial ischemia
SL/PO to prophylax effort induced angina
Long acting formulas for maintenance if beta blockers and CCBs contraindicated

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15
Q

Nitrate formulations

A

Amyl nitrate- rapid onset, used for cyanide poisoning
Nitroglycerin - SL ointment patch IV or PO
Isosorbide- dinitrate and mononitrate forms

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16
Q

Ranolazine uses

A

Chronic stable angina as add on to CCB beta blocker or nitrate

17
Q

MOA ranolazine

A

Sodium current inhibitor

18
Q

CI for ranolazine

A

Prolonged QT
Hypokalemia
Hepatic failure
CYP 3a4 inhibitors

19
Q

Adjunct therapy to prevent ACS in patients with unstable angina

A

Aspirin

20
Q

Other anti platelet treatments for angina

A

Clopidogrel
Prasugrel
Ticagrelor

21
Q

Used in patients with CAD to prevent dz progression but do not relieve angina directly

A

ACE inhibitors

22
Q

How to treat predictable episodes of angina caused by exertion

A

Nitroglycerin or isosorbide

23
Q

Frequent episodes of angina should be treated with

A

Nitroglycerin beta blocker CCB or nitrate

24
Q

How to treat angina in asthma patient

A

Non DHP CCB or cardioselective beta blocker

25
Q

How to treat angina in DM patient

A

Non DHP CCB most preferred also nitrates and cardioselective beta blockers

26
Q

How to treat angina in heart failure patients

A

beta blockers and nitrates most preferred

27
Q

How to treat angina in HTN patient

A

Beta blocker and non DHP CCB

28
Q

How to treat angina in patient with prior MI

A

Beta blockers

29
Q

How to treat angina in patient with bradycardia or heart block

A

DHP CCB preferred

30
Q

Drugs for acute STEMI

A

Aspirin- all patients, start asap and continue forever
IV nitroglycerin - for first day or two, not if hypotension or bradycardia
Analgesics- morphine decreases pain and increases reperfusion
Beta blockers- start asap and continue post MI to reduce magnitude of infarction and rate of reinfarction
ACE inhibitors- post MI if left ventricle dysfxn or CHF
CCBs- controversial, can be given if intolerant to beta blockers
Anticoagulants- heparin, bivalrudin, fondaparinux
P2Y inhibitors- clopidogrel, pasugrel or Ticagrelor
Fibrinolytics- dissolve clots ex streptokinase, alteplase, reteplase, anistreplase, tenecteplase
Statins

31
Q

If CABG indicated what do you do with anti platelet drugs

A

Hold for 5-7 days

32
Q

Are fibrinolytics used in Non-STEMI patients

A

No, only STEMI patients

33
Q

Variant angina is caused by

A

Acute coronary vasospasm

Pharmacology semester 3 Test 1 (7 decks)

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