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Pharm Unit 4 > Angina Drugs > Flashcards

Angina Drugs Flashcards

1
Q

Diltiazem (Cardizem) misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

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2
Q

Aspirin (Unit IV) Class

A

NSAID

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3
Q

Ticlopidine (Ticlid) Class

A

Thienopyridine derivitive

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4
Q

Clopidogrel (Plavix) Class

A

Thienopyridine derivitive

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5
Q

Prasugrel (Effient) Class

A

Thienopyridine derivitive

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6
Q

Dipyradimole (Persantine) Class

A

Pyrimido-pyrimidine derivitive

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7
Q

ACE inhibitors Class

A

ACE inhibitor

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8
Q

Metoprolol, propranolol, bisoprolol Class

A

_-blocker

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9
Q

Nitrates Class

A

Vasodilator

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10
Q

Nefedipine (Procardia) Class

A

Calcium channel blockers (dihydropyridines, 1st generation)

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11
Q

Amlodipine (Norvasc) Class

A

Calcium channel blockers (dihydropyridines, 2nd generation)

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12
Q

Felodipine (Plendil) Class

A

Calcium channel blockers (dihydropyridines, 2nd generation)

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13
Q

Verapamil (Calan) Class

A

Calcium channel blockers (nondihydropyridines, phenylalkamine type)

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14
Q

Diltiazem (Cardizem) Class

A

Calcium channel blockers (nondihydropyridines, benzothiazepine type)

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15
Q

Aspirin (Unit IV) MOA

A

Irreversible inhibition of platelet COX

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16
Q

Ticlopidine (Ticlid) MOA

A

Inhibits platelet aggregation by ADP; reduces blood viscosity by decreasing plasma fibrinogen and increasing RBC deformability

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17
Q

Clopidogrel (Plavix) MOA

A

Selectively and irreversibly inhibits ADP binding to P2Y12 (blocks ADP-dependent activation of glycoprotein IIb/IIIa complex)

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18
Q

Prasugrel (Effient) MOA

A

Irreversibly binds P2Y12 receptor (G protein-coupled chemoreceptor for ADP)

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19
Q

Dipyradimole (Persantine) MOA

A

Increases platelet intracellular cAMP (inhibits phosphodiesterase 5, activates adenylate cyclase, inhibits uptake of adenosine from vascular endothelium and RBCs)

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20
Q

ACE inhibitors MOA

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

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21
Q

Metoprolol, propranolol, bisoprolol MOA

A

Decrease contractility, HR (reduced myocardial O2 demand); class II antiarrhythmics (inhibit sympathetic influence on cardiac electrical activity, increase AP duration and effective refractory period in AV node)

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22
Q

Nitrates MOA

A

Endothelium independent vasodilator; endothelial effects (inhibits platelet aggregation, inhibits leukocyte-endothelial interactions (anti-inflammatory))

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23
Q

Nefedipine (Procardia) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes dilation of epicardial coronary arteries, arteriolar resistance arteries; less heart-specific activity, but more than 1st generation

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24
Q

Amlodipine (Norvasc) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes dilation of epicardial coronary arteries, arteriolar resistance arteries; less heart-specific activity

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25
Q

Felodipine (Plendil) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes dilation of epicardial coronary arteries, arteriolar resistance arteries; less heart-specific activity

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26
Q

Verapamil (Calan) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes decreased contractility, firing rate of aberrant pacemaker sites, and conduction velocity; prolongs repolarization in SA node and AV node (–> decreases HR); less vasodilation

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27
Q

Diltiazem (Cardizem) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes decreased contractility, firing rate of aberrant pacemaker sites, and conduction velocity; prolongs repolarization in SA node and AV node (–> decreases HR); less vasodilation

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28
Q

Aspirin (Unit IV) Therapy

A

Reduction in adverse events (MI, CVA, death); for those w/stable angina, unstable angina, acute MI, prophylaxis

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29
Q

Ticlopidine (Ticlid) Therapy

A

Aspirin alternative

30
Q

Clopidogrel (Plavix) Therapy

A

Great antithrombotic

31
Q

Prasugrel (Effient) Therapy

A

Reduce thrombotic events in those w/percutaneous coronary intervention (e.g., stent)

32
Q

Dipyradimole (Persantine) Therapy

A

Decrease peripheral vascular disease (as an adjunct); stress test of heart

33
Q

ACE inhibitors Therapy

A

Often used as an add-on antihypertensive for anyone with chronic kidney disease/proteinuria, CHF, left ventricular hypertrophy, or post-MI (prevents left ventricular remodeling); reduces incidence of future CAD events, may reduce risk of diabetes

34
Q

Metoprolol, propranolol, bisoprolol Therapy

A

Prevent MIs, prevent sudden cardiac death, increase survival post-MI (if patients suddenly stop, really bad!)

35
Q

Nitrates Therapy

A

For acute episodes; long-acting formulations are for those already on other drugs and still can’t control angina

36
Q

Nefedipine (Procardia) Therapy

A

Hypertension, Raynauds, angina (3rd choice drug)

37
Q

Amlodipine (Norvasc) Therapy

A

Hypertension, Raynauds, angina (3rd choice drug)

38
Q

Felodipine (Plendil) Therapy

A

Hypertension, Raynauds

39
Q

Verapamil (Calan) Therapy

A

Hypertension, anti-anginal (chronotropic effects –> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)

40
Q

Diltiazem (Cardizem) Therapy

A

Hypertension, anti-anginal (chronotropic effects –> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)

41
Q

Ticlopidine (Ticlid) ISE

A

Neutropenia and, rarely, TTP

42
Q

Clopidogrel (Plavix) ISE

A

Bleeding

43
Q

Prasugrel (Effient) ISE

A

Massive bleeding risk

44
Q

Dipyradimole (Persantine) ISE

A

Vasodilation of coronary arteries can enhance exercise-induced ischemia (because it elevates extracellular adenosine levels)

45
Q

ACE inhibitors ISE

A

Dry cough, angioedema, decreased renal function, hypotension

46
Q

Metoprolol, propranolol, bisoprolol ISE

A

Fatigue, worsening claudication, impotence (so men don’t take)

47
Q

Nitrates ISE

A

Tolerance w/chronic use (need nitrate free periods of 8-12 hours), headaches, hypotension, activation of Bezold-Jarisch reflex (causes bradycardia)

48
Q

Nefedipine (Procardia) ISE

A

Leg edema, heart failure, AV nodal blockade, reflex tachycardia (lipophilic agents gain entry to brain and depress vasomotor center, rapidly dropping BP; this causes more reflex sympathetic activation (leading to adverse CV effects); long-acting agents are less lipophilic, and will cause less sympathetic activation and initial fall in BP)

49
Q

Amlodipine (Norvasc) ISE

A

Leg edema (less than 1st generation), heart failure, AV nodal blockade, reflex tachycardia (lipophilic agents gain entry to brain and depress vasomotor center, rapidly dropping BP; this causes more reflex sympathetic activation (leading to adverse CV effects); long-acting agents are less lipophilic, and will cause less sympathetic activation and initial fall in BP)

50
Q

Felodipine (Plendil) ISE

A

Leg edema (less than 1st generation), heart failure, AV nodal blockade, reflex tachycardia (lipophilic agents gain entry to brain and depress vasomotor center, rapidly dropping BP; this causes more reflex sympathetic activation (leading to adverse CV effects); long-acting agents are less lipophilic, and will cause less sympathetic activation and initial fall in BP)

51
Q

Verapamil (Calan) ISE

A

Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure

52
Q

Diltiazem (Cardizem) ISE

A

Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure

53
Q

Metoprolol, propranolol, bisoprolol OSE

A

Decreased exercise tolerance, lethargy, insomnia,

54
Q

Nitrates OSE

A

Decrease preload

55
Q

Nefedipine (Procardia) OSE

A

Constipation (most common), headache, flushing

56
Q

Amlodipine (Norvasc) OSE

A

Constipation (most common), headache, flushing

57
Q

Felodipine (Plendil) OSE

A

Constipation (most common), headache, flushing

58
Q

Verapamil (Calan) OSE

A

Constipation (most common), headache, flushing

59
Q

Diltiazem (Cardizem) OSE

A

Constipation (most common), headache, flushing

60
Q

Aspirin (Unit IV) misc

A

Low-doses; if you’re allergic, you’ll get asthma

61
Q

Ticlopidine (Ticlid) misc

A

Not really used anymore

62
Q

Clopidogrel (Plavix) misc

A

No surgical or dental procedures if patient taking this

63
Q

ACE inhibitors misc

A

Short-acting; contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure

64
Q

Metoprolol, propranolol, bisoprolol misc

A

Contraindicated in severe bradycardia, high degree AV block, sick sinus syndrome, unstable LV failure; relative contraindication is asthma, severe depression, peripheral vascular disease

65
Q

Nitrates misc

A

Contraindicated in hypertrophic cardiomyopathy, severe aortic stenosis, significant hypotension, use of phosphodiesterase inhibitors

66
Q

Nefedipine (Procardia) misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

67
Q

Amlodipine (Norvasc) misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

68
Q

Felodipine (Plendil) misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

69
Q

Verapamil (Calan) misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

70
Q

Diltiazem (Cardizem) misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

Pharm Unit 4 (7 decks)

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