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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
Felodipine (Plendil) MOA
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
26
Verapamil (Calan) MOA
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
27
Diltiazem (Cardizem) MOA
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
28
Aspirin (Unit IV) Therapy
Reduction in adverse events (MI, CVA, death); for those w/stable angina, unstable angina, acute MI, prophylaxis
29
Ticlopidine (Ticlid) Therapy
Aspirin alternative
30
Clopidogrel (Plavix) Therapy
Great antithrombotic
31
Prasugrel (Effient) Therapy
Reduce thrombotic events in those w/percutaneous coronary intervention (e.g., stent)
32
Dipyradimole (Persantine) Therapy
Decrease peripheral vascular disease (as an adjunct); stress test of heart
33
ACE inhibitors Therapy
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
Metoprolol, propranolol, bisoprolol Therapy
Prevent MIs, prevent sudden cardiac death, increase survival post-MI (if patients suddenly stop, really bad!)
35
Nitrates Therapy
For acute episodes; long-acting formulations are for those already on other drugs and still can't control angina
36
Nefedipine (Procardia) Therapy
Hypertension, Raynauds, angina (3rd choice drug)
37
Amlodipine (Norvasc) Therapy
Hypertension, Raynauds, angina (3rd choice drug)
38
Felodipine (Plendil) Therapy
Hypertension, Raynauds
39
Verapamil (Calan) Therapy
Hypertension, anti-anginal (chronotropic effects --> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)
40
Diltiazem (Cardizem) Therapy
Hypertension, anti-anginal (chronotropic effects --> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)
41
Ticlopidine (Ticlid) ISE
Neutropenia and, rarely, TTP
42
Clopidogrel (Plavix) ISE
Bleeding
43
Prasugrel (Effient) ISE
Massive bleeding risk
44
Dipyradimole (Persantine) ISE
Vasodilation of coronary arteries can enhance exercise-induced ischemia (because it elevates extracellular adenosine levels)
45
ACE inhibitors ISE
Dry cough, angioedema, decreased renal function, hypotension
46
Metoprolol, propranolol, bisoprolol ISE
Fatigue, worsening claudication, impotence (so men don't take)
47
Nitrates ISE
Tolerance w/chronic use (need nitrate free periods of 8-12 hours), headaches, hypotension, activation of Bezold-Jarisch reflex (causes bradycardia)
48
Nefedipine (Procardia) ISE
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
Amlodipine (Norvasc) ISE
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
Felodipine (Plendil) ISE
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
Verapamil (Calan) ISE
Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure
52
Diltiazem (Cardizem) ISE
Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure
53
Metoprolol, propranolol, bisoprolol OSE
Decreased exercise tolerance, lethargy, insomnia,
54
Nitrates OSE
Decrease preload
55
Nefedipine (Procardia) OSE
Constipation (most common), headache, flushing
56
Amlodipine (Norvasc) OSE
Constipation (most common), headache, flushing
57
Felodipine (Plendil) OSE
Constipation (most common), headache, flushing
58
Verapamil (Calan) OSE
Constipation (most common), headache, flushing
59
Diltiazem (Cardizem) OSE
Constipation (most common), headache, flushing
60
Aspirin (Unit IV) misc
Low-doses; if you're allergic, you'll get asthma
61
Ticlopidine (Ticlid) misc
Not really used anymore
62
Clopidogrel (Plavix) misc
No surgical or dental procedures if patient taking this
63
ACE inhibitors misc
Short-acting; contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure
64
Metoprolol, propranolol, bisoprolol misc
Contraindicated in severe bradycardia, high degree AV block, sick sinus syndrome, unstable LV failure; relative contraindication is asthma, severe depression, peripheral vascular disease
65
Nitrates misc
Contraindicated in hypertrophic cardiomyopathy, severe aortic stenosis, significant hypotension, use of phosphodiesterase inhibitors
66
Nefedipine (Procardia) misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block
67
Amlodipine (Norvasc) misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block
68
Felodipine (Plendil) misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block
69
Verapamil (Calan) misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block
70
Diltiazem (Cardizem) misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

Pharm Unit 4 (7 decks)

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