Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio > Anti-angina Meds > Flashcards

Anti-angina Meds Flashcards

1
Q

Which drugs has anecdotal evidence of efficacy?

A

Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nitrates will do what to the systemic circulation?

A
  1. Venodilation
  2. Arteriolar vasodilation
  3. Arterial vasodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nitrates will effect the coronary circulation by

A

Increasing the coronary blood flow and reducing the diastolic blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does nitrates activate? What odes it result in?

A

It activates Guanylate Cyclase leading to an increase in cGMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nitrates ultimately is an agent that

A

Reduce myocardial oxygen demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the significance of dose response of oral nitrates?

A

As we increase nitrate dose, there is a difference in the opening of the veins and arteries.

Capacitance veins have a great effect and will show immediate dilation, conductance arteries will have a gradual widening and resistance artery takes a while for ir to dilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Will nitrates reduce preload and afterload?

A

Yep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the bottom line for nitrates to work on dilating coronary arteries?

A

You need functional smooth muscle cells around the circumference of the artery for coronary dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Will smaller coronary arteries dilate proportionally more than larger coronary arteries with the administration of nitrates?

A

Yep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which dilate more with the administration of nitrates: a eccentrically diseased heart or concentrically diseased heart

A

Eccentrically diseased heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nitrates tolerance… tell me about it

A

There are multiple potential mechanism for tolerance one of them is due to the depletion of R-SH but the best way to avoid tolerance with chronic administration is have nitrate free interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when are nitrates contra-indicated?

A

when patient has taken sildenafil since it also leads to vasodilation

this combination can results in severe hypotension and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what to give to a patient who has been given both sildenafil and nitrates?

A

receive fluid administration, vasopressors and be monitored closely for hemodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

sildenafil works by

A

inhibiting the breakdown of cGMP thus leads to increased levels of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Beta blockers effects (4)

A
  1. reduce heart rate
  2. reduce BP
  3. reduce contractility
  4. increases wall tension in patients with left ventricular dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

net effect of beta blockers

A

reduces myocardial oxygen demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when are beta blockers particularly useful in anti-angina effects?

A

conditions of heightened SNS activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

can coronary blood flow go down with beta blockers?

A

yep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

classification of beta blockers (3)

which one is not used for angina?

A
  1. beta-1 selective
  2. non-selective
  3. combined alpha/beta blockers
  • neither non-selective or combined is used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

some side effects of beta blockers

A
  1. bradycardia
  2. aggravation of heart failure
  3. fall in HDL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

are beta blockers used in acute MI?

A

yea, reduces risk fo sudden death, reacurrent MI and progression to heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

beta blockers with intrinsic sympathomimetic activity are

A

not benefitcial

23
Q

which calcium channel blockers have myocardial effects

A

non-dihydropyridine

24
Q

what is the mechanism of non-dihydro calcium blockers

A

lenghten the conduction time and prolong the refractoriness of the atrio-ventricular node

25
Q

examples of non-dihydro calcium blockers

A
  1. verapamil

2. diltiazem

26
Q

mechanism of dihydropyridine calcium blockers

A

effect on vascular smooth muscle at the concentrations used clinically

27
Q

examples of dihydropyridine calcium blockers

A
  1. amlodopine

2. nifedipine

28
Q

calcium channel blockers effects (4)

A
  1. reduce HR
  2. reduce BP
  3. reduce contractility
29
Q

net overall effect of calcium channel blockers

A

reduced myocardial oxygen demand

30
Q

verapamil and diltiazem in addition to increasing coronary blood flow, lowering coronary resistance, reducing afterload, reducing coronary spasms like all calcium blockers they also

A
  1. reduce HR

2. reduce contractility

31
Q

adverse effect of verapamil and diltiazem

A
  1. bradychardia

2. AV block

32
Q

nifedipine adverse effects

A
  1. edema

2. headache

33
Q

treatment for variant angina

A
  1. calcium channel blocker

2. long-acting nitrates

34
Q

tailored medical therapy after nitrates:

sinus brady

A

Dihydro CCB

35
Q

tailored medical therapy after nitrates:

Sinus tachy

A

B-blocker

36
Q

tailored medical therapy after nitrates:

supraventricular tachy

A

verapamil and B-blocker

37
Q

tailored medical therapy after nitrates:

Afib

A

verapamil, diltiazem or B-blocker

38
Q

tailored medical therapy after nitrates:

L.ventricular dysfunction

A

B-blocker

39
Q

tailored medical therapy after nitrates:

COPD

A

CCB

40
Q

what should always be part of all anginal patients’s regimen

A

NG sublingual

41
Q

which medication enhances the efficacy of dihydro CCB

A

B-blockers

42
Q

aspirin in angina treatment:

  1. stable angina
  2. primary prevention
  3. secondary MI prevention
  4. unstable angina
A
  1. yes, reduction in adverse CV events
  2. recommended for high risk patients
  3. yes, reduces both mortality and reinfarction
  4. yes, reduction in MI and mortality
43
Q

Aspirin blocks

A

cyclo-xygenase leading to decreased platelet aggregation

44
Q

aspirin side effects

A

GI bleeding

45
Q

treatment guideline of aspirin

A

75-162

46
Q

ranozaline

A

can inhibit the cardiac late sodium current

47
Q

which ion channel is enhanced in ischemia

A

late sodium channel

48
Q

late sodium channel actiation has been associated with

A

intracellular sodium and calcium loading, leading to cellular and reperfusion injury

49
Q

does ranolazine increase QT?

A

modest increase but there is no increaae in risk for torsade de Pointes

50
Q

ranolazine has multiple drug interactions

A

yes

51
Q

Class 1 angina meds

A
  1. beta blockers
  2. CCB
  3. long acting nitrates
  4. NG
52
Q

Class IIa angina meds

A
  1. long acting non-dihydro CCB

2. ranolazine

53
Q

nicorandil, ivabradine and trimetazidine

A

meds available outside of USA

Cardio (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions