Anti Anginals Flashcards
What is angina caused by
Insufficient oxygen to meet myocardial demands- usually from athrometous plaque
During shins test pain how does the EKG appear
ST segment depression or elevation
What meds can be used instead of a stress test
Vasodilators like dipyridamole or adenosine or dobutamine
What is vasospastic angina
Occurs at rest and unrelated to atherosclerosis
What is the common cause of unstable angina
A ruptured plaque or sub occlusive thrombus
How can you tell if there’s is no myocardial necrosis
There is no release of enzymes or bio markers
What are the common drug classes used in angina
Nitrates. CCB, BB and ranolazine
Which vitamin works well with CCB I. Variant agina
Vit e decreased angina symptoms
Which meds reduce rates of mortality with angina?
Beta blockers
What med should be avoided with angina
IR DPH CCB
How does ranolazine work for angina
Reduces calcium
How do nitrates affect platelets?
They inhibit platelet aggregation
When is ER nitro indicated?
Angina prophylaxis, but they build a rapid tolerance
When is IV nitrate indicated
Emergent acute use
What are the rapid acting forms of nitrate
Sublingual or translingual spray
Why do oral nitrates require larger doses
Large first pass effect
What are the three forms of long acting nitrates
Isosorbide dinitrate, isosorbide mononitrate and NTH 2% ointment
When is nitro therapy contraindicated
MI,, anemia, increased ICP, patients taking PDE5, pericardial tampons de, cardiomyopathy, and methemoglobinemia
What patients should avoid ER nitrates
Excessive GI motility
What are the vasodilation effects of nitrates
Orthostatic hypotension, tachycardia, headache, vertigo, weakness, and palpitations
What are signs of OD on nitrates
Blurred vision, diploma, and halos around lights
When should patients call 911 around nitrates
Pain not relived by nitro
How do BB prevent angina
They decrease HR and force of contraction and BP
How do CCB help prevent angina
In variant- increase coronary blood flow
Unstable - not recommended
