Brainscape's Knowledge GenomeTM

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


See full index

Pharm 2 module 2 > Antianginal agents > Flashcards

Antianginal agents Flashcards

1
Q

What is a common symptom of CAD

A

Angina pectoris

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

If a patient has chest pain that radiates to the neck, what symptoms will they have

A

choking

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

If a patient has ulnar distribution, where is their angina most likely radiating to

A

left shoulder / arm

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

What symptoms will a patient present with that has unstable angina or an acute MI

A

New onset
increase in intensity / frequency
increase in duration
occurs at rest

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

What are the types of angina

A

effort angina
vasospastic angina
unstable angina

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

What is the most common form of angina

A

effort / stable

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

How will a patient with stable angina present

A

short lasting
heavy
burning
squeezing in chest
relieved at rest

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

What is the cause of stable angina

A

inadequate blood flow in the presence of CAD

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

How do you best treat effort angina

A

nitrates or rest

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

What are other names for vasospastic angina

A

prinzmetal
variant

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

What are the causes of vasospastic angina

A

coronary artery spasm causing decreased blood flow to the heart muscle

*uncommon pattern, episodic

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

What is the treatment for vasospastic angina

A

coronary vasodilators
-nitrates
-Ca2+ blockers

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

Why is ACS an emergency

A

from a rupture of atherosclerotic plaque and partial / complete thrombosis of coronary artery

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

What happens if ACS isn’t treated

A

necrosis can occur leading to an MI

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

Necrosis in the heart leads to an increase in which biomarkers

A

troponins
creatinine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you determine cardiac oxygen consumption

A

Wall stress/tension (Volume, pressure, thickness)
Heart rate
contractility

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

What occurs in the heart when preload is changed

A

the ventricular stroke volume will chance

force of contraction will change

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

What factors increase preload

A

Increased atrial contractility
Increase ventricular compliance
Decrease HR
Increased aortic pressure
Increased central venous pressure
-Decrease venous compliance
- Increase thoracic venous blood volume

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

What is the most important factor affecting myocardial oxygen demand

A

Heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is contractility influenced by in the heart

A

calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What strategies can be used for angina relief

A

beta blocker
calcium channel blocker
organic nitrates
Na+ blockers
Interventional (IR / Cath lab / CABG)

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

What are metoprolol and atenolol useful for

A

stable and unstable angina

23
Q

What is the MOA for beta-1 blockers

A

Decrease oxygen demand of the myocardium = decrease HR, CO,BP, Contractility

**will work at rest and during exertion

24
Q

Which patients should you avoid non-selective beta blockers in and why

A

patients with asthma because it will cause severe bronchospasm

25
Q

Which type of angina should beta blockers not be used in

A

vasospastic

26
Q

Why should Pindolol be avoided in patient with a prior MI / angina

A

because of its sympathomimetic affects

27
Q

What are the side effects of beta blockers

A

Cold hands / feet
fatigue
Weight gain

28
Q

What is recommended as the initial antianginal therapy (unless vasospastic)

A

Beta blockers

29
Q

Why should beta blockers not be stopped abruptly

A

needs to be tapered over 2-3 weeks to avoid rebound angina, MI, hypertension

30
Q

Which types of angina are calcium channel blockers useful for

A

stable and vasospastic angina

31
Q

What is the MOA of Ca2+ blockers

A

dilate arterioles causing a decrease in smooth muscle tone and vascular resistance

32
Q

What are contraindications of calcium channel blockers

A

AV block
sick sinus syndrome
symptomatic hypotension
ACS
grapefruit juice

33
Q

What are the side effects of Ca2+ blockers

A

lightheadedness
hypotension
bradycardia
constipation
swelling in feet / ankles

34
Q

When are non-dihydropyridines beneficial

A

in patients with atrial tachyarrhythmia

35
Q

When are non-dihydropyradines contraindicated

A

Risk for heart block
heart failure

36
Q

how quickly does diltiazem work and where is it frequently used

A

immediately

In the ER with afib+RVR

37
Q

Where in the body does verapamil have the greatest effect

A

myocardium

38
Q

When are organic nitrates indicated

A

stable, vasospastic, and unstable angina

39
Q

What is the MOA of nitrates

A

Venous dilation (decrease O2 requirement and preload)

decrease in arteriolar resistance (decrease after load and O2 demand)

40
Q

What are the contraindications of nitrates

A

coadministration of PDE-5 inhibitors (viagra)
severe anemia
increased ICP
circulatory failure / shock

41
Q

What are the side effects of nitrates

A

headaches
dizziness
hypotension
flushing

42
Q

When is nitro utilized

A

anginal attacks

43
Q

Which sodium channel blocker is useful in angina

A

ranolazine

44
Q

How does Ranolazine help with angina

A

Inhibits late phase of Na+ currents which improves oxygen supply and demand

45
Q

What are the risks with ranolazine

A

Drug interactions
prolonged QT

46
Q

When is isosorbide dinitrate useful

A

can be taken before exercise in anticipation of angina when mononitrate isn’t wanted

47
Q

When is a combination therapy utilized with angina

A

when there is an intolerance or angina symptoms persist despite optimal dosage of single drug

48
Q

What determines the combination therapy someone is on

A

How frequently angina attacks occur within a given week

Comorbidities and type of angina

49
Q

Which combination will help decrease cardiac ischemia and improve exercise tolerance

A

nitrate with beta blocker or calcium channel blocker

50
Q

What is sildenafil

A

PDE-5 inhibitor

51
Q

What is the MOA of Sildenafil

A

binds to guanylate cyclase receptors, increasing cGMP causing smooth muscle relaxation (vasodilation)

52
Q

What are the indications for sildenafil

A

erectile dysfunction
PAH

53
Q

Why should Nitrate and sildenafil never be combined

A

it lead to hypotension and blood flow which can precipitate a heart attack

Pharm 2 module 2 (4 decks)

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