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Clin phar > CAD: Acute > Flashcards

CAD: Acute Flashcards

1
Q

Group of condition similar to symptoms of chest pain
which is not, or only partially relieved by GTN

A

Acute Coronary Syndrome

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2
Q

Conditions of ACS include

A
  • Acute myocardial infarction (AMI)
  • UA
  • NSTEMI
  • STEMI
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3
Q

ACS arises from rupture of an
__________

A

unstable atheromatous plaque

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4
Q

determine the degree of
myocardial necrosis that occurs

A

Volume of the eventual thrombus and the time
the vessel is occluded

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5
Q

Chest pain that often occurs at rest, can occur suddenly, may
worsen suddenly or may be stuttering, recurring over days to weeks

A

Unstable Angina

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6
Q

Symptoms similar to unstable angina but differentiated on the basis
of markers and ECG

A

Non-ST- Elevation Myocardial Infarction

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7
Q

A condition that requires immediate reperfusion therapy, through
either thrombolysis or percutaneous coronary intervention (PCI)

A

ST-Elevation Myocardial Infarction

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8
Q

Acute Coronary Syndrome includes

A

Unstable Angina
Non-ST- Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction

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9
Q

ST-Elevation Myocardial Infarction requires immediate _______

A

reperfusion therapy

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10
Q

Manifestations of Acute Coronary Syndrome:
1. __________ chest pain and discomfort
2. _____________ cellular injury
3. Release of ____________ - (Troponin I and T, CK-MB, CPK,
LDH)
4. _________________s- (ST elevation, T wave inversion,
pronounced Q waves)
5. Inflammatory response from the __________
6.___________

A
  1. Severe chest pain and discomfort
  2. Irreversible cellular injury
  3. Release of myocardial enzymes - (Troponin I and T, CK-MB, CPK,
    LDH)
  4. Electrocardiogram changes- (ST elevation, T wave inversion,
    pronounced Q waves)
  5. Inflammatory response from the injured myocardium
  6. Coagulative necrosis
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11
Q

Release of myocardial enzymes such as ________________ manifests acute coronary syndrorme

A

Troponin I and T, CK-MB, CPK,
LDH

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12
Q

Electrocardiogram changes such as ____________ manifests acute coronary syndrorme

A

ST elevation, T wave inversion,
pronounced Q wave

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13
Q
  • Results
    from decreased oxygen and
    nutrient delivery To
    myocardium
A

Myocardial Ischemia

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14
Q

Results if
ischemia progresses unresolved
or untreated

A

Myocardial Injury

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15
Q

Death
of myocardial cells

A

Myocardial Infarction

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16
Q

indicates full thickness
cardiac muscle injury

A

ST-segment elevation

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17
Q

indicates muscle necrosis

A

pathological Q-wave

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18
Q

indicates
muscle ischemia.

A

T-wave inversion

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19
Q

Cardiac Markers

A

*Troponin
*Creatinine kinase

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20
Q

found in cardiac and skeletal muscle

A

Troponin T

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21
Q

found only in cardiac muscle

A

Troponin I

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22
Q

found in cardiac and skeletal muscles

A

Troponin C

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23
Q

Found primarily in the heart muscle, skeletal muscle
and brain tissue

A

Creatinine kinase

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24
Q

Aids in the diagnosis of acute myocardial or skeletal
muscle damage

A

Creatinine kinase

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25
Q

CK- BB

A

Brain tissues

26
Q

CK- MM

A

– Skeletal muscles

27
Q

CK-MB

A

Heart muscle

28
Q

Overall Treatment Goals for ACS
1. __________ chest pain and anxiety
2. __________ cardiac workload and _________ cardiac
rhythm
3. Prevent / reduce myocardial damage by limiting the
__________ and preserving the __________
4. Prevent or arrest complications
5. Reopen ( reperfuse ) closed coronary vessel with
__________________

A
  1. Reduce chest pain and anxiety
  2. Reduce cardiac workload and stabilize cardiac
    rhythm
  3. Prevent / reduce myocardial damage by limiting the
    area affected and preserving the pump function
  4. Prevent or arrest complications
  5. Reopen ( reperfuse ) closed coronary vessel with
    thrombolytic drug and/or PCI
29
Q

Causes venous pooling and reduces
preload, cardiac workload and oxygen
consumption

A

Morphine

30
Q

Morphine causes venous pooling and __________ (increases/reduces)
preload, cardiac workload and oxygen
consumption

A

reduces

31
Q

Morphine is used for ________

A

myocardial pain and anxiety

32
Q

May cause orthostatic hypotension and fainting and Can produce bradyarrhythmia

A

Morphine

33
Q

Morphine may cause _______ and ________. It can also produce

A

orthostatic hypotension and fainting; bradyarrhythmia

34
Q

Administered in patients with arterial
saturation less than 90%, respiratory distress
or high risk features of hypoxemia

A

Oxygen

35
Q

Oxygen is administered in patients with arterial
saturation __________________, respiratory distress
or high risk features of hypoxemia

A

less than 90%

36
Q

causes venous dilation which reduces left
ventricular volume (preload) and myocardial wall
tension, decreasing oxygen demand

A

Nitrates

37
Q

Nitrates causes venous dilation which ________(increases/reduces) left
ventricular volume (preload) and myocardial wall
tension, decreasing oxygen demand

A

reduces

38
Q

also reduce arteriolar resistance, helping reduce
afterload, which decrease myocardial oxygen demand

A

Nitroglycerin

39
Q

Nitroglycerin also (increase/reduce) arteriolar resistance, helping (increase/reduce)
afterload, which (increase/decrease) myocardial oxygen demand

A

reduce; reduce; decrease

40
Q

T/F: Antiplatelet therapy should be initiated promptly

A

T

41
Q

T/F: Aspirin should be administered as soon as possible
after presentation and continued indefinitely

A

T

42
Q

should be administered to patients who
cannot tolerate GI effect and those who are
hypersensitive to ASA

A

Clopidogrel

43
Q

Management for STEMI

A

*Fibrinolytics
Aspirin
Thienopyridine
Glycoprotein IIB/ IIIA Receptor inhibitor
Anticoagulant
Nitroglycerin
Beta-blockers
Calcium channel blocker

44
Q

causes the
thrombus clot to be lysed when administered early after
symptom onset (6 to 12 hrs) and to restore blood flow

A

thrombolytic agents/Fibrinolytics

45
Q

The conversion of _______ to ________ promotes
fibrinolysis and breakdown of the clot.

A

Plasminogen to plasmin

46
Q

Therapy of choice when PCI is not available

A

Fibrinolytics

47
Q

Preferred antiplatelet agent in the treatment of all ACS

A

Aspirin

48
Q

Clopidogrel and ticlopidine

A

Thienopyridine

49
Q

Recommended to be administered to patients with ST elevation ACS if patient
is allergic to aspirin

A

Thienopyridine

50
Q

First line GP IIB/IIIA receptor inhibitor for patients undergoing PCI who have not
received fibrinolytics

A

Abciximab

51
Q

Should not be administered if patients who will not undergo PCI

A

Abciximab

52
Q

Combination of Abciximab with _____________________ has been shown to reduce risk of
reinfarction and need for repeated PCI

A

Aspirin/thienopyridine and UFH

53
Q

Initiated at time of PCI and infusion is continued for 12 h

A

Abciximab

54
Q

Abciximab is initiated at time of PCI and infusion is continued for _______

A

12 hours

55
Q

Abciximab may (increase/decrease) risk of bleeding

A

increase

56
Q

UFH administered as continuous infusion

A

Anticoagulant

57
Q

First line anticoagulant for treatment of patients with ST elevation

A

Anticoagulant

58
Q

Should be initiated in the ED and continued for 24 hours or longer in patients
who will bridged over to receive chronic warfarin therapy following MI

A

Anticoagulant

59
Q

Dose is frequently adjusted to a target activated partial thromboplastin time
(aPTT)

A

Anticoagulant

60
Q
A

Clin phar (3 decks)

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