CAD & ANGINA MEDS (EXAM 2) Flashcards
WHAT DO NITRATES DO?
POTENT VASODILATOR
DECREASE PRELOAD AND AFTERLOAD (BP!)
WHAT SHOULD THE PATIENT DO WHEN ON NITRATES?
PATCHES APPLIED TO NONHAIRY OR FATTY FOR BEST ABSORPTION
SITES ROTATED
APPLY 14 HOURS, REMOVE 10-14 HRS TO PREVENT TOLERANCE
S/E : HA
A/E: HYPOTENSION
DIZZY, AVOID ED DRUGS
EXAMPLES OF NITRATES
SUBLINGUAL TABS: NITROSTAT, NITROQUICK (Q5MIN,3TAB) MUCUS MEMB.
SUBLINGUAL SPRAY: NITROLINGUAL
TRANSDERMAL NITROGLYCERIN: MINITRAN, NITRO DUR, NITREK
ISOSORBIDE DINITRATE
ISOSORBIDE MONONITRATE
BP (ORTHOSTATIC CHANGES! DECREASE IN BP WITH VASODILATION)
DO NOT GIVE TO PATIENTS TAKING SEX DRUGS (SILDENAFIL, TADALAFIL, VARDENAFIL)
WHAT DO BETA BLOCKERS DO
NOTE: ALPHA= CONSTRICT, BETA= DILATE
B1 SELECTIVE= A - N
B1/2 NON= O-Z
DECREASE HR, BP, CONTRACTILITY, CO
EXAMPLES OF BETA BLOCKERS
CARVEDILOL (COREG CR)
METOPROLOL (LOPRESSOR, TOPROL XL, BETALOC) CARDIOSELECTIVE BETA ADRENERGIC BLOCKER
DONT ADMINISTER: HR <50-60
HOLD FOR SYSTOLIC <90-100
HF= DECREASE CO
WHEEZING, SOB = BETA 2 EFFECTS LUNGS CAN CAUSE BRONCHOCONSTRICTION
WHAT DO CALCIUM CHANNEL BLOCKERS DO
DECREASE HR, CONTRACTILITY, AFTERLOAD BP
ORTHOSTATIC HYPOTENSION
CCB: DIHYDROPYRIDINES
AMLODIPINE, FELODIPINE, NIFEDIPINE, NICARDIPINE
DECREASE SVR
CCB: NON-DIHYDROPYRIDINES
DILTIAZEM, VERAPAMIL
DECREASE SVR (SYSTEMIC VASCULAR RESISTANCE)
DECREASE CONTRACTILITY, SINUS NODE, AV NODE
ANTIPLATELETS
ASPIRIN, P2Y12 INHIBITORS (CLOPIDOGREL, PRASUGREL, TICAGRELOR, CANGRELOR), PAR-1 INHIBITOR (VORAPAXAR SULFATE)
BLEEDING!!!!!!!
NO OTC
WITH FOOD
EARS RINGING (ASPIRIN TOXIC)
DRUGS TO LOWER LDL LEVELS
HMG-COA REDUCTASE INHIBITORS (STATINS): SIMVASTATIN!!!
STATINS REDUCE CHOLESTEROL SYNTHESIS IN LIVER AND INCREASE CLEARANCE OF LDL FROM BLOOD
CONTRAINDICATED W LIVER DISEASE
CAUSE MUSCLE MYOPATHIES
DISCONTINUED IF MUSCLE CRAMPING OR ELEVATED LIVER ENZYME
NO GRAPEFRUIT- FURANOCOUMARINS INACTIVATE CYP3A4 (METABOLIZE DRUGS)
