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Pharmacology 3 > CAD Drugs > Flashcards

CAD Drugs Flashcards

1
Q

Diagnostic results for stable angina:

A

normal ECG

normal troponin

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2
Q

Diagnostic results for unstable angina:

A

normal troponin

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3
Q

Diagnostic result for NSTEMI:

A

elevated troponin

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4
Q

Diagnostic result for STEMI:

A

elevated ST segment

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5
Q

Myocardial oxygen supply is determined by

A

Absolute volume of coronary blood flow

Oxygen carrying capacity of blood

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6
Q

Myocyte oxygen demand is influenced by:

A

Heart rate
Myocardial contractility
Myocardial wall stress

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7
Q

Treatment for supply side ischemia:

A

Anti-platelet and anti-coagulant drugs

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8
Q

Treatment for demand side ischemia:

A

CAD drugs

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9
Q

ST elevation indicates these conditions:

A 
May be normal
Acute myocardial infarction
Variant angina pectoris
Acute coronary spasm
Pericardial effusion
Left ventricle aneurysm
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10
Q

ST depression indicates these conditions:

A

Always abnormal
Ischemia
Left ventricular hypertrophy
Digitalis toxicity

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11
Q

More invasive CAD interventions:

A

Percutaneous Coronary Intervention

Coronary Artery Bypass Graft

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12
Q

Used as noninvasive estimate of myocardial oxygen consumption (MVO2):

A

Heart rate x Systolic blood pressure

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13
Q

Heart measure related to myocardial contractility:

A

Stroke volume (CO=HRxSV)

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14
Q

Considered the prototype of the nitrates group:

A

Nitroglycerin

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15
Q

Oral bioavailability is low in these nitrates:

A

Nitroglycerin

Isosorbide dinitrate

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16
Q

Nitrate not susceptible to first pass metabolism (100% BA):

A

Isosorbide mononitrate

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17
Q

Nitrate used as maintenance drug:

A

isosorbide mononitrate

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18
Q

Half-life and excretion of nitrates:

A

2-8 minutes; kidney

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19
Q

___ and ___ administration avoid nitrate first-pass metabolism, and ___ route provides rapid absorption:

A

Sublingual and transdermal; inhalational

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20
Q

Groups in the cell membrane that allow nitrate to enter:

A

sulfhydryl groups

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21
Q

Nitrate stimulated cGMP causes:

A

Intracellular Ca inhibiton (vasodilation)
Inhibition of calcium channels
Inhibition of mitochondrial respiration

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22
Q

Exogenous nitroglycerin is transformed by:

A

mitochondrial aldehyde dehydrogenase

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23
Q

Effects of nitrates on circulation:

A

Reduced venous return (reduced preload)
Increased systemic arterial and CA diameter (reduced afterload, extrinsic compression)
Recruitment of collateral vessels

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24
Q

Reduced preload effects on myocardial supply/demand:

A

Increased coronary blood flow (supply)

Reduced myocardial wall stress (demand)

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25
Adverse effects of nitrates:
Headache (meningeal artery) Tachycardia Orthostatic hypotension (vasodilation) Rebound withdrawal
26
Mechanisms of nitrate tolerance:
Volume expansion (retention of salt and water) Neurohumoral activation (reflex tachycardia) Free radical generation (damages heart) Depletion of sulfhydryl groups
27
Phenomenon responsible for nitrates paradoxical aggravation of angina:
Coronary steal
28
Nitrates should not be administered to:
``` Systolic BP less than 90 mm/Hg or 30 mm/Hg below baseline Severe bradycardia (less than 50 bpm) Tachycardia RV infarction Hypertrophic cardiomyopathy Aortic stenosis ```
29
These drugs may cause severe hypotension when given with nitrates:
PDE-5 inhibitors
30
β1 receptors promote the production of ___ and activated ____ channels:
cAMP; L-type Calcium
31
β-blockers enhance coronary blood flow by increasing ____, but this in turn leads to increased ___:
diastolic perfusion; preload
32
β-blockers used to treat CAD must be WITHOUT:
Intrinsic sympathomimetic activity
33
β-blocker of choice for CAD patients with asthma:
Celiprolol (β2 agonistic activity)
34
CI in those taking β-blockers:
Verapamil and dilitazem | Anti-arrhythmics (amiodarone)
35
L-type Ca receptors are dominant in:
Cardiac and smooth muscle
36
CCB decrease effects on the heart:
``` Decreased contraction (inotropy) Decreased HR (chronotropy) ```
37
Ca has an anti-atherogenic effect and is needed in these coagulation factors:
Factors VII, IX, X, XIII, II and I
38
DHP CCB used in cerebral blood vessels:
Nimodipine
39
DHP CCB used in coronary vessels:
Nicardipine
40
CCB effect on cardiac preload:
Do not affect cardiac preload (little effect on venous beds)
41
Why does Nifedipine increase HR and contractility?
Very rapid vasodilation leading to reflex tachycardia
42
CCB are used to treat these types of angina:
Vasospastic: Variant Exertional
43
Contraindicated in unstable angina or threatened MI:
DHP CCB
44
Adverse effects of CCBs:
``` Hypotension (DHP) CHF exacerbation (verapamil and diltiazem) Conduction abnormalities (V & P) Edema GERD ```
45
Nifedipine should be used in conjunction with a ___ in patients with ischemic heart disease:
β-blockers
46
Indicated drugs in angina of effort:
Nitrates CCB β-blockers
47
Indicated drugs in vasospastic angina:
CCB | Nitrates
48
Indicated drugs in unstable angina:
β-blockers Anti-platelets NTG ACE inhibitors
49
Nitrates + β-blockers cancel out these undesirable effects:
no effect on contractility | no effect on ejection time
50
This drug combination may result in AV block:
Diltiazem/Verampamil + β-blockers
51
Prototype ACE inhibitor:
Captopril
52
More common type of AR blocker:
non-peptide (-sartan drugs)
53
ACE inhibitors are give to MI patients who are NOT:
hypotensive
54
ACE inhibitor precautions:
Pregnancy | Bilateral renal artery stenosis
55
P-FOX prototype:
Trimetazidine
56
P-FOX adjunct used in surgical intervention:
Ranolazine
57
Benefit of P-FOX drugs:
promotes shift towards more oxygen-efficient glucose pathway
58
How does ranolazine blunt the effects of ischemia?
Inhibits the late Na current responsible for Ca overload (electrical and mechanical dysfunction)
59
PCI is indicated in:
Single or double vessel disease | Inability to tolerate surgery
60
CABG is indicated in:
Triple vessel or left main disease Diabetes mellitus Failed PCI

Pharmacology 3 (5 decks)

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