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DIT Cardiology > Car 18 - Antianginal Therapy And Lipid-Lowering Agents > Flashcards

Car 18 - Antianginal Therapy And Lipid-Lowering Agents Flashcards

1
Q

What is angina pectoris?

A

Chest pain due to ischemia of heart. Caused by atherosclerosis. Worsens gradually: from stable angina (pain during exertion) to unstable angina (^ severity/during rest).

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2
Q

What are 5 factors that ^ O2 demand?

A

Preload. Blood pressure. Contractility. Ejection time. HR.

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3
Q

What is another name for preload? What substances increase it and what substances decrease it?

A

AKA end diastolic volume. Nitrates \/ preload (Dilates the veins). Beta-blockers ^ preload. A mix of two will \/ slightly preload.

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4
Q

What is a good measure of afterload? What substances \/ it?

A

A good measure of afterload is BP. Nitrates and beta blockers \/ afterload. Combination of the two makes a greater \/.

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5
Q

What does beta-blockers do to contractility? Nitrates? Combination of the two?

A

Beta-blockers \/. Nitrates ^. Combination causes little change.

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6
Q

What does beta-blockers do to HR? Nitrates? Combination of the two?

A

Beta-blockers: \/. Nitrates ^. Combination: net \/ (beta-blockers are a little stronger).

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7
Q

What does beta-blockers do to Ejection time? Nitrates? Combination of the two?

A

Beta-blockers: ^. Nitrates: \/. Combination: no effect.

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8
Q

What does beta-blockers do to Myocardial oxygen deman? Nitrates? Combination of the two?

A

Beta-blockers: \/. Nitrate: \/. Combination: greater \/.

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9
Q

What are five statins?

A

Lovastatin. Pravastatin. Simvastatin. Atorvastatin. Rosuvastatin.

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10
Q

What are the effects of Statins?

A

Inhibit the ability to produce de novo cholesterol. ^ cell surgace LDL receptors. \/ plasma LDL. ^ HDL. \/ triglycerides.

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11
Q

What are the side effects of statins?

A

Hepatotoxicity. Myalgias. Myositis. Rhabdomyolysis.

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12
Q

What are three Bile acid binding resins? What do they do?

A

Cholestyramine. Colestipol. Colesevelam. They prevent reabsorption of bile.

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13
Q

What are the side effects of Bile acid binding resins?

A

Prevent reabsorption of bile. Cause GI problems. \/ absorption of fat soluble vitamins. Rarely lead to development of cholesterol gallstones.

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14
Q

What is a unique use of Cholestyramine?

A

Will bind Clostridium difficile toxin.

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15
Q

What is Ezetimibe? How does it work?

A

It is a cholesterol absorption blocker. It prevents cholesterol reabsorption at the small intestine brush border. Side effect: ^ in LFTs.

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16
Q

What is the drug of choice to raise HDL? What are the side effects?

A

Niacin. Side effects are flushing, rash, itching.

17
Q

Which type of drugs are the most effective in lowering triglycerides? What are two examples of it?

A

Fibrates. Two examples are Gemfibrozil and Fenofibrate.

18
Q

What are adverse effects of Fibrates?

A

Myositis. Myalgias. Hepatotoxicity. ^ cholesterol gallstones. Take care when combine w/ Statins.

19
Q

What foods have omega-3 fatty acids? What do they do?

A

Fish Oil (salmon, halibut, coldwater ocean). Flaxseed oil. It lowers triglycerides.

20
Q

Which lipid-lowering agent matches the following description: SE of facial flushing.

A

Niacin.

21
Q

Which lipid-lowering agent matches the following description: SE of elevated LFTs, myositis.

A

Statins, fibrates.

22
Q

Which lipid-lowering agent matches the following description: SE of GI discomfort, bad taste.

A

Bile acid binding resins.

23
Q

Which lipid-lowering agent matches the following description: Best effect on HDL.

A

Niacin.

24
Q

Which lipid-lowering agent matches the following description: Best effect on triglycerides/VLDL.

A

Fibrates, omega-3 fatty acids.

25
Q

Which lipid-lowering agent matches the following description: Best effect on LDL/cholesterol.

A

Statins.

26
Q

Which lipid-lowering agent matches the following description: binds C.diff toxin.

A

Cholestyramine.

27
Q

A 50 y.o man starts on lipid-lowering medication. Upon his first dose, he develops a rash, pruritus, and diarrhea. What drug is he taking?

A

Niacin.

28
Q

How can the flushing reaction of niacin be prevented?

A

Aspirin or NSAID 30 mins before niacin. Avoid alcohol/hot beverages. Take at bedtime. Be persistent.

29
Q

Which enzyme do statins inhibit?

A

HMG-Coenzyme A reductase.

DIT Cardiology (22 decks)

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