cardiac meds

Question 1

4 major athero targets for drugs

Answer 1

1. large lipid core
   - lower chol.
   - reduce inflammation
2. thin fibrous cap
   - stabilize
3. endothelium
   - inprove function
4. thrombus
   - anti-platelet
   - anti-coag.

Question 2

target of a statin

Answer 2

inhibit acteyl CoA, so can’t synthesize chol.

Question 3

effects of statins on LDL

Answer 3

atorvastatin - 40-50%

rosuvastatin - 50-60%

Question 4

4 other chol. drugs and their effects

Answer 4

1. Cholestramine - resin - 20-30
2. ezetimibe - block GI absorb - 20
3. ibrates - 20
4. niacin - 30, also raises HDL

Question 5

what is new lipid drug

Answer 5

PCSK9 inhibitor

• don’t break down LDL-r, so pull in more to the liver
• another 50% reduciton

Question 6

3 main targets to stop platelet activation

Answer 6

1. ADP
2. COX
3. fibrinogen

Question 7

main COX blocker for the heart

Answer 7

ASA

Question 8

ASA effects

Answer 8

less strokes and coronary events

Question 9

what are ADP blockers (4)

Answer 9

1 .clopidigrel

2. ticlopidine
3. ticagrelor
4. prasugrel

Question 10

what is effect of ADP blockers

Answer 10

more effective than ASA, but more expensive too

Question 11

what are GP2b/3a inhibs

Answer 11

abciximab to stop final step of platelet aggregation

Question 12

what are 2 old anti-coags and what did they do

Answer 12

1. warfarin - blocks 10a

2. heparin - blocks thrombin

Question 13

issues with old ones

Answer 13

• hard to dose

- need monitoring

Question 14

new option to heparin

Answer 14

LMWH - fractionated

- dose is clear

Question 15

what are new oral anti-coags

Answer 15

1. apixaban and rivaroxiban
   - both with in 10a
2. dabigatran
   - works on thrombin

Question 16

adv. of new ones

Answer 16

stable dosing

• no need to monitor
• not as easy to reverse though

Question 17

what are clot busters

Answer 17

streptokinase (tPa)

- help form plasmin faster, which breaks down fibrin

Question 18

2 main classes to improve endothelial function

Answer 18

ACEis

ARBs

Question 19

4 main effects of ACE and ARB

Answer 19

1. vasodilation
2. renal preservation
3. endothelial stabilization
4. cardiac protection

Question 20

use for nitrates

Answer 20

helps supply of blood

Question 21

4 ways to give nitrates

Answer 21

1. SL - rapid onset, short duration
2. oral - tachyphylaxis
3. topical
4. IV

Question 22

2 main actions of Bblockers

Answer 22

1. reduce HR

2. reduce contracttility

Question 23

**2 main types of BB

Answer 23

1. non-selective B1 and B2
   - propranalol
2. selective for B1
   - atenalol
   - metopralol

Question 24

3 main actions of CCBs

Answer 24

1. smooth muscle relax on vessel walls
2. SA and AV node slowing
3. slow contraction in myocardium