Cardiovascular- angina Flashcards
What causes angina?
atherosclerotic plaques in coronary arteries. Restrict blood flow and oxygen to heart
How do you manage acute attacks?
S/L GTN. If attacks occur more than twice a week need regular drug therapy
What should patients with stable angina have?
Beta blocker or CCB
What should patients with left ventricular dysfunction have?
Low dose beta blocker titrated very slowly over a period of weeks or months
What should you use if a single agent fails?
combination of beta blocker and dihydropyrimidne CCB
What should you use in patients intolerant to beta blocker and CCB?
monotherapy with long acting nitrate, ivabradine, nicorandil or ranolazine
How often should response to treatment be assessed?
every 2-4 weeks
How do nitrates, CCBs and potassium channel activators work?
Vasodilators so lower BP
What is nicorandil?
Potassium channel activator with nitrate component. Causes venous and arterial dilation. Licensed for prevention and long term treatment
How does ivabradine work?
Lowers heart rate by acting on the sinus node
What type of therapy is ranolazine?
adjuvant
When are glycoprotein 2b and 3a inhibitors licensed?
As an adjunct to heparin and aspirin for prevention of ischaemic complications in high risk patients undergoing PCI.
Examples of glycoprotein 2b and 3a inhibitors
Abciximab, Eptifibatide, Tirofiban
