Cardiovascular Disorders Flashcards
define acute coronary syndrome (ACS)
acute myocardial ischemia classified by STEMI, NSTEMI, and unstable angina (UA)
how does acute coronary syndrome present?
pt in acute distress and may have a hypertensive crisis, acute HF, cardiogenic shock, or cardiac arrest
classic symptoms of ACS?
abrupt chest pain that persists for 10 minutes or longer that may radiate to arms and shoulders, back, abdomen, or jaw. N/V, cold sweats, or SOB may be present
treatment for ACS?
*b-blockers: carvedilol 6.25mg bid or metoprolol 25-50mg up to 200mg qd
*CCBs: diltiazem, verapamil, amlodipine, nicardipine, or nifedipine
*antiplatelets
*high-intensity statins
*ACEi/ARB
treatment for A fib/A flutter?
*B-blocker
* CCB
*digoxin
what is the most common disease that leads to cardiac arrest, causing 75% of cardiac deaths?
coronary artery disease
when do we use ezetimibe for hyperlipidemia? MoA?
counseling points?
as adjunct therapy w/ statins
reduces LDL-C by inhibiting an important transporter of cholesterol absorption
well tolerated, some possible diarrhea and myalgia
when do we use cholestyramine?
counseling points?
combined w/ statins when LDL-C levels are not achieved
can cause constipation, bloating, fullness, nausea and flatulence. SEs can be minimized by increasing fluid intake and using stool softeners. do not take at the same time as fat-soluble vitamins (ADEK)
alirocumab and evolocumab are PCSK9 inhibitors, what do they do?
inhibiting PCSK9 promotes intracellular degradation of hepatic LDL-C, prevents LDL receptor recycling, and reduces LDL-C clearance from circulation
when do we use mipomersen and lomitapide for high cholesterol?
used in combo in pts with familial hypercholesterolemia.
what is digoxin used for?
A fib/flutter, tachycardia, and HF
how does digoxin help HF?
inhibits sodium/potassium pump in heart cells to cause an increase of intracellular sodium which promotes calcium influx via the Na/Ca pump increasing contractility
how does digoxin help arrhythmias?
suppresses AV node conduction to increase refractory period and decrease conduction velocity
what do we use to treat ischemic heart disease?
-antiplatelets
-ACE/ARB
-B-blockers
-CCBs when B-blockers are contraindicated
-nitrates
MoA of Ranolazine?
when is it used?
reduces intracellular sodium and improves myocardial function and perfusion with no impact on HR, BP, inotropic state, or coronary blood flow.
monotherapy/add-on for angina sx if pt cannot tolerate other agents due to adverse effects
