Cholesterol, Angina, Antithrombotic Drugs

Question 1

Omega-3-fatty acid

Answer 1

decrease O6:O3 ratio, hypertriglyceridemia, SE: fish breath cause you have to take a lot

Question 2

Lovastatin, simvastatin, pravastatin, pitavastatin, fluvastatin

Answer 2

HMG-CoA reductase inhibitor, moderate intensity statin for hypercholesterolemia, SE: hepatotoxicity, myalgia

Question 3

Amlodipine

Answer 3

Selective vascular L-type Ca++ channel blocker for vasodilation, stable angina (as add-on to bb) and VARIANT angina, SE: coronary steal, hypotension

Question 4

Warfarin

Answer 4

Inhibits Vit K epoxide reductase, inhibits clotting factor synthesis, prevention of PE, DVT, AF but mostly for PROSTHETIC VALVE, SE: intracranial bleeding in elderly, must be titrated individually, dietary restriction, drug interactions

Question 5

Hirudin, Bivalirudin, Desirudin

Answer 5

Reversible IIa inhibitor, prevent fibrinogen binding to thrombin; given when heparin is not an option, SE: bleeding

Question 6

Ezetimibe

Answer 6

Blocks dietary absorption of cholesterol in SI, hypercholesterolemia in patients intolerant of statins

Question 7

LMWH, Fondaparinux

Answer 7

Brings Xa (only) and antithrombin III together, used for thromboprophylaxis for hip and knee surgeries, SE: thrombocytopenia via thrombus formation

Question 8

Alirocumab, Evolocumab (subQ 2Xmo)

Answer 8

PCSK9 inhibitor which prevents LDL-R downregulation, statin intolerance and as add-on to statin

Question 9

Atenolol, Metoprolol

Answer 9

Selective B1 antagonist, inhibit activation of adenyl cyclase and reduces chronotropy/inotropy (not vasodilator), used for stable/unstable angina, SE: exercise intolerance, asthma exacerbation, blunt recognition of hypoglycemia, CNS effects

Question 10

Tirofiban, Epifibatide

Answer 10

Reversible blocker of GPIIA/IIIB, used for post-MI, post-angioplasty, SE: thrombocytopenia

Question 11

Protamine

Answer 11

Antidote for UFH, reverse heparin induced anticoagulation, SE: bleeding

Question 12

Dabigatran

Answer 12

NOAC reversible IIA inhibitor, instead of warfarin, SE: bleeding

Question 13

Verapamil, Diltiazem

Answer 13

Cardiac and vascular L-type Ca++ channel blocker to vasodilate and negative chronotropic/inotropic effect, used for stable/unstable angina, patients with asthma who can’t take bb, SE: excessive cardiac depression

Question 14

Ivabradine

Answer 14

HCN4 (phase 4) pacemaker channel blocker, reduces chronotopy ONLY, used for stable angina as add-on or alternative

Question 15

TPA

Answer 15

Fibrinolytic drug by activating plasmin, ACUTE ISCHEMIC STROKE, AMI, PE, SE: bleeding

Question 16

Cholestyramine, Colestipol

Answer 16

Bile acid sequestrants which shifts hepatic cholesterol metabolism, hypercholesterolemia in patients intolerant of statins, SE: GI distress

Question 17

Clopidogrel, Prasugrel, Ticagrelor

Answer 17

Irreversible P2Y12 inhibitor that prevents ADP from reducing cAMP, therefore inhibiting platelet aggregation, prevention of arterial thrombi after MI, SE: bleeding, and poor bioavailability because prodrug (except ticagrelor) and doesn’t work in certain races

Question 18

Niacin (Nicotonic acid)

Answer 18

Inhibits VLDL synthesis and lipolysis in the liver- reducing FFA availability in liver to make bad stuff, used for hypertriglyceridemia and to raise HDL after MI, SE: flushing that can be alleviated by NSAID

Question 19

Idarucizumab

Answer 19

Antidote for dabigatran-induced bleeding,

Question 20

Ranolazine

Answer 20

Slow Na+ channel blocker, reduces inotropy ONLY, used for stable angina as add-on or alternative

Question 21

Atorvastatin, Rosuvastatin

Answer 21

HMG-CoA reductase inhibitor, high intensity statin for hypercholesterolemia, SE: hepatotoxicity, myalgia

Question 22

Streptokinase

Answer 22

bacterial enzyme that is fibrinolytic, binds plasminogen everywhere and may have systemic effects, AMI, PE, DVT, SE: bleeding

Question 23

Aspirin

Answer 23

Irreversible inhibitor of COX enzymes, inhibits thromboxane A2 formation and platelet activation, arterial thrombotic diseases, secondary prevention, SE: bleeding, peptic ulcer

Question 24

Argatroban (IV)

Answer 24

Reversible IIa inhibitor, prevent fibrinogen binding to thrombin; given as prophylaxis for HIT, SE: bleeding

Question 25

Rivaroxaban, apixaban, edoxaban

Answer 25

NOAC irreversible Xa inhibitor, instead of warfarin, SE: bleeding

Question 26

Clofibrate, Fenofibrate, Gemifibrozil

Answer 26

PPAR-a transcription factor activator- reduce ApoC-III, increase beta oxidation, increase lip lip, hypertriglyceridemia (first-line), SE: GI upset, gallstones

Question 27

UFH (IV)

Answer 27

Brings IIa + Xa and antithrombin III together, used for everything, SE: bleeding, thrombocytopenia, has zero order elimination

Question 28

Nitrates (nitroglycerin, isosorbide dinitrate)

Answer 28

NO, vein dilation to reduce preload without coronary steal, used for stable/unstable angina and sublingual to terminate attack, SE: dull HA, hypotension

Question 29

Abciximab

Answer 29

Chimeric monoclonal Ab that is a GPIIA/IIIB antagonist, post-MI, post-angioplasty treatment, bleeding/thrombocytopenia

Question 30

Dipyridamole

Answer 30

Inhibits cyclic nucleotide PDE, increases cAMP/cGMP and prevents platelet activation also an adenosine uptake inhibitor, used for arterial thrombotic diseases