Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > Coronary Artery Disease > Flashcards

Coronary Artery Disease Flashcards

1
Q

Coronary Heart Disease

A

caused by damage to the coronary arteries resulting in build-up of lipids and fibrous matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Plaques

A

lipid (fat) build-up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classification of CHD

A

Stable Angina- fixed plaque
Acute Coronary Syndrome
1. unstable angina - Unstable plaque
2. non-ST-segment elevation MI (NSTEMI) - partial occlusion
3. ST segment elevation MI (STEMI) - complete occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Angina

A

Sudden pain beneath the sternum; may radiate to left shoulder, arm and jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Drug Therapy for Angina

A

Prevention - cholesterol-lowering and antiplatelet agents

Treatment of Pain- nitrates, beta-blockers, , CCBs, and ranolozaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of Angina

A

(fixed plaque)

  1. Chronic Stable
  2. Variant (Prinzmetal’s)
  3. Unstable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chronic Stable Angina

A
  • most common, caused by partial occlusion
    Triggered By- increase in physical activity, emotional excitement, large meals, cold exposure
    Therapeutic Agents - organic nitrate, beta-blockers, calcium channel blockers, ranolazine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Variant Angina

A

aka prinzmetals, caused by vasospasm
-can occur at rest, while sleeping, normal activity
Therapeutic agents - calcium channel blockers, organic nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Unstable Angina

A

Caused by vasospasm and plaque rupture
- can happen at rest, exertion
Therapeutic Options- organic nitrates, beta-blockers, oxygen, iv morphine

Anti-platelet therapy- aspirin, clopidogrel, tricagrelor, prasugrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nitrates

A

MOA: acts primarily on cells of vascular smooth muscle
Physiologic effect: vasodilation, greater effect on veins than arteries
ex. nitroglycerin (NTG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nitroglycerin

A

given in stable and variant angina
reduces venous return to the heart and reduces preload and relaxes spasms in ca’s helping to increase oxygen supply

  • rapidly metabolized by the liver
  • large first-pass effect
  • short half-life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Adverse Effects- NTG

A

Headache
orthostatic hypotension
reflex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Drug Interactions - NTG

A 
(can't be given at the same time)
anti-hypertensive agents
Beta-Blockers
Phosphodiesterase-5 (PDE5)
Non-dihydrophyridine calcium channel blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Other Nitrates

A 
Isosorbide dinitrate (IR) - 3x daily 
Isosorbide mononitrate (ER) - 2x daily *isomer to remember er*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ranolazine

A

used to increase efficiency of heart beating; may be added to BB, CCBs, or nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adverse Effects of Ranolazine

A

QT prolongation
Elevation in BP
Constipation, dizziness, nausea, headache

17
Q

Drug Interactions with Ranolazine

A

CYP3A4 inhibitors
QT prolonging drugs
CCB - can inhibit except for Amlodipine

18
Q

Common counseling points for BB

A
  • patients may be drowsy

- do not discontinue BB abruptly as patient may experience a ‘rebound tachycardia’

19
Q

Common counseling point for CCB

A
  • avoid combining with beta-blockers
20
Q

Reduction of Risk Factors

A
  • smoking cessation
  • reduction of cholesterol
  • reduction of hypertension
  • adequate treatment of diabetes
  • increase exercise
21
Q

Myocardial Infarction (MI)

A

heart attack, necrosis (death) of the myocardium due to ischemia (lack of oxygen)

22
Q

Tests For MI

A

EKG
CK-MB
Troponin I and T

23
Q

Immediate Treatments for STEMI

A 
MONAB
morphine
oxygen
nitroglycerin
aspirin
beat-blockers
24
Q

What does Morphine do?

A

vasodilation - decreases myocardial oxygen demand

relieves pain

25
Q

What does Oxygen do?

A

Increases o2 saturation and supply to myocardium

26
Q

What does nitroglycerin do?

A

decreases preload
increase collateral blood flow to the heart
vasodilation
helps treat ischemia-related pain

27
Q

What does aspirin do?

A

Suppresses platelet aggregation (clotting)

Immediately given

28
Q

What do Beta-blockers do?

A

Decrease HR and contractility

Decrease myocardial oxygen demand

29
Q

What are the Reperfusion Therapy Options?

A
  1. Fibrinolytic

2. Percutaneous Coronary Intervention (PCI)

30
Q

What are the drugs used to dissolve clots and examples?

A

Fibrinolytics

ex. Alteplasee (tPA) and reteplase

31
Q

What are the anticoagulants used in reperfusion therapy?

A
  1. Heparin IV
  2. Fondaparinuz SQ
  3. Bivalirudin IV
32
Q

What are the antiplatelets used in reperfusion therapy?

A
  1. Thienopyridines (CPT) - “grel”
  2. Glycoprotein IIb/ IIIa inhibitors
  3. Aspirin
33
Q

Why are ACE inhibitors or ARBS used after reperfusion therapy

A
  1. decrease short-term mortality post MI

2. decrease remodeling of the ventricles

34
Q

Complications of STEMI

A
  1. Ventricular dysrhythmias
  2. Cardio shock
  3. Heart Failure
  4. Cardiac Rupture
35
Q

What meds should all patients post-MI be taking

A
  1. Beta-blocker
  2. ACE-I or ARB
  3. Antiplatelet drug (aspirin/aspirin+theinopyridine)
  4. Statin

Pharm (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions