CV II Flashcards
Exam I
used in a preventative setting, best combined with hydralazine. Preferred in African-Americans and ACEI intolerant pts
isosorbide dinitrate
nitrate tolerance develops quickly. T/F
TRUE
what medications are cautioned when using nitrates that work along the same mechanism
erectile dysfunction drugs
most effective drug in preventing MI attacks
beta blockers
how do beta blockers work
decrease contractility
when are beta blockers contraindicated?
variant angina, increase likelihood of vasospasm
calcium channel blocker effects
decrease BP, decrease pain episodes
which calcium channel blockers are used in angina
verapamil and diltizium
drug for stable angina
beta blockers
sodium channel blocker, effective when calcium and beta blockers aren’t
ranolazine
ACE inhibitors are contraindicated in __.
pregnancy
Adverse effects of niacin?
Cutaneous flushing, hepatotoxicity
What cholesterol medication do you give in pregnant women?
bile acid-binding agents
How do statins works?
Block cholesterol synthesis
What are the adverse effects of statins?
liver damage, myo/rhabdo, contradindicated in teens, pregs, kids
What enzymes do you check in statin use?
creatine kinase (muscles), AST & ALT
What statin has the least interaction with CYP 3a4/5?
pravastatin
What are other uses of statins?
anti-inflammatory, cancer prevention, neurodegenerative diseases
What population are fibrates avoided in?
pregnancy, renal/liver failure
What the indications of omega-3?
hypertriglyceridemia, prevent MI reoccurence
What are the adverse effects of omega3?
mild anticoagulant, diabetic issues, increased risk of prostate cancer
What are the first and second treatments of lipid lowering?
statins, bile acid binding, fibrates, sterol absorp inhib, omega 3
What is another indciation for for lipid rx?
plaque stabilization
What lipid lowering drug caused an increase in cardiovascular deaths?
Torcetrapib
How would you treat ACS?
oxygen, pain relief, manage arhythmias, block platelet fx, reperfusion, reduce the size of infarction
Reperfusion after ischemia may damage what?
mitochondria, use cyclosporine
Stable angina is relieved with ?
rest
Describe prinzmetal’s angina.
atypical, extreme fatigue with minimal exertion, w/o activity or emotional causes, will wake someone up at night
What adjective best describes what is going on with Prinzmetal’s angina?
vasospasm
What is a risk factor for prinzmetals?
smoking
How do you treat prinzments?
calcium channel blocker
What is the main problem with stable angina?
coronary vessel stenosis
What are the risk factors for stable angina?
anemia, fever, hyperthyroidism, cardiac arrhythmia
What are the pharm tx for stable angina?
nitrates, betas, calcium, sodium, hyperlipidemia tx
What is a great medication for someone who is intolerant to ACEI to manage CHF?
Isosorbide Dinitrate + Hydralazine
How would you prevent nitrate tolerance from developing?
have a nitrate free interval, especially when sleeping
What medication is contraindicated with nitrates?
erectile dysfx drugs
What is the reason why beta blockers are used with angina?
most effective at preventing attacks b/c it reduces output and afterload
What are the 3 cautions with beta blockers?
don’t use in LVHF, severe brady, variant angina
Ranolazine helps with chronic angina management, what is it and what are adverse effects?
sodium channel blocker, prolongs QT interval, inhibits CYP2d6
