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Pharmacology > CVS - Ischemic Heart Disease > Flashcards

CVS - Ischemic Heart Disease Flashcards

1
Q

Ischemic Heart disease can be classified into

A

Angina
MI

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2
Q

Angina can be classified into

A

Classical Angina
Variant angina or Prinzmetal Angina or Vasospastic angina

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3
Q

Classical Angina

A

Atherosclerosis in small coronary arteries
Chest pain only during exertion

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4
Q

Aim of treatment in Classical Angina

A

Decrease work of heart

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5
Q

Variant Angina

A

Spasm in main coronary artery
Chest pain even at rest

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5
Q

Aim of treatment in Variant Angina

A

Dilation of coronary artery

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5
Q

Drugs used in Angina

A

Nitrates
Calcium channel blockers
Potassium channel openers
Beta blockers

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6
Q

Nitrates are metabolized to NO by which enzyme

A

Aldehyde dehydrogenase

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6
Q

Nitrates acts by increasing

A

cGMP levels - which further stimulates Protein kinase a - activate MLCK - Leads to smooth muscle relaxation (Vasodilation)

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7
Q

Nitrates include which drugs

A

Glyceryl trinitrate
Isosorbide dinitrate
Isosorbide mononitrate
Pentaerythrital tetranitrate
Amyl nitrite

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7
Q

Nitrates which can be given sublingually, used in acute attack of Angina (DOC)

A

NTG
Isosorbide dinitrate

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7
Q

Which nitrate have minimum first pass metabolism

A

Isosorbide mononitrate

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8
Q

Longest acting Nitrate

A

Pentaerythrital tetranitrate

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8
Q

Shortest acting nitrate

A

Amyl nitrite

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8
Q

Nitrate free period should be atleast

A

6-8 hours
Can show tolerance if remains 24 hrs in blood

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9
Q

Uses of Nitrates

A

A - Angina
B - Biliary Colic
C - Cyanide Poisoning
D - Dil ka Daura (MI)
E - Esophageal spasm
F - Failure (CHF)

9
Q

Which nitrate can convert Hb to Methb and can reverse Cyanide Poisoning

A

Amyl nitrite + Sodium Thiosulfate to convert CyanmetHb to Sodium thiocyanate - passes from urine

10
Q

Preferred antidote for Cyanide Posioning

A

Iv Hydroxycobalamin

11
Q

Which drugs if given with Nitrates can cause severe Hypotension

A

Sildenafil
Tadalafil - PDE Inhibitors - can leads to high level of cGMP - Vasodilation

11
Q

Calcium channel blockers used in Angina

A

Verapamil
Diltiazem
DHPs

12
Q

Action of Verapamil and Diltiazem in Angina

A

Decreases preload nd Afterload
Decreases HR

12
Q

Action of DHPs in Angina

A

Can cause tachycardia and can precipitates Angina
Normally not preferred

13
Q

Side effects of Calcium channel blockers

A

Headache
Constipation
Gum hypertrophy

13
Q

Drugs of Dihydropyridines(DHPs) group

A

Nifedipine
Clevidipine
Nimodipine
Nicardipine
Amlodipine
Clenidipine

14
Q

Which DHPs are contraindicated in Anginal patients

A

Nifedipine
Clevidipine - Shortest acting

14
Q

Which DHP is Cerebroselective and used in Subarachnoid hemorrhage

A

Nimodipine

14
Q

DOC in Hypertensive emergencies

A

Long acting DHPs
Nicardipine
Amlodipine

14
Q

Potassium channel openers used in Angina

A

Releases NO

NICORANDIL

15
Q

Action of beta blockers in Angina

A

Decreases HR
contraindicated in Variant Angina

15
Q

Which drugs show Coronary steal Phenomenon

A

Vasodilation of only small coronary arteries
H - Hydralazine
I - Isoflurane
D - Dipyridamole
E - Enflurane

16
Q

Bradycardiac agent that can be used in Angina

A

Ivabradine

17
Q

Rho kinase inhibitor which is approved for angina

A

Fasudil

18
Q

Metabolic modulators mechanism of action in Angina

A

Inhibits Fatty acid oxidation and let use glucose instead of fatty acids

19
Q

Metabolic modulators drugs used in Angina

A

Trimetazidine
Ranolazine - mainly acts as Na+ channel blocker

20
Q

Characteristics of Myocardial Infarction

A

Severe pain
Long duration
Other associated symptoms

21
Q

Treatment of STEMI

A

S - Streptokinase
O - O2
N - Nitrate
A - Aspirin
M - Morphine

22
Q

Drugs used in NSTEMI

A

M - Morphine
O - O2
N - Nitrates
A - Aspirin

Pharmacology (14 decks)

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