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CV > druggie drugs for angina/UA/NSTEMI/STEMI (week 4) > Flashcards

druggie drugs for angina/UA/NSTEMI/STEMI (week 4) Flashcards

1
Q

list nitrates

A

nitroglycerin

isosorbide dinitrate
isosorbide mononitrate

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2
Q

nitrates MOA

A

stimulates release of NO–> venodilation–> reduced venous return to heart and therefore decreases workload of the heart

vasodilatory effect on coronary vessels to increase perfusion

effect = decreased cardiac workload and decreased O2 demand

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3
Q

indications for nitrates

A

SYMPTOMATIC treatment for acute ischemic episodes

may also be taken for short term prophylaxis

no evidence for improved survival or MI prevention

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4
Q

contraindications for nitrates

A

preload dependent patients (i.e aortic stenosis, RV dysfunction, viagra users)

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5
Q

list Beta blockers

A

metoprolol

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6
Q

beta blocker MOA

A

beta receptor antagonists, blocking both inotropic and chronotropic effects

effect = decrease myocardial O2 demand by slowing HR and contractility

also increases coronary blood flow by increasing diastolic time through slower HR

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7
Q

indications for beta blockers

A

CAD

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8
Q

contraindications for beta blockers

A

obstructive airway disease
LV dysfunction
marked bradycardia or heart block
insulin treated diabetes patients

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9
Q

side effects of beta blockers

A

sexual dysfunction and fatigue

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10
Q

non-DHP calcium channel blockers examples

A

diltiazem and verapamil

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11
Q

non-DHP calcium channel blocker MOA

A

antagonize voltage gated L-type calcium channels

in doing so, they decrease inotropy and slow HR

minor vasodilatory effect

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12
Q

indications for non-DHP calcium channel blockers

A

reserved for those in whom ischemia persists despite beta blockers and nitrate therapies or for those who have contraindications to beta blockers

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13
Q

contraindications for non-DHP calcium channel blockers

A

LV systolic dysfunction

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14
Q

list lipid lowering agents

A
  1. STATINS
  2. niacin
  3. fibric acid derivatives
  4. bile acid binding agents
  5. cholesterol intestinal absorption inhibitors
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15
Q

MOA of statins

A

HMG-CoA reductase inhibitors

inhibit the rate limiting step/enzyme responsible for cholesterol biosynthesis

results in reduction in intracellular cholesterol

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16
Q

MOA of bile acid binding agents

A

increase secretion of bile acids

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17
Q

MOA of nicotinic acid

A

decrease VLDL secretion and LDL formation and increase HDL formation

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18
Q

MOA of fibrates

A

decrease VLDL secretion and increase triglyceride removal

19
Q

anti-platelets examples

A

ASA

20
Q

MOA of antiplatelets

A

irreversible cyclooxygenase inhibition

inhibit platelet synthesis of THROMBOXANE A2, which is a potent mediator of platelet activation

has anti-thrombotic activities through the inhibition of platelet aggregation as well as anti-inflammatory properties

21
Q

indications for anti-platelets

A

CAD

22
Q

counterindications for antiplatelets

A

gastric bleeding
allergies

*should be continued indefinitely in all patients with CAD

23
Q

anti-thrombin agents

A

heparin (unfractionated and LMWHs)

24
Q

MOA of anti-thrombins

A

heparin

bind to and increase potency of ANTITHROMBIN III which inactivates clot-forming thrombin

inhibits COAGULATION FACTOR Xa which slows thrombin formation and therefore reduces further clot development

it is an ANTICOAGULANT

25
Q

indications for heparin/anti-thrombins

A

standard therapy for UA and NSTEMI

decrease likelihood of progression from UA to NSTEMI

adjunctive antithrombotic therapy after fibrinolytics or PCI in STEMI

26
Q

fibrinolytic drugs

A

alteplase tPA
reteplase rPA
tenecteplase TNK-tPA

27
Q

fibrinolytics MOA

A

stimulate the natural fibrinolytic system by transforming the inactive precursor PLASMINOGEN into the active protease PLASMIN which lyses fibrin clots

accelerates the lysis of the occlusive coronary thrombus

28
Q

indications for fibrinolytics

A

in STEMI and ONLY for STEMI

29
Q

contraindications for fibrinolytics

A 
underlying bleeding disorder
active peptic ulcer disease
recent stroke
recovering from recent surgery
pregnancy
intracranial tumor 
suspected aortic dissection 
pericarditis
30
Q

nitroglycerin

A

a nitrate

31
Q

metoprolol

A

beta blocker

32
Q

diltiazem

A

non-DHP calcium channel blocker

33
Q

alteplase tPA

A

fibrinolytic

34
Q

heparin

A

anti-thrombin

35
Q

ASA

A

anti-platelet

36
Q

statins

A

lipid lowering agent

37
Q

niacin

A

lipid lowering agent

38
Q

verapamil

A

non-DHP calcium channel blocker

39
Q

reteplase rPA

A

fibrinolytic

40
Q

fibric acid derivatives

A

lipid lowering agent

41
Q

isosorbide dinitrate or mononitrate

A

nitrate

42
Q

tenecteplase TNK-tPA

A

fibrinolytic

43
Q

bile acid binding agents

A

lipid lowering agent

CV (9 decks)

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