Drugs for Angina Pectoris 2

Question 1

beta blocker drugs

Answer 1

Propranolol (Inderal), metoprolol (Lopressor), carvedilol (Coreg)

Question 2

beta blockers decrease cardiac oxygen demand by

Answer 2

blocking Beta 1 receptors from norepinephrine and epinephrine

Question 3

result of beta blockers**

Answer 3

decrease heart rate, decrease blood pressure, decrease oxygen demand and oxygen consumption

Question 4

adverse effects of beta blockers

Answer 4

Bradycardia; Decreased AV conduction; Reduction of contractility; Asthmatic effects; Caution with diabetes; Insomnia; Depression; Bizarre dreams; Sexual dysfunction

Question 5

bradycardia adverse effect

Answer 5

speed up the heart too much

Question 6

reduction of contractility adverse effect**

Answer 6

not going to pump as hard (left ventricle); negate autotropic effect

Question 7

asthmatic adverse effects if not

Answer 7

a selective beta blocker

Question 8

caution of beta blockers with

Answer 8

diabetes - hides symptoms of hypoglycemia

Question 9

calcium channel blocker drugs

Answer 9

verapamil (Isoptin, Calan) diltiazem (Cardizem)

Question 10

which calcium channel blocker do you see most often

Answer 10

diltiazem (Cardizem)

Question 11

diltiazem (Cardizem)

Answer 11

see to decrease HR **; decrease number of times muscle contracts and to relax vessels; so vasodilating effect

Question 12

calcium channel blockers do what

Answer 12

• Block calcium channels in vascular smooth muscle (Vascular Smooth Muscle)-primarily on the coronary vessels and in the AV node

Question 13

calcium channel blockers increase

Answer 13

blood flow to the heart

Question 14

calcium channel blockers decrease

Answer 14

impulses through the AV node

Question 15

calcium channel blockers used to decrease

Answer 15

decrease workload of heart and slow the heart rate

Question 16

calcium channel blockers used to treat

Answer 16

HTN, atrial fibrilliation, stable and variant angina

Question 17

CA blockers used for

Answer 17

hypotension; atrium fiber latrim (decrease impuluses through AV node); stable and varient angina (will open up vessels)

Question 18

“dipines”

Answer 18

peripheral vessel CA channel blockers - block CA from vessels = expand/vasodilate; also treats high bp or treatment of afib

Question 19

dipines examples

Answer 19

Amlodipine (Norvasc); Felodipine (Plendil)**; Nifedipine (Procardia XL, Adalat); Nicardipine (Cardene); Isradipine (Dynacirc); Nisoldipine (Sular); Clevidipine (Cleviprex) for IV use vs. esmolol or IV nicardipine)

Question 20

Clevidipine (Cleviprex) for

Answer 20

IV use vs. esmolol or IV nicardipine

Question 21

dipine MOA

Answer 21

Reflex tachycardia; Hypotension (increased with Beta blockers); Bradycardia; Heart failure; AV block

Question 22

Verapamil side effect—

Answer 22

significant constipation

Question 23

Cardizem (diltiazem) side effect—

Answer 23

less significant constipation than Verapamil

Question 24

Dipines side effects

Answer 24

significant peripheral vasodilation with peripheral edema (swollen feet—pedal edema); headaches; hypotension;

Question 25

probably with a Ca channel blocker will have

Answer 25

constipation and swollen feet

Question 26

antiplatelet drug ex.

Answer 26

aspirin (anti inflammatory)

Question 27

antiplatelet MOA

Answer 27

inhibits production of thromboxane, which under normal circumstances binds platelet molecules together to repair damaged blood vessels.

Question 28

antiplatelets also block **

Answer 28

action of cyclo-oxygenase, an enzyme necessary for thromboxane and prostaglandin production.

Question 29

cyclo-oxygenase,

Answer 29

clumping up of platelets

Question 30

if chest hurts then

Answer 30

CHEW aspirin (525mg) on the way to the hospital

Question 31

studies show that aspirin will

Answer 31

prevent death of tissue

Question 32

aspirin used long term

Answer 32

low doses to prevent heart attacks, strokes, and blood clot formation in people at high risk.

Question 33

Aspirin may be given immediately

Answer 33

after a heart attack to decrease muscle damage or of the death of cardiac tissue.

Question 34

Aspirin is indicated for all patients with

Answer 34

acute CAD regardless of age and should be continued indefinitely in all patients with documented CHD; 81.5 mg per day for chronic use

Question 35

Recommended dosage in acute setting is

Answer 35

160-325 mg— CHEW it!

Question 36

Recommend low-dose ASA –

Answer 36

men age 45-79; women age 55-79

Question 37

aspirin is both **

Answer 37

anitplatelet and antiinflammatory

Question 38

Risk of bleeding with aspirin is usually offset by –

Answer 38

aspirin’s cardiovascular benefits

Question 39

men do better with MI then women

Answer 39

bc women’s coronary arteries are smaller so harder to treat

Question 40

For men? 1° benefit –

Answer 40

is to prevent MI

Question 41

For women? 1° benefit is to

Answer 41

prevent ischemic stroke

Question 42

Make sure BP is controlled to reduce risk –

Answer 42

of hemorrhagic stroke

Question 43

Take regular ASA with –

Answer 43

food or use enteric-coated aspirin IF needed to reduce stomach irritation (only helps the local effects, does NOT reduce risk of bleeding)

Question 44

aspirin and ibuprofen

Answer 44

Take aspirin first thing in a.m. ; Take ibuprofen 2 hours later

Question 45

Use Aleve (naprosyn) if

Answer 45

an NSAID is required on a daily basis

Question 46

ASA also reduces risk of

Answer 46

colorectal cancer occurrence and recurrence Adverse Effects of ASA

Question 47

The main undesirable side effects of aspirin are

Answer 47

gastrointestinal ulcers, stomach bleeding, and tinnitus, especially in higher doses.

Question 48

In children and adolescents, aspirin is

Answer 48

no longer used to control flu-like symptoms or the symptoms of chickenpox or other viral illnesses, owing to the risk of Reye’s syndrome

Question 49

Reye’s syndrome

Answer 49

neurological disorder that can cause permanent damage