Drugs for CHD: Part 2

Question 1

Fibric acid medication name

Answer 1

Gemfibrozil (Lopid)

Question 2

Fibric acid is the most effective for…
Little to no effect on….
Can raise..

Answer 2

Lowering VLDL and triglycerides
LDL
HDL

Question 3

Fibric acid increases..

Answer 3

Lipolysis and decreases the production of triglycerides by the liver

Question 4

Adverse effects of fibric acid

Answer 4

GI upset, rashes, gallstones, myopathy, hepatotoxicity (increased if used with statin)

Question 5

Ezetimibe (Zetia)

Answer 5

Blocks absorption of cholesterol in the small intestine

Question 6

Adverse effects of Ezetimibe (Zetia)

Answer 6

Generally well tolerated

Question 7

Ezetimibe (Zetia) drug interactions: statins

Answer 7

Increased risk of hepatotoxicity

Question 8

Ezetimibe (Zetia) drug interactions: fibrates

Answer 8

Increased risk of gallstones

Question 9

Bile Acid sequestrants with zetia

Answer 9

Decrease efficacy of Zetia (if given at the same time)

Question 10

Angina pectoris

Answer 10

Occurs when cardiac oxygen demand is greater than oxygen supply

Question 11

Oxygen demand is determined by…

Answer 11

Heart rate
Contractility
Preload
Afterload

Question 12

Oxygen supply is determined by

Answer 12

Myocaridial blood flow

Question 13

Preload

Answer 13

Pressure stretching of the ventricles

Question 14

Afterload

Answer 14

Pressure that the heart has in order to expel blood

Question 15

Classic stable angina is AKA

Answer 15

Exertional angina

Question 16

Classic stable angina

Answer 16

Occurs with predictable stress or exertion

Question 17

Unstable angina

Answer 17

Occurs with progressive severity

Unpredictable regarding stress / exertion

Question 18

Variant (Prinzmetal, vasospastic)

Answer 18

Occurs at rest (calcium channel blockers)

Question 19

Antianginal therapy

Answer 19

Nitroglycerin 
Beta blocker
Calcium channel blockers
Oxygen 
Morphine

Question 20

What is the most significant anti-chest pain drug?

Answer 20

Nitroglycerin

Question 21

Morphine

Answer 21

Decreases anxiety of person and decrease oxygen demands of the heart

Question 22

Nitroglycerin (nitrates)

Answer 22

Improves the balance of myocardial oxygen supply and demand - relaxation of smooth muscle
Reduces myocardial ischemia

Question 23

Nitroglycerin: relaxation of smooth muscle

Answer 23

Venous dilation
Coronary vasodilation
Arterial vasodilation

Question 24

Adverse effects of nitrates

Answer 24

Headache
Orthostatic hypotension
Syncope
Reflex tachycardia

Question 25

What is the cause of Nitroglycerine's adverse effects?

Answer 25

Does not only vasodilator to the heart but also to the whole body

Question 26

Syncope

Answer 26

- feeling faint b/c blood is not able to be pushed to head when they stand up

Question 27

Nitrate drug interactions: hypotensive drugs

Answer 27

Caution with beta blockers, vasodilators, and calcium channel blockers

Question 28

Nitrate drug interactions: erectile dysfunction drugs

Answer 28

Absolutely contraindicated with Viagra, Cialis and Levitra (Also vasodilate) -Tolerance can develop

Question 29

Nitroglycerine is given...

Answer 29

Sublingually (b/c of extensive first pass effect)

Question 30

Nitroglycerin must be stored...

Answer 30

Away from heat, humidity and light

Question 31

Nitroglycerin should be replaced...

Answer 31

Every 6 months to maintain potency

Question 32

Nitroglycerin can be given...

Answer 32

Every 5 minutes | Nothing beyond 3 (take one, sit down and see if chest pain gets better)

Question 33

Ntg (Nitro-dur) transdermal

Answer 33

Apply patch to clean, dry skin | Rotate to prevent skin irritation

Question 34

Tolerance to nitroglycerin can be prevented by...

Answer 34

Removing patch nightly (8-12 hour nitrate free period)

Question 35

When you use paste, you always have to...

Answer 35

Have gloves on

Question 36

Beta blockers

Answer 36

Reduce chest pain by decreasing heart rate and cardiac contractility (reduce oxygen demand of the heart)

Question 37

Adverse effects of beta blockers

Answer 37

Bradycardia Dizziness Orthostatic hypotension GI upset

Question 38

Calcium channel blockers..

Answer 38

Relax vascular smooth muscle Relax coronary artery spasm Relax peripheral arterioles Slows AV conduction

Question 39

Adverse effects of calcium channel blockers

Answer 39

Bradycardia Orthostatic hypotension Constipation Reflex tachycardia