drugs for stable coronary disease Flashcards
what are the triggers for stable angina
emotional stress
exercise
types of stable coronary artery disease
stable angina
atypical angina
what is the difference between stable angina and unstable
stable is predictable and goes away with rest , stable is consistent and relieved with medication and also not an emergency.
risk factors for stable coronary diseases
hypertension
smoking
diabetes
hyperlipidaemia
drugs that cause vasodilation of the arteries
nitrates
ccb
potassium channel activators
drugs that are rate limiting
beta antagonists
ccb l type
f type
examples of antiplatelets
aspirin
clopidogrel
ticagrelor
prasugrel
cholesterol lowering drugs
HMG-CoA reductase inhibitors
Fibrates
PCSK-9 inhibitors
what are the side effects of beta blockers
asthma
peripheral vascular disease
fatigue
bradycardia
acute heart failure
examples of cardio -selective beta antagonists
bisoprolol , metoprolol, atenolol
example of non-selective beta antagonists
propranolol
carvedilol
benefits of beta antagonists
they block beta receptors and therefore reduce sympathetic activity , reduce heart rate
benefits of beta blockers
they reduce heart rate
reduce ischaemic events and mortality
action of dihydropyridine
they prevent entry of calcium ions which prevents contraction of smooth muscle, therefore causing vasodilation .
for myocytes same action but reduce contractility of the heart muscle.
action of non-dihydropyridines
reduction of heart rate
examples of dihydropyridine
amlodipine
felodipine
nifedipine
examples of non -dihydropyridine
verapamil
diltiazem
side effects of ccb
oedema ( dhp )
reduced lv function
bradycardia (ndhp)
headache
flushing
action of nitrates
cause vasodilation and therefore reduce preload and workload , and improve coronary blood supply.
side effects
severe aortic stenosis
hypotension
headache
when are vasodilators used
sublingual - during acute attacks
nicorandil vasodilator
they activate ATP sensitive potassium channels which causes an influx of potassium
side effects of potassium channel activator
GI ulceration
second line rate limiting drugs
ivabradine
inhibits the funny channels in the SA node
precaution with ivabradine
sinus rhythm
what are the side effects of ivabradine
bradycardia
sa node disease
sodium channel ranolazine
inhibits late sodium current in myocardial cells
inhibits rapid phase of delayed potassium rectifier curent
slow disease progression drugs
drugs that lower lipid levels by reducing cholesterol production 2or reducing cholesterol absorption
examples of lipid lowering therapies
HMG-CoA reductase inhibitors
fibrates
LDL targets
HMG-CoA inhibitor drugs
atorvastatin
simvastatin
rosuvastatin
fibrates
bezafibrate
fenofibrate
drugs that reduce cholesterol absorption
ezetimibe which inhibits cholesterol uptake in the gut
liver is forced to increase uptake from blood -stream which lowers LDL levels
benefits of lipid lowering therapies
reduce rate of mi
plaque stabilisation
types of antiplatelets
thromboxane inhibitors
p2y12 inhibitors
thromboxane a2 inhibitor
aspirin
inhibits platelet activation via TXA2 pathway
p2y12 inhibitors
clopidogrel
ticagrelor
prasugrel
inhibition of platelet activation via ADP mediated pathway
benefits of aspirin
reduce adverse cardiac events MI /death when utilised correctly
