Exam #3: Cardiovascular

Question 1

Nitroglycerin

Answer 1

anti-ischemic

Question 2

Propranolol

Answer 2

Slows heart rate to decrease oxygen demand of the heart

Question 3

HR in Angina

Answer 3

50-60- heart pumping slower does not need as much oxygen

Question 4

Ranolazine

Answer 4

Treats angina- Can be combined with other drugs
Benefits modest- greater in men
Can prolong QT
Drug interactions with p450 inhibitors like ritonavir, erythromycin, azithromycin, -azole antifungals, and some Ca+ channel blockers
Combine with first line agents in case of inadequate response

Question 5

Afterload

Answer 5

Pressure

Question 6

Preload

Answer 6

Volume- how much the heart fills. End-diastolic volume (EDV) at the beginning of systole. Decreased when veins dilated.

Question 7

Variant angina

Answer 7

Vasospastic angina

Question 8

Unstable angina

Answer 8

Symptoms at rest. New onset exertional. Intensification of symptoms.

Question 9

Treatments for Unstable angima

Answer 9

Anti-ischemic- nitroglycerin
Antiplatelet- aspirin
Anticoagulants- heparin

Question 10

Anti-ischemic therapy

Answer 10

Nitroglycerin- One SL tab every 4 minutes up to 3 doses
Beta Blockers
O2
IV Morphine- calm heart
ACE inhibitor

Question 11

Anti-ischemic therapy for angina

Answer 11

Nitroglycerin- One SL tab every 4 minutes up to 3 doses
Beta Blockers
O2
IV Morphine- calm heart
ACE inhibitor

Question 12

Antiplatelet therapy for angina

Answer 12

Aspirin- indefinite dosing

Question 13

Anticoagulant therapy for angina

Answer 13

Subcutaenous LMW heparin or IV unfractionated heparin

Question 14

Nitroglycerin adverse effects

Answer 14

Headache due to vasodilation of cerebral vessels
Orthostatic hypotension
Reflex tachycardia, blunted with beta blocker

Question 15

Tolerance in nitroglycerin

Answer 15

Can develop rapidly. Use lowest effective dose.

Long acting formulas- 8 drug free hours per day- patch removed for 12 hours at night.