HIGH YIELD PHARM SUMMARY POINTS Flashcards
Antianginal that only decreases afterload (SBP) and preload (LV volume)
nitrates
antianginal that
* decreases HR, contractilty, afterload
* increases preload (by decreasing HR & increasing SV)
hint: it is also a HF med
BB
antianginal that
* decreases HR but causes reflex tachy
* decreases afterload
DHP CCB
antianginal that
* decreases HR, contractility, SBP
non-DHP CCB
which class of antianginals has the greatest effect on contractility
non-DHP CCB
which antianginal has NO effect on HR, contractility, afterload or preload? how does it work?
ranolazine
works by blocking late Na+ channel to decrease myocardial tension
2 HF classes that
* decreases afterload & preload and does NOT cause reflex tachycardia
which one affects preload > afterload?
- ace/arb/arni
- AA– affects preload more than afterload
2 HF meds that
* decreases afterload & preload + causes reflex tachycardia
hydralazine/isdn
HF med that
* decreases HR
* increases contractility (the only positive oral chronotrope)
* increases LV volume
digoxin
1st & 2nd line for prinzmetal angina
- CCB
- nitrates
which formulation of NTG is tolerance a concern?
long acting? NTG
how long should you wait between NTG tablets to avoid hypotension
5 mins
3 things to assess antianginal efficacy
- how often SL NTG is being taken
- if theres less episodes
- if theres less or no angina w/ exercise
effects of BB on exercise in SIHD
reduce exercise induced angina when dose is titrated to HR < 100 bpm during exercise
which two CCBs do NOT worsen HF
amlodipine
felodipine
which antianginal has ADR of high dose QT prolongation
ranolazine
angioedema is an ADR of which 3 classes
ACE, ARB, ARNI
bradycardia is an ADR of which 3 classes
BB, nonDHP, digoxin
hyperkalemia is an ADR of which 4 classes
ACE, ARB, ARNI
aldosterone antagonist
peripheral edema is a main ADR of which class
CCB
reflex tachy is an ADR of which 2 classes
nitrates
CCB
which med improves cardiac function in HFrEF by doing these things
- decreases remodeling after MI
- decreases HR
- inhibits NE
- prevents arrhythmiaas
evidence based beta blockers
when would you want to switch from an ACE/ARB to an ARNI?
- stage C
- HFrEF w/ hemodynamic stability, no h/o angioedema
also needs to be able to afford it
when would you want to switch from an ACE/ARB to an ARNI?
- stage C
- HFrEF w/ hemodynamic stability, no h/o angioedema
also needs to be able to afford it
BB is indicated with HF but why would you not want to use it if a patient is hypervolemic?
BB first make it worse before it gets better so you should only start it if the patient is euvolemic
how long is the washout period when switching from ACE to ARNI and why do we have a washout period?
- 36 hrs
- we do it bc of risk of angioedema
- we do NOT need one for ARBs
2 ways that spironolactone is beneficial in HF
- decreases risk for afib
- prevents further cardiac fibrosis
what electrolyte is important to monitor in pt taking digoxin
potassium
which medication requires serum K+ < 5 mEq/L before initiation
spironolactone
4 med classes used in HFpEF
- aldosterone antagonist
- SGLT2 inhibitor
- ARNI
- diuretics in stage C
when do you use milrinone in HF
for palliation of sx in stage D
which HF med does this
blocks PDE + increase cAMP = increase Calcium & contractility
milrinone
Synthetic catecholamine that targets B1 (&B2, A1)
* increases contractility & peripheral vasodilation
dobutamine
