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Pharmacology II > ischemia2 > Flashcards

ischemia2 Flashcards

1
Q

what is the fastest acting nitrate

A

nitroglycerin tabs

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2
Q

the long acting forms of nitroglycerin is used for what

A

prophylaxis of angina

treatment of angina

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3
Q

what is IV nitroglycerin used for?

A

treating unstable angina

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4
Q

what is preferred for acute stable angina?

A

short acting nitroglycerins

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5
Q

what is isosorbide dinitrate used for (ISDN)

A

both prophylaxis and treatment

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6
Q

what is the active metabolite of isosorbide dinitrate

A

isosorbide mononitrate ISMN

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7
Q

what has a longer half life ISDN or ISMN

A

ISMN

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8
Q

what are the adverse effects of nitrates (7 total)

A
  1. hypotension
  2. reflex tachycardia (compensatory mech)
  3. syncope
  4. headache
  5. flushing
  6. rash
  7. tolerance (side effects are transient)
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9
Q

what causes hypotension with nitrates

A

vasodilation

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10
Q

why should nitrates not be taken at night

A

probly don’t need it then and gives down time so tolerance won’t build as fast
drug free interval needed with nitrates!

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11
Q

what are some contraindications for nitrates

A

phosphodiesterase 5 inhibitors (PDEI-5)
alcohol use
brain injury or damage

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12
Q

what does phosphodiesterase normally breakdown?

A

breaks down cGMP

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13
Q

what are 3 clinical goals with ischemic heart disease

A
  1. balance oxygen supply and demand (tx often decreases demand)
  2. restore and maintain coronary lumen
  3. modify risk factors (lipids and BP)
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14
Q

where else can nitrates work other than venous capacitance (decreased preload)?

A

dilate epicardial arteries, increasing o2 supply

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15
Q

list 3 types of ACS (acute coronary syndromes)

A
  1. unstable angina
  2. ST elevation MI
  3. nonSTEMI
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16
Q

what are 3 facts about chronic choronary artery disease (CAD)/ stable angina

A
  1. angina on exertion (reproduced by work load)
  2. relieved by rest or nitroglycerin
  3. fixed atherosclerosis in coronary artery
17
Q

what determines systolic ventricular wall stress

A

afterload/ arterial tone

18
Q

what determines diastolic ventricular wall stress

A

preload/ venous tone

19
Q

what are 3 determinants of oxygen demand

A
  1. ventricular wall stress
  2. heart rate
  3. contractility
20
Q

what is inversely related to systemic vascular resistance

A

coronary blood flow/ oxygen supply

21
Q

when is coronary blood flow/ oxygen supply to the heart greatest

A

diastole

22
Q

list 3 types of drugs that decrease oxygen demand

A
  1. nitrates
  2. calcium channel blockers
  3. beta blockers
23
Q

list 3 drugs that increase oxygen supply

A
  1. calcium channel blockers (any vasodilator)
  2. statins
  3. thrombotics

Pharmacology II (15 decks)

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