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Ischemic Heart Disease Flashcards

1
Q

Vasospastic angina is caused by

A

Functional changes in epicardial arteries

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2
Q

Stable angina is

A

Obstructive coronary artery disease

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3
Q

CCS is due to

A

Structural or functional changes in epicardial or cardiac arteries

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4
Q

Treatment method for CCS is

A

Use of antiischemic agents and prevention of adverse cardiovascular events

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5
Q

Antiischemic is same as

A

Antianginal

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6
Q

NO donors are

A

Glyceril trinitrate and isosorbide mononitrate

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7
Q

1st gen BAB

A

Propranalol

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8
Q

Non dihydropiridine calcium channel blockers

A

Verapamil and diltiazem

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9
Q

SA node inhibitor

A

Ivabradine

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10
Q

Late sodium flow inhibitors

A

Ranolazine

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11
Q

Hypolipidemic agents are

A

Atorvastatin, fenofibrate,ezetimibs, evolozumab

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12
Q

Cause of angina

A

Disrupted balance between oxygen supply and oxygen consumption in myocardium

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13
Q

To restore balance

A

Reduce oxygen consumption or increase oxygen supply

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14
Q

Decrease in blood supply can be caused by

A

Increase HR, increase ventricular wall tension, decrease in vessel caliber, decrease in perfusion pressure

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15
Q

Increased oxygen demand can be caused by

A

Increase in HR, ventricular wall tension,heart contractility, increase in preload and afterload

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16
Q

Antiischemic activity is ensured by

A

Reduction of preload , afterload and CMV (all these reduce oxygen demand)

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17
Q

Increase Oxygen supply can be provided by

A

Coronary blood vessel dilation and negative chronotropy (HR)-increase in diastolic filling time)

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18
Q

Nitrates and CCB (dihydropiridine) can also cause

A

Reflex tachycardia like doxazosin

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19
Q

NO provides peripheral arterial dilation in

A

High doses,in low doses only venodilation

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20
Q

NO dilates veins , peripheral arteries and coronary artery so it has

A

Antianginal and hypotensive effect

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21
Q

NO increases

A

cGMP-causes dephosphorylation of myosin light chain-dilation

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22
Q

Fast and short acting organic nitrate

A

Glyceril trinitrate (action onset in 1-3 minutes, duration of action 20 to 30 min)

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23
Q

Use of glyceril trinitrate

A

Angina attack

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24
Q

Long acting isosorbide mononitrate (6-8hr duration of action) use

A

Prevention of angina attack

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25
Nitrates free interval needed
10 to 12 hr
26
SE of glyceril trinitrate
Headache , hypotension, reflex tachycardia
27
Dihydropiridine blockers action
Dilates peripheral arteries and coronary arteries -antianginal and hypotensive effect
28
Use of dihydropiridine blockers
Prevention of angina attack, prevention of vasospastic angina attack, arterial hypertension
29
SE of dihydropiridine blockers
Headache, facial flushing, fatigue, peripheral edema ankles, constipation
30
Non dihydropiridine blockers are
Non vasoselective and has cardiodepressent effect
31
Non dihydropiridine blockers
Reduce CMV,dilates peripheral and coronary artery,prolongs diastole,reduce AV conduction (antiarrhythmic)
32
Use of Non dihydropiridine calcium channel blockers
Prevention of angina attack and vasospastic angina attack
33
CCB suppress
L type voltage dependent calcium channel
34
L type channel have
Slow or prolonged action but activates quickly, slowly inactive
35
NO and PGI2 inhibits
Platelet activation
36
CCB are metabolic poisons because
It increases heart dependence on carbohydrate metabolism than usual fat metabolism+inhibition of insulin release -difficult to use carbohydrates during shock
37
Life threatening bradyarrythmia is caused in interaction between
Beta blockers and verapamil,on parentaral administration can also cause asystole
38
Macrolide antibiotics and grapefruit juice can increase the amount of
Calcium antagonist by inhibing CYP 450 enzyme CYP 3A4
39
Dihydropiridine+ACE inhibitors and/or ARB combined overdose cause
Hypotension
40
Calcium antagonist intoxication cause
Bradycardia and hypotension
41
Dihydropiridine cause ----shock
Vasodilatory shock
42
Verapamil and diltiazem cause ---- shock
Combined vasodilatory and cardiogenic shock
43
Verapamil and diltiazem can also cause
Sinus bradycardia,2nd and 3rd degree AV block, sinus arrest
44
Verapamil affect
PR interval even in Therapeutic dose
45
Verapamil
Prolongs PR interval
46
CCB intoxication non cardiacanifedtations are
Hyperglycaemia, nausea, vomiting, metabolic disorders
47
Hyperglycaemia is due to
Inhibition of insulin release by CCB
48
Atropine can be used
Bradyarrythmia
49
Antidote for CCB toxicity
Calcium chloride or calcium gluconate(improves depression of cardiac contractility)/High dose insulin euglycemic therapy/cardiogenic shock -Epinephrine, Dobutamine, isoproterenol/vasodilatory shock -Norpinephrine and phenylephrine
50
BAB action
Reduce CMV,Prolon diastole,Reduce AV conduction
51
Use of BAB
Prevention of angina attack, antihypertensive
52
SE of BAB
Bradycardia,AV block, Bronchospasm, cold extremities
53
Nitrate action
Increase HR and contractility and decrease Arterial pressure,EDV, ejection time
54
BAB and calcium channel blockers action
Increase ejection time and EDV, decrease HR, contractility,arterial pressure
55
If NO combined with calcium channel blockers or BAB cause
Decrease in HR and Arterial pressure.No change in others
56
Ivabradine acts on -----channel and Inhibits ----
HCN,Na ion flow in 4th phase of AP in SA node
57
Ivabradine only cause decrease in
HR,not change contractility or induce vasoconstriction
58
Use of ivabradin
Prevention of stable angina attack
59
BAB is used only when
There is BAB intolerance or contraindications,as well as in combination
60
SE of ivabradin
Light phenomenon in the retina (photopsy), pronounced bradycardia
61
Ischemia induces accumulation of
Na and calcium ions in myocardium
62
Ranolazine
Blocks na channel, indirectly reduce intracellular calcium ions,so decrease myocardial tension-decresed oxygen consumption and improve perfusion
63
Ranolazine reduces the use of
GTN
64
Atorvastatin action
Inhibition of HMG co A reductase+pleiotropic effects, decrease synthesis of mevalonic acid in liver, Increase LDL receptor and decrease LDL in plasma
65
Atorvastatin uses
Dyslipidemia and prevention of cardiovascular events
66
SE of atorvastatin
Hepatic function impairment (hepatopathy), myopathy
67
Fenofibrate are
Fibric acid derivatives or PPAR alpha agonist
68
Activation of PPAR alpha leads to activation of
Serum lipoprotein lipase -lipolysis-decrease TG and increase LDL receptor
69
PPAR receptor are seen in
Blood vessel endothelium
70
Cholesterol absorption inhibitor is
Ezetimibe
71
Ezetimibe reduce the
Absorption of cholesterol in enterocyte villi by blocking NPC1L1 transport protein,It doesn't affect fat soluble vitamins,bile acids,TG
72
Evolozumab
PCSK9 inhibitor,inhibits LDL receptor degrading enzymes
73
Evolozumab use ----to bond to PCSK9
Human IgG2 monoclonal antibody
74
INOCA (vasospastic angina treatment
Calcium channel blockers,long acting organic nitrates
75
Treatment for microvascular angina with structural changes
BAB,ACE inhibitors,Statins
76
Treatment for microvascular angina vasospastic (functional form)
CCB,Long acting organic nitrates

Pharma 2 (7 decks)

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