Ischemic Heart Disease/ Acute Coronary Syndrome / Angina

Question 1

Unfractioned heparin

Answer 1

Anti-coagulant

Complexes with antithrombin III

Treats: venous thrombosis, pulmonary embolism, myocardial infarction, unstable angina

Toxicity: bleeding, thrombocytopenia, osteoporosis

monitor carefully if given with other anticoagulants

Question 2

Enoxaparin

Answer 2

Anti-coagulant

Low molecular weight heparin

Treats: venous thrombosis, pulmonary embolism, myocardial infarction, unstable angina

Toxicity: bleeding, thrombocytopenia, osteoporosis

monitor carefully if given with other anticoagulants, longer duration of action than unfractionated heparin

Question 3

Clopidogrel

Answer 3

Anti-platelet

Non-competitive P2Y12 receptors antagonist

Treats: venous thrombosis, prevent stent-induced restenosis, myocardial infarction, unstable angina

Toxicity: bleeding, itching

DDIs with proton pump inhibitors

Question 4

Abciximab

Answer 4

Anti-platelet

glycoprotein IIb/IIIa antagonist

Treats: acute coronary syndrome, prevent restenosis during PCI, unstable angina

Toxicity: bleeding, thrombocytopenia

DDIs with anticoagulants and thrombolytics

Question 5

Acetylsalicylic acid

Answer 5

anti-platelet

non-selective, irreversible cyclooxyrgenase inhibitor

Treats: prevention and treatment of arterial thrombosis, anti-inflammatory

Toxicity: GI- and nephro-toxic, hypersensitivity reactions

DDIs: NSAIDs, acetazolamide, corticosteroids, spironolactone

Question 6

Alteplase

Answer 6

Thrombolytic

converts plasminogen to plasmin

Treats: coronary artery thrombosis, pulmonary embolism, ischemic stroke

Toxicity: bleeding, cerebral hemorrhage

analog of endogenous tissue plasminogen activating factor (tPA)

Question 7

Streptokinase

Answer 7

Thrombolytic

activates tPA

Treats: coronary artery or deep vein thrombosis, pulmonary embolism, ischemic stroke

Toxicity: bleeding, cerebral hemorrhage

isolated from streptococci

Question 8

Beta-blockers

Answer 8

Treat angina

Metoprolol and Carvedilol

See other cards for more info

Question 9

Diltiazam

Answer 9

Ca2+ channel blockers
(verapamil)

cardioselective L-type Ca2+ channel blocker

Treats: angina, arrhythmias, hypertension

Toxicity: excessive cardiac depression, constipation

strong cardiac blocking effect, weaker vascular smooth muscle blocking effect relative to dihydropyridines

Question 10

Amlodipine

Answer 10

Ca2+ channel blockers
(nifedipine)

vascular selective L-type Ca2+ channel blocker

Treats: angina, hypertension

Toxicity: hypotension, flushing, dizziness

long duration of action relative to nifedipine

Question 11

Nitroglycerin

Answer 11

Vasodilator
(isosorbide dinitrate)

nitric oxide donor

Treats: angina, acute coronary syndrome

Toxicity: tachycardia, hypotension

sublingual: short duration, oral: long duration