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NAPLEX > Ischemic Heart Disease & Acute Coronary Syndromes > Flashcards

Ischemic Heart Disease & Acute Coronary Syndromes Flashcards

1
Q

Define stable angina

A

also known as stable ischemic heart disease
associated with predictable chest pain, often brought on by exertion or emotional stress and relived within minutes by rest or with nitroglycerin

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2
Q

Define unstable angina

A

type of acute coronary syndrome

the chest pain increases (in frequency or duration) and is not relieved with nitroglycerin or rest

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3
Q

Define prinzmetal’s angina

A

chest pain due to vasospasm of coronary arteries; it is unpredictable and can occur at rest but is not usually associated with underlying CAD

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4
Q

Define acute coronary syndrome

A

acute chest pain that is severe and not relieved by rest or nitroglycerin; acute medical care is needed (includes UA, NSTEMI, STEMI)

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5
Q

Define silent ischemia

A

transient myocardial ischemia without symptoms of chest pain

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6
Q

common cause of stable angina or stable ischemic heart disease

A

atherosclerosis or CAD

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7
Q

recommended antiplatelet for IDK

A

ASA

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8
Q

What is the first line anti-anginal for IHD

A

beta-blockers

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9
Q

ASA MOA

A

binds irreversibly cyclooxygenase-1 and 2 (COX 1 and 2) enzymes which results in decreased prostaglandin and thromboxane A2 production. TXA2 is a potent vasoconstrictor and inducer of platelet aggregation.

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10
Q

Clopidogrel MOA

A

prodrug that irreversibly inhibits P2Y12 ADP-mediated platelet activation and aggregation

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11
Q

which cyp enzyme converts clopidogrel from its prodrug

A

Cyp2C19

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12
Q

DAPT for bare metal stent

A

1 month

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13
Q

DAPT for drug-eluting stent

A

6 months

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14
Q

DAPT post-CABG

A

12 months

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15
Q

Which drug should be avoided in prinzmetal’s angina

A

BB

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16
Q

Ranolazine MOA

A

selectively inhibits the late phase Na current and decreases intracellular Ca; may decrease myocardial oxygen demand by decreasing ventricular tension and O2 consumption

17
Q

Nitroglycerin CI

A

concurrent use with PDE-5 inhibitor

-cause a decrease in BP

18
Q

What is required when using a long acting nitrate to reduce tolerance

A

10-12 hour nitrate-free period

19
Q

Define ACS

A

results from plaque buildup in the coronary arteries that causes sudden, reduced blood flow and an imbalance between myocardial oxygen supply and demand

20
Q

3 things that ACS encompasses

A

NSTEMI
STEMI
UA

21
Q

classic symptoms of ACS

A

chest pain lasting > 10 min
severe dyspnea
diaphoresis
pain can radiate to the arms, back, neck, jaw, epigastric

22
Q

treatment for ACS

A 
MONA-GAP-BA
morphine
oxygen
nitrates
asa

Gpllb/llla antagonist
anticoagulants
P2Y12 inhibitors

beta blockers
acei

23
Q

Define PCI

A

coronary revascularization procedure that involves inflating a small balloon inside a coronary artery to widen it and improve blood flow. Usually metal mesh, called a stent is placed into the artery afterward to keep the artery owpen

24
Q

MOA of morphine in ACS

A

produces arterial and venous dilation: leading to a decrease in myocardial O2 demand; provides pain relief

25
Q

List GPllb/llla receptor antagonists (3)

A

abciximab
eptifibatide
trofiban

26
Q

MOA GPllb/llla receptor antagonists in ACS

A

block fibrinogen from binding to the GPllb/llla receptors on platelets preventing platelet aggregationf

27
Q

List P2Y12 inhibitors

A

clopidogrel
prasugrel
ticagrelor

28
Q

Which P2Y12 inhibitors are irreversible

A

clopidogrel

prasugrel

29
Q

CI to prasugrel

A

history of TIA or stroke

30
Q

Fibrinolytics MOA

A

cause fibrinolysis (clot breakdown) by binding to fibrin in a thrombus (clot) and converting entrapped plasminogen to plasmin.

31
Q

Fibrinolytics are only used for what

A

STEMI

32
Q

time to deliver a PCI

A

90 minutes door-to-balloon-time

120 minutes of first medical contact

33
Q

When should a fibrinolytic be administered

A

within 30 minutes of hospital arrival

34
Q

List fibrinolytics (3)

A

alteplase
tenecteplase
reteplase

35
Q

CI to finbrinolytics

A

history of recent stroke
prior ICH
severe uncontrolled HTN

NAPLEX (65 decks)

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