Ischemic Heart Disease Drugs (Exam III)

Question 1

Heparin

Answer 1

Anticoagulant; complexes with antithrombin III
Tx: venous thrombosis, PE, MI, unstable angina
Toxicity: bleeding, thrombocytopenia, osteoporosis
Notes: monitor carefully if given with other anticoagulants

Question 2

Enoxaparin

Answer 2

Anticoagulant; low molecular weight heparin
Tx: venous thrombosis, PE, MI, unstable angina
Toxicity: bleeding, thrombocytopenia, osteoporosis
Notes: longer duration than unfractionated heparin; monitor if given w/ other anticoags

Question 3

Clopidogrel

Answer 3

Anti-platelet; Non-competitive P2Y12 receptor antagonist
Tx: venous thrombosis, MI, unstable angina, prevents stent-induced restenosis
Toxicity: Bleeding, itching
Notes: DDIs w/ proton pump inhibitors (omeprazole)

Question 4

Abciximab

Answer 4

Anti-platelet; glycoprotein IIb/IIIa antagonist
Tx: Acute coronary syndrome, prevents restenosis during PCI, unstable angina
Toxicity: Bleeding, thrombocytopenia
Note: DDIs w/ anticoagulants + thrombolytics

Question 5

Acetylsalicylic acid

Answer 5

Anti-platelet; non-selective, irreversible cyclooxyrgenase inhibitor; aka aspirin
Tx: anti-inflammatory, prevention + treatment of arterial thrombosis
Toxicity: GI- and nephro-toxic, hypersensitivity reactions
Notes: DDIs w/ NSAIDs, acetazolamide, corticosteroids, spironolactone

Question 6

Alteplase

Answer 6

Thrombolytic; converts plasminogen to plasmin
Tx: coronary artery thrombosis, PE, ischemic stroke
Toxicity: Bleeding, cerebral hemorrhage
Notes: Analog of endogenous tissue plasminogen activating factor (tPA)

Question 7

Streptokinase

Answer 7

Thrombolytic; converts plasminogen to plasmin
Tx: coronary artery + deep vein thrombosis, PE, ischemic stroke; used in reperfusion therapy
Toxicity: Bleeding, cerebral hemorrhage
Notes: Isolated from streptococci

Question 8

Metoprolol

Answer 8

Beta blocker; beta1 receptor antagonist
Tx: CHF, hypertension, angina
Toxicity: Bradycardia, AV block, CNS sedation
Notes: Fewer bronchial effects

Question 9

Carvedilol

Answer 9

Beta blocker; alpha1 beta receptor antagonist
Tx: CHF, hypertension, angina
Toxicity: Bradycardia, AV block, CNS sedation
Notes: 4 stereoisomers; reduces mortality in HF patients

Question 10

Diltiazem

Answer 10

Ca2+ channel blocker; cardioselective L-type Ca2+ channel blocker
Tx: Angina, arrhythmias, hypertension
Toxicity: Excessive cardiac depression, constipation
Notes: strong cardiac blocking effect, weaker vascular smooth muscle blocking effect relative to dihydropyridines

Question 11

Amlodipine

Answer 11

Ca2+ channel blocker; vascular selective L-type Ca2+ channel blocker
Tx: angina, hypertension
Toxicity: hypotension, flushing, dizziness
Notes: long duration of action relative to nifedipine

Question 12

Nitroglycerin

Answer 12

Vasodilator; nitric oxide donor
Tx: angina, acute coronary syndrome
Toxicity: tachycardia, hypotension
Notes: sublingual = short duration; oral = long duration; decreases preload by dilating veins in the periphery (very little effect on coronary arteries)