Myocardial Ischemia Flashcards
Short Acting Nitrates (2)
GTN
Isosorbide dinitrate
Long-Acting Nitrates
Isosorbide mononitrate Beta blocker CCB Ivabradine Ranolazine Nicorandil
Describe symptoms of a acute angina attack
Chest neck and shoulder pain
Describe symptoms of a atypical angina attack
The same as typical angina but with SOB / GI discomfort and nausea
What ate the special consideration for GTN tablet
Sublingual and expires 8 weeks after opening
What do you need to do in an Angina attack?
Take one dose under tongue
Take another dose if that doesn’t work take another dose (after three tries, call 999).
If pain last longer than 15 minutes call 999.
One dose of GTN is equivalent to what in sprays and tablet?
1 dose = 1 tablet and 1-2 sprays
What to do to avoid tolerance in nitrates
Leave patch off overnight
Take second dose after 8 hours not 12
Use MR formulations OD
Treatment in Angina prophlyxasis first line
First option is: Beta Blocker or CCB
OR
Beta blocker + Dihydyradine CCB
If first line treatment for angina prophylaxis does not work what are your second line options
Beta blocker and rate controlling CCB (verapamil / Diltiazem)
If second line treatment for angina prophylaxis does not work what are your third line options
Long-acting nitrates
- Isosorbide mononitrate
- MR isosorbide dinitrate
Side effects of GTN
Vasodilation: headache , flushing , severe hypotension, tachycardia , dizziness , head throbbing.
Why should abrupt withdrawal of nitrates be avoided
Worsens angina
When would you consider secondary prevention in people with angina
People with stroke
T2DM
Patients taking statin
Hypertensive drugs
Side effects of Nicorandil
Ulcers (skin / eye / mucosal area / GI ulceration
QT interval prolongation
