pharmacology of stable coronary disease

Question 1

benefits of beta blockers

Answer 1

reduces myocardial workload
decreases contractility
decreases systolic wall tension- improve relaxation
increases diastolic perfusion time
reduces rate of ischaemic events and mortality

Question 2

mechanisms of action of calcium channel blockers

Answer 2

prevents calcium influx into myocyte and smooth muscle by blocking L type channels.

Question 3

name a few calcium channel blockers

Answer 3

amlodipine, felodipine, nifedipine

Question 4

name a few calcium channel blockers

Answer 4

amlodipine, felodipine, nifedipine

Question 5

side effects of calcium channel blockers

Answer 5

brachycardia, oedema, hypotension, headache, flushing

Question 6

benefits of calcium channel blockers

Answer 6

slows heart rate, reduce contractility, reduce after load, increase diastolic perfusion time, ini

Question 7

mechanism of vasodilators

Answer 7

nitric oxide relaxes smooth muscle, non selective

Question 8

benefits of vasodilators

Answer 8

reduce preload and afterloac therefore reduces myocardial workout, improves coronary flow, doesn’t reduce mortality

Question 9

what is nicorandil

Answer 9

(vasodilator) activates ATP sensitive potassium channels causing potassium influx can lead to GI ulcerations

Question 10

what is ivabradine

Answer 10

inhibits the funny channels in the sinoatrial node. only works when patient is in the sinus rhythm

Question 11

what is ranolazine

Answer 11

(sodium channel inhibitor) inhibits late sodium current in myocardial cells, rapid delay of potassium rectifier current.

reduces oxygen demand due to reduced wall stress

Question 12

name 4 anti platelet drugs

Answer 12

aspirin, clopidogrel, ticagrelor, prasugrel

Question 13

NSTEMI

Answer 13

predictable, plaque rupture but blood still flows and you get a ST depression

Question 14

STEMI

Answer 14

complete blockage, ST elevation and rise in troponin

Question 15

how do you increase myocardial oxygen supply

Answer 15

coronary vasodilation, correct hyperaemia, stop platelet aggregation

Question 16

how do you decrease myocardial oxygen demand

Answer 16

reduce heart rate, reduce blood pressure, reduce preload, reduce contractility and wall stress

Question 17

initial management of STEMI and unstable angina

Answer 17

morphine, oxygen, nitrates, aspirin, clopidogrel

Question 18

antiplatelets and their agents

Answer 18

aspirin- thromboxane A2 inhibitor (inhibits platelet activation)
clopidogrel/ticagrelor/prasugrel (inhibits ADP activation of PY212 receptor)

Fondaparinux ( converts fibrinogen to fibrin) to reduce clots

Question 18

antiplatelets and their agents

Answer 18

aspirin- thromboxane A2 inhibitor (inhibits platelet activation)
clopidogrel/ticagrelor/prasugrel (inhibits ADP activation of PY212 receptor)

Fondaparinux ( converts fibrinogen to fibrin) to reduce clots

Question 19

fibrin specific agents

Answer 19

altepase, tenecteplase
All catalyse conversion of plasminogen to plasmin in the absence of fibrin

Question 20

non- fibrin specific agents

Answer 20

streptokinase- low bleeding risk catalyse systemic fibrinolysis