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CVR Biweekly 2 > Rx for Ischemic Heart Disease > Flashcards

Rx for Ischemic Heart Disease Flashcards

1
Q

plaque rupture followed by thrombosis leads to

A

MI

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2
Q

main Rx of Prinzmetal angina (supply angina)

A

vascular CCB’s
nitrates

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3
Q

main Rx of stable angina (demand angina)

A

cardiac CCB’s
beta-blockers

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4
Q

main Rx for thromboembolic angina

A

t-PA
PCI
CAGB

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5
Q

PCI

A

percutaneous coronary intervention (stent)

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6
Q

CABG

A

coronary artery bypass graft

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7
Q

Ranolazine

A

Na+ channel blocker used to treat angina

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8
Q

Nicorandil

A

K+ channel opener used to treat angina

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9
Q

Ivabradine

A

funny current (HCN) channel blocker used to treat angina

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10
Q

1st line Rx for all patients with stable angina

A

nitrates
beta-blockers
aspirin

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11
Q

what not to use for vasospasm

A

beta blockers (will exacerbate a1 mediated constriction)

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12
Q

2nd line treatment for stable angina

A

long acting nitrates
Ivabradine
P2Y12 blockers

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13
Q

invasive treatment for stable angina

A

PCI (stents)
CABG

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14
Q

angina at rest; vasospasm

A

Prinzmetal Angina

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15
Q

to diagnose Prinzmetal angina

A

Ergonovine (reproduces chest pain)

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16
Q

to Rx Prinzmetal angina

A

nitrates
CCB (NIFEDIPINE)

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17
Q

Ca2+ channel blocker used to Rx Prinzmetal angina

A

NIFEDIPINE

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18
Q

what is contraindicated in Prinzmetal angina

A

beta-blockers (will exacerbate vasoconstriction)

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19
Q

how to administer nitroglycerin for acute angina attacks

A

sublingual or buccal spray

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20
Q

drug that is 100% destroyed by the liver, so must be administered not in pill form

A

nitroglycerin

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21
Q

how NTG decreases O2 demand

A

venodilation—-decrease EDV—–decrease wall stress

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22
Q

how NTG increases O2 supply

A

coronary artery dilation

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23
Q

some people can develop tolerance to nitroglycerin

A

tachyphylaxis

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24
Q

used for angina attacks and cyanide poisoning

A

Amyl Nitrate

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25
Q

enriched in venous smooth muscle; NO release by this

A

mtALDH2 (mitochondrial aldehyde dehydrogenase 2)

26
Q

binds to heme proteins; causes vasodilation, decrease in platelet aggregation, helper T cell differentiation

27
Q

long acting nitrate for angina that is not broken down by the liver

A

ISOSORBIDE MONONITRATE

28
Q

SE of nitrates

A

profound vasodilation (HA, lightheadedness, palpitations)

29
Q

do not combine nitrates w/ _____

A

PDE5 inhibitors (hypotension)

30
Q

do not use what if patient already experiencing hypotension

31
Q

do not use _____ in RV MI (preload is already very little)

32
Q

1st line chronic therapy for IHD (CAD)

A

beta blockers

33
Q

Metoprolol
Esmolol
Atenolol

A

B1 selective inhibitors

34
Q

Propranolol
Pindolol
Sotalol

A

B1,B2 blockers

35
Q

MoA of beta blockers

A

decrease HR, contractility and increase diastolic filling time (O2 demand decreases, O2 supply increases)

36
Q

what can mask the sign of hypoglycemia (tachycardia) in insulin-treated patients

A

beta blockers

37
Q

SE of beta blockers

A

asthma
erection dysfunction
fatigue
heart block
heart failure
masking palpitations (insulin)
nightmare

38
Q

The Heart is Blocked1, and then it’s Failin’2,
Masking3 palpitations of GLIPIZIDE, INSULIN
Asthma4 always Fatigues5 you fast
It’s a Nightmare6 – Erection7 doesn’t last!

A

SE of beta blockers

39
Q

SA nodal cell Ca2+ channel blocker=

A

decreases HR

40
Q

VERAPAMIL
DILTIAZEM

A

cardiac Ca2+ channel blockers

41
Q

cardiomyocyte Ca2+ channel blocker=

A

decrease in contractility

42
Q

SE’s of cardiac Ca2+ channel blockers

A

bradycardia
constipation
edema

43
Q

AMLODIPINE
NIFEDIPINE
NICARDIPINE

A

vascular CCB’s

44
Q

3 ways vascular Ca2+ channel blockers work

A

decrease afterload
increase O2 supply
decrease preload

45
Q

SE’s of vascular CCB’s

A

HA
flushing
ankle edema

46
Q

NCX channel on cardiomyocyte

A

Na+ in and Ca2+ out

47
Q

blocks Na+ channel in cardiomyocytes and decreases contractility

A

RANOLAZINE

48
Q

ischemia ____ Na+ influx and ____ Na+ influx in NPX, decreases Ca2+ efflux, increase intracellular Ca2+=

A

increases, decreases, increase contractility

49
Q

used only as an adjunct drug

A

RANOLAZINE

50
Q

NICORANDIL

A

K+ channel opener (difficult to undergo contraction)

51
Q

funny current channel blocker (HCN)

A

IVABRADINE

52
Q

start with what drugs for anti-anginal therapy

A

aspirin
statin
NTG (sublingual)
beta blocker

53
Q

add these drugs in later if needed for anti-anginal therapy

A

CCB’s
long acting nitrate

54
Q

initial Rx of unstable angina and NSTEMI

A

(anti-platelet + anti-coagulant)

aspirin + ticagrelor

AND heparins or bivalirudin

55
Q

Rx of STEMI:

A

PCI
fibrinolytic therapy
CABG

56
Q

______Therapy Salvages Most Myocardium

A

early reperfusion

57
Q

greatest reduction of mortality if reperfusion happens when

A

w/in 2-3 hours after onset of sx’s

58
Q

how many hours after symptom onset is PCI warranted

A

<12 hours or 12-48 hours

59
Q

meets the patient at the door with these things to control pain and discomfort of STEMI

A

Morphine
O2
Nitroglycerine
Aspirin
(MONA)

60
Q

reduces pain and reduces risk of reinfarction

A

METOPROLOL

61
Q

stroke w/in 1 yr
intracranial neoplasm
recent head trauma
active internal bleeding
suspected aortic dissection

A

absolute contraindications to fibrinolytic therapy

62
Q

acute anti-coagulant therapy in STEMI

A

-RUDINs
-PARINs
Aspirin

CVR Biweekly 2 (15 decks)

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