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THERAPEUTICS > SIHD > Flashcards

SIHD Flashcards

1
Q

what is ischemia

A

restriction in blood supply

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2
Q

Printzmetals angina is what kind of ischemia?

A

supply ischemia

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3
Q

chronic stable angina is what kind of ischemia

A

demand ischemia

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4
Q

unstable angina is what kind of ischemia?

A

supply ischemia

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5
Q

what two things lead to ischemia?

A

decreased coronary blood flow and increased oxygen consumption

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6
Q

what things cause increased oxygen consumption?

A

increased HR, preload, afterload, and contractility

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7
Q

what is preload?

A

volume of blood in ventricles at the end of diastole

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8
Q

what is afterload?

A

pressure left ventricle must overcome to eject blood during contraction

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9
Q

if we decrease contractility we decrease what

A

oxygen consumption

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10
Q

if we decrease HR we decrease/inc what?

A

decrease O2 consumption and increase coronary perfusion

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11
Q

if we decrease preload what happens

A

decrease o2 consumption, increase in myocardial perfusion

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12
Q

how do we decrease preload?

A

venodilation

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13
Q

how do we decrease afterload?

A

arterial dilation

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14
Q

what happens if we decrease afterload?

A

decrease in o2 consumption

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15
Q

BP and A1c goals

A

<130/80
<7%

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16
Q

ASA mechanism of action

A

irreversible inhibition of COX1 and blocking TXA2 synthesis

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17
Q

what does COX-1 do

A

increase platelet aggregation and vasoconstriction

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18
Q

what does COX-2 and prostacyclin do

A

inhibit aggregation and has vasodilation

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19
Q

P2Y12 inhibitors MOA

A

inhibit ADP induced platelet aggregation with no effect on TXA2, inhibits adenyl cyclase

20
Q

ASA adverse effects

A

GI bleed, brain bleed

21
Q

clopidogrel adverse effects

A

bleeding, diarrhea, rash

22
Q

prasugrel side effects

A

bleeding, diarrhea, rash

23
Q

ticagrelor side effects

A

bleeding, bradycardia, heart block, dyspnea

24
Q

elective PCI pts antiplatelet therapy

A

ASA indefinitely
low risk bleeding: clopidogrel 6 months
high risk bleeding: DAPT 1-3 months, P2y12 till 12 months

25
Q

CABG pts antiplatelet therapy

A

DAPT 12 months

26
Q

which drug must ASA dose be below 100 mg

A

ticagrelor

27
Q

how does colchicine reduce inflammation

A

reduction in IL-1b and IL-18

28
Q

nitrates effect on O2 demand

A

increase HR, decrease preload and afterload

29
Q

beta blockers effect on O2 demand

A

decrease HR, decrease contractility, decrease afterload, increase preload (LV volume)

30
Q

DHP effect on O2 demand

A

increase HR, decrease contractility, decrease preload and afterload

31
Q

non DHP effect on O2 demand

A

decrease HR, decrease contractility, decrease preload and afterload

32
Q

nitrates MOA

A

nitric oxide releasers / donors, activators of guanyl cyclase

33
Q

ionotropy is what

A

contractility

34
Q

chronotropy is what

A

heart rate

35
Q

beta blockers moa

A

competitive reversible inhibition of beta stimulation by catecholamines

36
Q

beta blockers side effects

A

bradycardia, sinus arrest, AV block, fatigue, depression, broonchoconstruction

37
Q

DHPS have much more ___ selectivity than non DHP

A

vascular

38
Q

verapamil brands

A

isoptin, calan

39
Q

diltiazem brands

A

cardizem, dilacor, tiamate

40
Q

nifedipine brands

A

procardia, adalat

41
Q

DHP side effects

A

hypotension, flushing, headache, dizziness
peripheral edema
reflex adrenergic

42
Q

non DHP side effects

A

hyptension, flushing, headache, dizziness
constipation
av block, bradycardia

43
Q

ranolazine MOA

A

inhibit late inward Na current to decrease Ca influx

44
Q

what drugs to not use with ranolazine

A

-onazole, non DHP, carbemazepine

45
Q

ranolazine adverse effects

A

constipation, nausea, dizziness, headache

46
Q
A

THERAPEUTICS (8 decks)

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