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cardiovascular system > SIHD and Angina - Therapy > Flashcards

SIHD and Angina - Therapy Flashcards

1
Q

what is Clopidogrel

A

anti platelet agent used in the secondary prevention of atherosclerosis disease and embolic events

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2
Q

beta blockers are reversible antagonists, what receptors do they act on

A

B1 B2

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3
Q

newer drugs that have a similar action to beta blockers can be described as cardioselective in their action, what receptors are they most likely to act on

A

the B1 receptors

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4
Q

what are the two agents that beta blockers block the response to in the body

A

adrenaline
noradrenaline
(the sympathetic system)

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5
Q

beta blockers decrease 3 major determinants of myocardial oxygen demand, what are these 3 determinants

A

heart rate
contractility
systolic wall tension

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6
Q

what is the “Rebound Phenomena” with sudden cessation of beta blockers

A

sudden cessation of beta blocker therapy may precipitate myocardial infarction

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7
Q

what are some contraindications of giving beta blockers

A

asthma
peripheral vascular disease
Raynauds syndrome
heart failure (those patients who are dependant on sympathetic drive)

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8
Q

what is peripheral vascular disease or (PAD)

A

condition in which build-up of fatty deposits in the arteries restricts blood supply typically to the leg muscles

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9
Q

what do negative inotropes do to heart beat

A

weaken the force of the heart beat, weakening the contraction and slowing the hearts rate

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10
Q

what are 3 examples of calcium channel blockers

A

Diltiazem
Verapamil
Amlodipine

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11
Q

what do calcium channel blockers do

A

Prevent calcium influx into myocytes and smooth muscle lining arteries and atrerioles by blocking the L-Type calcium channel

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12
Q

calcium channel blockers reduce afterload, why is this

A

CCB reduce vascular tone and so cause vasodilation causing a reduce in afterload

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13
Q

why should you NEVER use Nifedipine immediate release

A

Evidence that the use of rapidly acting vasodilatatory-CCBs (nifedipine) may precipitate acute MI or stroke

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14
Q

what are some adverse drug reactions of calcium channel blockers

A

ankle oedema
headache
flushing
palpitation

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15
Q

how do nitrovasodilators cause vasodilation

A

The nitrovasodilators relax almost all smooth muscle by releasing NO which then stimulates the release of cGMP whch produces smooth muscle relaxation.

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16
Q

GNT is a nitrovasodilator it is commonly given for the rapid treatment of angina pain by sublingual route, why

A

to avoid first pass metabolism it is given sublingual

17
Q

when are intravenous nitrates used

A

they are the main stay in treatment of unstable angina

18
Q

what is heparin

A

an aticoagulant (blood thinner) that prevents the formation of blood clots

19
Q

what vasodilator is it common to develop a tolerance to

A

nitrates

20
Q

what is an example of a potassium channel blocker

A

Nicorandil

21
Q

what do potassium channel blockers do

A

activate “silent” potassium channels, the entry of potassium into cardiac myocytes inhibits the calcium influx and so has a negative inotrophic effect.

22
Q

why is potassium channel openers now a third line treatment

A

bowel ulceration

23
Q

what is Asprin commonly used as

A

antiplatelet agent

24
Q

what does Ivabradine do

A

If channel inhibitor it slows the diastolic repolarisation slope of the SA node results in a REDUCTION in heart rate

25
Q

aspirin is a potent inhibitor of what

A

platelet thromboxane production

26
Q

what is the most common cause of admission for a GI bleed

A

low dose aspirin

27
Q

HMG CoA Reductase Inhibitors are also commonly known as what

A

statins

28
Q

the adverse drug effects of CCB can referred to as HADFI what does this stand for

A 
H-headache
A-ankle oedema
D-dizzy
F-flushing
I-indigestion
29
Q

the adverse drug reactions of ACEI can be referred to as CART1 what does this stand for

A 
C-cough
A-angiodema
R-renal impairment 
T-taste disturbance
1-1st dose hypotension
30
Q

the adverse drug reactions of BB can be referred to as FIBB what does this stand for

A

F-fatigue
I-impotence
B-bradycardia
B-bronchospasm

31
Q

what are the adverse drug reactions of nitrates

A

headache and hypotension

32
Q

the adverse drug reactions of a-adrenoreceptor anatgonsits can be referred to as H1DD what does this stand for

A

H-headache
1-1st dose hypotension
D-dizzy
D-dry mouth

33
Q

what is the treatment regime for a patient with angina

A 
Beta blocker
Aspirin 
Statin
CCB
Nitrate
Nicorandil
Refer to cardiologist and for possible stenting

cardiovascular system (34 decks)

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