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Cardiovascular System > SIHD and Angina Therapy > Flashcards

SIHD and Angina Therapy Flashcards

1
Q

Risk factors of ischaemic heart disease

A 
Hypertension
Smoking
Hyperlipidaemia
Hyperglycaemia
Male
Post-menopausal females
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2
Q

Attacks of angina precipitated by

A

Any stress which increases heart rate, stroke volume or blood pressure

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3
Q

Determinants of oxygen demand

A

Heart rate
Systolic blood pressure
Myocardial wall stress
Myocardial contractility

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4
Q

Determinants of supply

A

Coronary artery diameter and tone
Collateral blood flow
Perfusion pressire
Heart rate (duration of diastole)

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5
Q

Demand ischaemia

A

During stress

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6
Q

Supply ischaemia

A

At rest

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7
Q

Drugs correct supply/demand imbalance by

A

Decreasing oxygen demand and increasing oxygen supply

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8
Q

Ischaemic heart disease caused by

A

Imbalance of oxygen supply/demand

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9
Q

Drugs decrease oxygen demand by

A

Reducing heart rate, myocardial contractility and afterload

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10
Q

Rate limiting drugs

A

Beta blockers
Ivabradine
Calcium channel blockers

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11
Q

Vasodilator drugs

A

Calcium channel blockers

Nitrates

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12
Q

Potassium channel opener

A

Nicorandil

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13
Q

Anti-ischaemic drug for alleviating stable angina symptoms

A

Ranolazine

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14
Q

Anti-platelet drugs

A

Aspirin
Clopidogrel
Tigagrelor

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15
Q

Cholesterol lowering agents

A

Fibrates

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16
Q

Examples of beta blockers

A

Bisoprolol

Atenolol

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17
Q

Function of beta blockers

A

Block sympathetic system by blocking beta 1 and 2 receptors

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18
Q

Contraindications of beta blockers

A 
Asthma
Peripheral vascular disease
Raynauds syndrome
Heart failure
Bradycardia/heart block
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19
Q

Effect of beta blockers

A

Increase diastolic perfusion time
Decrease heart rate, contractility and blood pressure
Increase exercise threshold

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20
Q

Adverse drugs reactions of beta blockers

A 
Tiredness/fatigue
Lethargy
Impotence
Bradycardia
Bronchospasm
Rebound phenomena
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21
Q

Drug-drug interactions of beta blockers

A

Hypotension when used with hypotensives
Bradycardia when used with other rate limiting drugs
Cardiac failure when used with negatively inotropic agent
NSAIDS antagonise antihypertensive actions
Exaggerate hypoglycaemic actions of insulin

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22
Q

Examples of calcium channel blockers with types

A

Diltiazem - rate limiting
Verapamil - rate limiting
Amlodipine - vasodilator

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23
Q

Function of calcium channel blockers

A

Block L-type calcium channels to prevent calcium influx into myocytes and smooth muscle lining arteries and arterioles

24
Q

Effect of rate limiting calcium channel blockers

A

Reduce heart rate and myocardial contractility

25
Q

Effect of vasodilating calcium channel blockers

A

Reduce vascular tone, produce vasodilation and reduce afterload

26
Q

Contraindications of calcium channel blockers

A

Post MI

Unstable angina

27
Q

Adverse drug reactions of calcium channel blockers

A

Ankle oedema
Headache
Flushing
Palpitation

28
Q

Example of nitrovasodilators

A

Glyceryl trinitrate (GTN)
Isosorbide mononitrate
Isosorbide dinitrate

29
Q

Function of nitrovasdilators

A

Relax almost all smooth muscle cells via NO and cGMP

30
Q

Effect of nitorvasodilators

A

Reduce afterload and preload
Relieving coronary vasospasm
Redistributing myocardial blood flow to ischaemic areas

31
Q

Adverse drug reactions of nitrates

A

Headache
Hypotension
GTN - syncope

32
Q

Drug for metabolic modulation

A

Trimetazidine

33
Q

Drug for sinus node inhibition

A

Ivabradine

34
Q

Drug for late sodium current inhibition

A

Ranolazine

35
Q

Drug for preconditioning

A

Nicorandil

36
Q

Second line therapy

A

Nicorandil
Ibabradine
Ranolazine

37
Q

Function of nicorandil

A

Activates ATP sensitive potassium channel, the entry of potassium into myocytes inhibits calcium influx and so negative inotropic action

38
Q

Effect of nicorandil

A

Relaxation of vascular smooth muscle and coronary dilation

Decreases preload and afterload

39
Q

Function of ivabradine

A

Inhibits If pacemaker in the sinoatrial node, slows diastolic depolarisation slip of SA-node

40
Q

Effect of ivabradine

A

Reduces heart rate

41
Q

Ivabradine is used in combination with

A

Beta-blockers

42
Q

Function of ranolazine

A

Inhibits sodium inward current in heart muscle in voltage gated channels leading to reduced intracellular calcium levels

43
Q

Effect of ranolazine

A

Reduced tension in the heart wall

44
Q

Aspirin dosage

A

75-100mg

45
Q

Function of aspirin

A

Inhibits platelet thromboxane production which stimulates platelet aggregation and vasoconstriction

46
Q

Effect of aspirin

A

Stops aggregation of platelets

47
Q

Aspirin is combined with

A

Beta blockers

48
Q

Aspirin and clopidogrel reduce

A

Acute MI and unstable angina mortality, reinfarction

49
Q

Risk of aspirin and clopidogrel

A

GI bleed

50
Q

Function of clopidogrel

A

Inhibits ADP receptor activated platelet aggregation

51
Q

Effect of clopidogrel

A

Prevents platelet aggregation

52
Q

Examples of cholesterol lowering agents

A

Simvastatin
Pravastatin
Atorvastatin

53
Q

Function of cholesterol lowering agents

A

HMG CoA reductase inhibitors

54
Q

First line therapy

A

Beta blockers

55
Q

Patients with stable angina should be considered for treatment with

A

ACE inhibitor

Cardiovascular System (27 decks)

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