Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PR - CARDIOVASCULAR SYSTEM > STABLE ANGINA > Flashcards

STABLE ANGINA Flashcards

1
Q

Stable angina

A

Predictable chest pain or pressure due physical exertion or emotional stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of stable angina

A
  • chest pain and pressure,
  • pain may radiate neck, shoulders, jaw or arms

symptoms relieved by rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes

A
  • atherosclerotic plaques in the coronary arteries
  • restrict blood flow and oxygen supply to the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Complications

A
  • stroke
  • unstable angina
  • myocardial infarction
    (NSTEMI and STEMI)
  • sudden cardiac death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is stable angina considered an “Acute Coronary Syndrome (ACS)”?

A
  • No
    ACS are a group of conditions describing
  • UNSTABLE angina
  • NSTEMI
  • STEMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is used for immediate relief of angina?

A
  • Sublingual glyceryl trinitrate often given as a spray
  • This can be taken immediately before activities that are known to bring on an attack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How would you instruct a person with angina in a situation where they experience symptoms i.e. chest pain?

A
  • Stop what they are doing and rest
  • Use GTN spray (sprayed under the tongue) or tablets for immediate relief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

GTN administration counselling

A
  • Take the first dose of GTN spray or S/L tablets (both are administered under the
    tongue)
  • Dose to be taken in 5 min intervals
  • Aim spray under the tongue and close mouth immediately after
  • Sit down before using the spray and for a few mins after
  • Learn how to use spray before angina attack, you may need to use it in an emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many doses of GTN during an angina attack should be taken before contacting emergency help

A

2 doses that are 5 minutes apart and with no relief of chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long do the effects of GTN last for

A

20-30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

GTN SE

A

headache, facial flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Long term prevention treatment

A
  1. Beta-blocker (RL-CCB if B-blocker contraindicated)
  2. Beta-blocker + CCB
  3. add Long-acting nitrate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What if both beta-Blockers and CCBs are Cl/intolerated?

A

Monotherapy with long-acting nitrate
- Ivabradine
- Nicorandil
- Ranolazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When would you refer patients with stable angina to a specialist?

A

If a combination of two drugs at max dose fails to control
symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the drugs for secondary prevention of CVD for patients with stable angina?

A
  • Antiplatelet for all patients (Aspirin 75mg Daily)
  • Statins
  • If they have diabetes AND angina, give them ACE inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nicorandil SE

A
  • Headache - very common
  • Vasodilation - dizziness, flushing
  • Ulceration - STOP
17
Q

Interactions

A
  • Drugs that cause hypotension - antihypertensives, PDE5i
  • Drugs that cause ulceration - NSAIDs, CSs
18
Q

What are the cautions and contra-indications for Ivabradine?

A
  • Caution in arrhythmias and
    AF as treatment is ineffective in these patients
  • DO NOT initiate Ivabradine for angina if BPM is less than 70
19
Q

Ivabradine - SE

A
  1. Headache
  2. Vision disorders
  3. Bradycardia
20
Q

Ivabradine - blurred vision

A
  • Blurred vision is very common
  • Phosphenes (brief spots or flashes of light) can occur in the first 2 months and resolve on continuous treatment
  • Advise patients to be careful when driving at night
21
Q

Ivabradine - interactions

A
  1. Inducers or inhibitors of CYP3A4 enzymes
    - Ivabradine are metabolised by CYP3A4 enzymes
  2. Rate-limiting CCBs
    - Can cause severe bradycardia
    - Avoid
  3. Drugs that prolong QT
    interval
    - e.g. amiodarone, erythromycin
22
Q

What are the side effects of Ranolazine?

A
  1. Headache
  2. Gl symptoms - Constipation, N&V
23
Q

Which drugs interact with Ranolazine?

A
  1. Statins
    - Ranolazine prevents clearance of statins
    - Simvastatin max dose with ranolazine is 20mg
  2. CYP3A4 inducers and inhibitors
    - Ranolazine is metabolised by
    CYP3A4 enzymes
24
Q

Which side effect do all the long-acting nitrates have in common?

A

Headache

PR - CARDIOVASCULAR SYSTEM (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions