Stable Angina - Quiz 4 Flashcards
Chest pain, pressure, and tightness that is caused by ischemia of the heart muscle or spasm of the coronary arteries
What is the difference between stable and unstable angina?
Stable: predictable from exertion or emotional stress that is relieved by rest or SA nitroglycerin
Unstable: ACS not relieved by nitro or rest
What causes chest pain?
Imbalance between myocardial oxygen demand and supply -> increased heart rate, contractility, or left ventricular wall tension
How do we diagnose angina?
- Cardiac stress test/imaging
- CHitory or physical
- CBC, CK-MB, troponins, aPTT, PT/INR, lipid panel, glucose
- ECG
- Cardiac cath/angiography
Non pharm for angina?
- Heart healthy diet
- BMIL 18.5-24.9
- Waist circumference <35 (females), <40 (males)
- Aerobic activity
- Limit alcohol and smoking
- Avoid chronic NSAID use
What is the treatment for stable angina?
- Antiplatelet (secondary prevention)
- Antianginal (to reduce chest pain)
What is the recommended antiplatelet? Alternative?
Aspirin; Clopidogrel
Treatment regimen for angina?
- Antiplatelet and antianginal
- Blood pressure
- Cholesterol and smoking cessation
- Diet and diabetes
- Exercise and education
Drugs used as antianginal maintenance?
- Beta blockers
- CCBs
- LA nitrates
Drugs used for angina symptoms?
SA and SL nitroglycerins or TL spray
MOA of aspirin?
Irreversibley inhibits COX1 and 2 decreasing PG and TXA2 (potent vasoconstrictor and iducer of platelet aggregation)
MOA of Clopidogrel?
Prodrug that irreversiblely inhibits P2Y12 ADP mediated platelet aggregation and activation
Aspirin
Bayer, Bufferin, Ecotrin
Dosing of Aspirin?
75-100 mg QD
CI of aspirin?
Children -> Reyes syndrome
Other NSAIDs or salicylate allergies
ADR of aspirin
- Bleeding
- Tinnitus (OD)
- Dyspepsia
- Heatburn
What type of aspirin is used for ACS
Non-enteric coated chewables
* If EC aspirin is only available it should be chewed (325mg), they do not have rapid onset
How to prevent GI bleed from aspirin?
PPIs