Therapy for stable ischaemic heart disease and angina Flashcards
State some risk factors for stable IHD and angina
Hypertension Smoking Hyperlipidaemia Hypercholesterolaemia Hyperglycaemia Male Post-menopausal females
Describe rebound phenomena
Sudden cessation of beta blockers can precipitate MI by causing tachycardia, increased blood pressure, increased anginal attacks and worsening of HF symptoms
Describe some contraindications for beta blocker use
Asthma (block B2 receptors) Peripheral vascular disease Raynauds syndrome (caused by BB use) HF (effect on sympathetic drive in danger) Bradycardia or heart block
Describe some ADRs associated with beta blockers
Tiredness Fatigue Impotence Bradycardia Bronchospasm
Why shouldn’t you use nifedipine immediate release?
May precipitate MI or stroke due to rapid vasodilation
Describe some ADRs associated with calcium channel blockers
Ankle oedema
Headache
Flushing
Palpitations
How do nitrovasodilators work?
Relax smooth muscle by releasing NO, which then stimulates the release of cGMP, which produces smooth muscle relaxation
How can we prevent tolerance with nitrovasodilators?
Giving asymmetric doses during the day
Using sustained release prep with nitrate free periods
Describe some ADRs associated with nitrovasodilators
Headache
Hypotension
Syncope
Describe a complication associated with nicorandil, a K+ channel opener
Bowel ulceration
Whats considered a low dose of aspirin?
75-150mg
Describe the mechanism of action of aspirin
Inhibits platelet thromboxane production, therefore preventing platelet aggregation and vasoconstriction
What is the most common cause of hospital admission with GI bleeds?
Aspirin use (even at low dose)
Describe the mechanism of action of clopidogrel
Inhibits ADP receptor activated platelet aggregation
Name some ADP receptor inhibitors
Clopidogrel
Prasugrel
Ticagrelor
