Angina drugs

Question 1

nitrate vasodilators

Answer 1

NTG

isosorbide dinirrate

Question 2

CaCh Blockers

Answer 2

verapamil
diltiazem
DHPs

Question 3

DHPs

Answer 3

Nifedipeine
amlodipine
felodipine

Question 4

Beta blockers

Answer 4

atenolol
metoprolol
propranolol

Question 5

antiplatelet agents

Answer 5

asiprin
clopidorgrel
reasugrel
IIa/IIIb inhibitors

Question 6

IIa/IIIb inhibitors

Answer 6

abciximab
tirofibran
eptifibatide

Question 7

anticoagulants

Answer 7

heparin

Question 8

chronic coronary artery disease/stable angina

Answer 8

aspirin
beta blockers
nitragtes
CaCh blockers
ACE inhibitors
Ranolazine

Question 9

Acute coronary syndromes

Answer 9

aspirin
beta blockers
nitrates

Question 10

acute w/no ST elevation

Answer 10

heparin + GPIIb-IIIa inhibitors +
ADP R blocker
or
bivalirudin + ADP R blocker

Question 11

STEMI thrombolysis

Answer 11

thrombolytic agent
heparin
ADP R blocker

Question 12

STEMI angioplasty

Answer 12

heparin + GPIIb-IIIa inhibitors +
ADP R blocker
or
bivalirudin + ADP R blocker

Question 13

Post MI management

Answer 13

statin
ACE inhibitor
aldosterone receptor antagonist
aspirin
ADP R antagonist

Question 14

typical angina

Answer 14

induced by exercise
alleviated by NTG
lasts no longer then 15min, 5-15 episodes/week
ST segment depression

Question 15

unstable angina

Answer 15

if symptoms not relieved by 3 NTG tablets w/in 15min should call 911/get to ED asap

Question 16

treatment of typical angina

Answer 16

beta blockers + aspirin (clopidogrel if aspirin not tollerated)
can also add long-acting nitrate
Nitrate for acute attacks
ACE inhib in diabetes or left ventricular dysfunction
long acting DHP when beta blocker contraindicated, not working, or causing intolerable side effects

Question 17

unstable angina treatment

Answer 17

MONA
beta blocker
if beta blocker contrainidcated use verapamil or diltiazem
aspirin + heparin
PCI
cbg
thrombolytics

Question 18

MONA

Answer 18

morphine
O2
NTG
ASA

Question 19

Thrombolytics

Answer 19

alteplase
reteplase
tenecteplase
streptokinase

Question 20

NO

Answer 20

increases cGMP

Question 21

Isosorbide dinitrate

Answer 21

long acting vasodilator

Question 22

adverse effects of vasodilators

Answer 22

headaches
facial flush
dizziness
orthostatic hypotension (worse w/ethanol)

Question 23

nitrate limitations

Answer 23

tolerance
must have 8hr/day drug free
drug holidays

Question 24

nitrates contraindications

Answer 24

in AMI avoid if RV infarction

patients on erectile dysfunction drugs dangerous fall in BP

Question 25

Non DHPs

Answer 25

verapamil diltiazem primarily cardiac effects

Question 26

DHPs

Answer 26

vasodilatory effects Nifedipine amlodipine felodipine

Question 27

CaCh blocker over all effects

Answer 27

cause neg inotropic effect, but concurrent drop in TPR can cause drop in BP activating barorecptor reflex increasing HR

Question 28

non-DHPs actioin

Answer 28

drop rate of SA node depolarization and decrease AV nodal conduction

Question 29

All CCBs

Answer 29

decrease coronary vascular resistance and increase coronary blood flow

Question 30

CCB toxcity

Answer 30

``` excessive vasodilation-dizziness, hypotension, headache, flushing, nausea verapamil- constipation peripheral edema coughing wheezing pulmonary edema coronary steal ```

Question 31

CCB contraindications

Answer 31

nonDHPs cannot be used w/beta blocker ->AV block SA, AV nodal conduction defects systolic pressure <90

Question 32

clopidogrel

Answer 32

slectively inhibits ADPRs irreversible long term inhibition of platelet aggregation useful for unstable angina, prevention and Tx of TIA and stroke stent replacement

Question 33

abciximab

Answer 33

used during angioplasty | monoclonal Ab against GPIIb/IIIaR

Question 34

other angioplasty drugs

Answer 34

tirofiban eptifibatide inhibit ligand binding to IIb/IIIa R

Question 35

acute prophylaxis and Tx of single attacks

Answer 35

NTG

Question 36

maintenance therapy of chronic stable angina

Answer 36

beta blockers, CCBs, or long duration nitrates or combo

Question 37

vasospastic angina

Answer 37

CCB or nitrates