Anti-Anginal Agents I Flashcards Preview

CV II Exam 3 > Anti-Anginal Agents I > Flashcards

Flashcards in Anti-Anginal Agents I Deck (51)
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1

isosorbide dinitrate

nitrate vasodilator

2

nitroglycerin

nitrate vasodilator

3

non-DHP CCB

verapamil and diltiazem

4

DHP CCB

nifedipine
amlodipine
felodipine

5

-dipines

DHP CCBs

6

clopidogrel

antiplatelet

7

aspirin

antiplatlet

8

heparin

anticoag

9

IIa IIIb inhibitors

abciximab
tirofiban
eptifibatide

10

angina pectoris

Sx of IHD

CAD usually the cause

11

heavy pressing substernal discomfort
-radiates to left shoulder, jaw

sensation of angina

12

typical angina

exertional
-induced by exercise and relieved by rest and/or nitroglycerin

ST segment depression

13

atypical angina

at rest

coronary vasospasm episodically reduced coronary flow

transient ST segment elevation

14

prinzmetal

vasospasm

15

unstable angina

rupture of plaque

abrupt decrease in flow

Sx not relieved by 3 nitro in 15 minutes - call 911

16

angina

loss of O2 supply and demand balance

17

agents that decrease O2 demand

beta blockers
CCBs

18

approach to typical angina

decrease O2 demand

-beta-blocker and aspirin
-or clopidogrel if ASA contraindicated

-beta-blocker and aspirin and long acting nitrate
-sub-lingual nitro - acute attacks

-ACE inhibitors - patients with DM or left vent dysfunction

-long acting CCB - DHPs - if beta blocker contraindicated

19

approach to unstable angina

MONA
-morphine, O2, nitro, ASA

and beta blocker or non-DHP CCB if beta blocker CI'd and no LV dysfunction

PCI
CBG
thrombolytics

20

avoid non-DHP CCB and beta blocker

can cause heart block

21

organic nitrates

prodrugs sources of NO
-decrease preload and afterload

mainly - large veins - decreased preload

also dilate coronary arteries (subendocardial region)

22

mechanism of NTG

increased guanylyl cyclase and cGMP
-leads to de-P of myosin and relaxation of smooth muscle**

23

isosorbide dinitrate

long acting nitrate vasodilator

24

adverse effect of nitrates

headaches, facial flush, dizziness, orthostatic hypotension (alcohol worsens)

25

tolerance of nitrates

effectiveness diminishes significantly with continued use

need to go 8hr drug-free/day

26

patients on erectile dysfunction drugs

contraindicated use of nitrates

sildenafil, tadalafil, vardenafil, cyclic nucleotide

27

right ventricular infarction

contraindication for nitrates

28

verapamil

non-DHP CCB

-cardiac effects

29

diltiazem

non-DHP CCB

-cardiac effects

30

DHPs

CCB with predominant vasodilation effects

nifedipine, amlodipine, felodipine

initial vasodilation with reflex tachycardia