CAD Flashcards
What are modifiable risk factors for CAD?
- smoking cessation
- treat sleep apnea
- weight loss
- correct illnesses worsen symptoms
What is the management of angina pectoris?
4 drug regimen –
daily aspirin + beta blockers + short acting nitroglycerin PRN + daily statin
In CAD, if someone is allergic to aspirin what should you use instead?
clopidogrel
What’s second line for angina pectoris?
anti-anginal = add calcium channel blockers or ranolazine
All CAD patients should be on ___ unless clear contraindications
aspirin
How do you treat severe anginal pectoris symptoms?
revascularization for relief of anginal symptoms in patients on optimal management –
1) percutaneous transluminal coronary angioplasty
2) stent deployment
consider CABG!
How do you treat unstable angina + NSTEMI?
anti-angina – nitrates, beta blockers, morphine
+ anti-clot antiplatelets
+ anticoagulants (heparin, thrombin inhibs)
+ statins
+ ACE-I/ARB if EF<40%
consider PCI
NO THROMBOLYTICS
How do you treat a STEMI?
anti-angina – nitrates, beta blockers, morphine
+ anti-clot antiplatelets
+ anticoagulants (heparin, thrombin inhibs)
+ statins
+ ACE-I/ARB if EF<40%
PCI is PREFERRED method!
thrombolytic therapy
PCI vs thrombolytics
PCI is preferred - 90 min or less, or 2 hours or less when traveling
If cannot – thrombolytics
MONA BASH in Paris (ACS)
M - morphine
O - oxygen
N - nitrates
A - aspirin + ADP inhibitors
B - beta blockers
A - ACE inhibitors
S - statins
H - heparin/anticoagulants
Is aspirin the only first line agent in MI?
No, guidelines call for a P2Y12 inhibitor to be added to aspirin for all patients with STEMI, regardless of whether reperfusion is given, and continued for at least 14 days, and generally for 1 year.
What ADP/P2Y12s are preferred for STEMIs?
ticregalor or prasugrel
What can a dry chronic cough be an ADR of
ACE-I
What anti-HTN is renoprotective?
ACE-I
What anti-HTNs should you not use in renal dysfunction?
diuretics
What should you choose in renal dysfunction for HTN?
ACE-I for renal protection and need baseline labs for close monitoring
What should you choose with a patient w gout for HTN?
CCBs, losartan
What would you choose with osteoporisis or elderly + HTN?
Thiazide diuretics
What would you choose post-MI HTN?
BB or ACE-I
what would you choose for angina or A fib and HTN?
BB or CCB
What anti-HTN do you use with BPH?
alpha blockers
What anti-HTN should you use with DM or CKD?
ACE-I or ARBs
What anti-HTN is reno (nephropathy) and cardioprotective?
ACE-I
