CAD 2 Flashcards
Clopidogrel use
- Acute MI
- Aspirin intolerance
- Recent angioplasty with stenting
Clopidogrel side effect
Thrombotic thrombocytopenic purpura
Ticlopedine side effect
Neutropenia
Prasugrel (antiplatelet med) use in
- Angioplasty & stenting
- All acute MI
- intolerant of aspirin
Prasugrel SE
> 75 increased hemorrhagic stroke
ACE inh. use
- low EF/systolic dysfunction
* regurgitant valvular disease
Statins ( HMG-CoA reductase inhibitors) CAD with
LDL> 100 mg/dl
CAD+ DM treat with statins when
LDL>70
CAD equivalents(LDL>100= statins)
- PAD. • DM
- Carotid disease
- Aortic atherosclerosis
Most common SE of statins
Liver dysfunction => check AST/ALT
Why statins improve mortality
Antioxidant effect on endothelial lining of CA
Niacin SE
- Glucose intolerance
- elev. of uric acid
- itchiness( histamine)
Niacin increase HDL, add to statins if
statins not control enough LDL
Fibric acid derivative
Gemfibrozil
Caution when use fibrates+ statins
Increased myositis
Cholestyramine ( bile acid sequestrant) SE
- Constipation & flatus, abd cramping
* interactions with med in gut
Ezetimibe use if statin doesn’t work
No benefit on mortality( MI, stroke)
Lower mortality the most
Statins
Myositis SE of
Statins
May increase mortality with CAD( inc HR)
Calcium channel blockers
CCB use ( verapamil, diltiazem DO NOT inr. HR)
Asthma ( can’t use bblockers)
- Cocaine induced chest pain
* prinzmetal
CCB ( v/d)
SE of CCB
- Edema • Constipation
* Heart block
CABG
- 3 vessels with > 70 % stenosis each
- L main
- 2v+ DM
