CV II

Question 1

used in a preventative setting, best combined with hydralazine. Preferred in African-Americans and ACEI intolerant pts

Answer 1

isosorbide dinitrate

Question 2

nitrate tolerance develops quickly. T/F

Answer 2

TRUE

Question 3

what medications are cautioned when using nitrates that work along the same mechanism

Answer 3

erectile dysfunction drugs

Question 4

most effective drug in preventing MI attacks

Answer 4

beta blockers

Question 5

how do beta blockers work

Answer 5

decrease contractility

Question 6

when are beta blockers contraindicated?

Answer 6

variant angina, increase likelihood of vasospasm

Question 7

calcium channel blocker effects

Answer 7

decrease BP, decrease pain episodes

Question 8

which calcium channel blockers are used in angina

Answer 8

verapamil and diltizium

Question 9

drug for stable angina

Answer 9

beta blockers

Question 10

sodium channel blocker, effective when calcium and beta blockers aren’t

Answer 10

ranolazine

Question 11

ACE inhibitors are contraindicated in __.

Answer 11

pregnancy

Question 12

Adverse effects of niacin?

Answer 12

Cutaneous flushing, hepatotoxicity

Question 13

What cholesterol medication do you give in pregnant women?

Answer 13

bile acid-binding agents

Question 14

How do statins works?

Answer 14

Block cholesterol synthesis

Question 15

What are the adverse effects of statins?

Answer 15

liver damage, myo/rhabdo, contradindicated in teens, pregs, kids

Question 16

What enzymes do you check in statin use?

Answer 16

creatine kinase (muscles), AST & ALT

Question 17

What statin has the least interaction with CYP 3a4/5?

Answer 17

pravastatin

Question 18

What are other uses of statins?

Answer 18

anti-inflammatory, cancer prevention, neurodegenerative diseases

Question 19

What population are fibrates avoided in?

Answer 19

pregnancy, renal/liver failure

Question 20

What the indications of omega-3?

Answer 20

hypertriglyceridemia, prevent MI reoccurence

Question 21

What are the adverse effects of omega3?

Answer 21

mild anticoagulant, diabetic issues, increased risk of prostate cancer

Question 22

What are the first and second treatments of lipid lowering?

Answer 22

statins, bile acid binding, fibrates, sterol absorp inhib, omega 3

Question 23

What is another indciation for for lipid rx?

Answer 23

plaque stabilization

Question 24

What lipid lowering drug caused an increase in cardiovascular deaths?

Answer 24

Torcetrapib

Question 25

How would you treat ACS?

Answer 25

oxygen, pain relief, manage arhythmias, block platelet fx, reperfusion, reduce the size of infarction

Question 26

Reperfusion after ischemia may damage what?

Answer 26

mitochondria, use cyclosporine

Question 27

Stable angina is relieved with ?

Answer 27

rest

Question 28

Describe prinzmetal's angina.

Answer 28

atypical, extreme fatigue with minimal exertion, w/o activity or emotional causes, will wake someone up at night

Question 29

What adjective best describes what is going on with Prinzmetal's angina?

Answer 29

vasospasm

Question 30

What is a risk factor for prinzmetals?

Answer 30

smoking

Question 31

How do you treat prinzments?

Answer 31

calcium channel blocker

Question 32

What is the main problem with stable angina?

Answer 32

coronary vessel stenosis

Question 33

What are the risk factors for stable angina?

Answer 33

anemia, fever, hyperthyroidism, cardiac arrhythmia

Question 34

What are the pharm tx for stable angina?

Answer 34

nitrates, betas, calcium, sodium, hyperlipidemia tx

Question 35

What is a great medication for someone who is intolerant to ACEI to manage CHF?

Answer 35

Isosorbide Dinitrate + Hydralazine

Question 36

How would you prevent nitrate tolerance from developing?

Answer 36

have a nitrate free interval, especially when sleeping

Question 37

What medication is contraindicated with nitrates?

Answer 37

erectile dysfx drugs

Question 38

What is the reason why beta blockers are used with angina?

Answer 38

most effective at preventing attacks b/c it reduces output and afterload

Question 39

What are the 3 cautions with beta blockers?

Answer 39

don't use in LVHF, severe brady, variant angina

Question 40

Ranolazine helps with chronic angina management, what is it and what are adverse effects?

Answer 40

sodium channel blocker, prolongs QT interval, inhibits CYP2d6