statin drugs are contraindicated in?
liver disease
ATP III guidelines set goals based on?
LDL goal based on calculated CHD risk
statin drug side effects
myalgias
myositis
myopathy
bile acid sequestrant contraindications
familial dysbetalipoproteinemia
TGs > 400
niacin contraindications?
chronic liver disease
severe gout
niacin has two effects?
decrease LDL production
increase HDL
fibric acid derivative two effects?
lower TGs
increase HDL
fibric acid derivative contraindications
severe hepatic or renal disease
pre-existing gallstones
ezetimbe (zetia) MOA
blocks cholesterol transporter, intestinal absorption of dietary and bilary cholesterol
ezetimbe contraindications?
don’t use w/ a statin in active liver disease
2013 AHA/ACC guidelines emphasize?
reduction of atherosclerotic events
statin use for high risk people
atherogenesis is?
an inflammatory process, resulting in a “fatty streak,” the precursor to atherosclerotic plaques
source of vasoconstriction and occlusion?
vulnerable plaques rupture and a clot forms
Acute Coronary Syndromes (3)
unstable angina
NSTEMI
STEMI
EKG findings for UA/NSTEMI?
possible ST depression or T wave elevation
labs to distinguish b/w UA & NSTEMI
elevated CK-MB &/or troponin in NSTEMI- an MI has happened!
most common cause of STEMI?
rupture of a vulnerable plaque causing complete occlusion
EKG/lab findings for STEMI?
ST elevation
elevated cardiac enzymes
tx for STEMI
MONA- Morphine, Oxygen, Nitroglycerin, Aspirin
early revascularization to limit infarct size
B-blockers, Ca2+ channel blockers, ACE inhibitors, statins
tx differences b/w UA/NSTEMI and STEMI? (2)
revascularization early for STEMI, later for UA/NSTEMI
thrombolytics are contraindicated in UA/NSTEMI
post-MI management? (4)
B-blockers, aspirin, ACE-I/ARB for LV dysfunction, cardiac rehab
tx of stable angina? (3)
nitrates
B-blockers
Ca2+ channel blockers
