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Flashcards in ischemia2 Deck (23)
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1

what is the fastest acting nitrate

nitroglycerin tabs

2

the long acting forms of nitroglycerin is used for what

prophylaxis of angina
treatment of angina

3

what is IV nitroglycerin used for?

treating unstable angina

4

what is preferred for acute stable angina?

short acting nitroglycerins

5

what is isosorbide dinitrate used for (ISDN)

both prophylaxis and treatment

6

what is the active metabolite of isosorbide dinitrate

isosorbide mononitrate ISMN

7

what has a longer half life ISDN or ISMN

ISMN

8

what are the adverse effects of nitrates (7 total)

1. hypotension
2. reflex tachycardia (compensatory mech)
3. syncope
4. headache
5. flushing
6. rash
7. tolerance (side effects are transient)

9

what causes hypotension with nitrates

vasodilation

10

why should nitrates not be taken at night

probly don't need it then and gives down time so tolerance won't build as fast
drug free interval needed with nitrates!

11

what are some contraindications for nitrates

phosphodiesterase 5 inhibitors (PDEI-5)
alcohol use
brain injury or damage

12

what does phosphodiesterase normally breakdown?

breaks down cGMP

13

what are 3 clinical goals with ischemic heart disease

1. balance oxygen supply and demand (tx often decreases demand)
2. restore and maintain coronary lumen
3. modify risk factors (lipids and BP)

14

where else can nitrates work other than venous capacitance (decreased preload)?

dilate epicardial arteries, increasing o2 supply

15

list 3 types of ACS (acute coronary syndromes)

1. unstable angina
2. ST elevation MI
3. nonSTEMI

16

what are 3 facts about chronic choronary artery disease (CAD)/ stable angina

1. angina on exertion (reproduced by work load)
2. relieved by rest or nitroglycerin
3. fixed atherosclerosis in coronary artery

17

what determines systolic ventricular wall stress

afterload/ arterial tone

18

what determines diastolic ventricular wall stress

preload/ venous tone

19

what are 3 determinants of oxygen demand

1. ventricular wall stress
2. heart rate
3. contractility

20

what is inversely related to systemic vascular resistance

coronary blood flow/ oxygen supply

21

when is coronary blood flow/ oxygen supply to the heart greatest

diastole

22

list 3 types of drugs that decrease oxygen demand

1. nitrates
2. calcium channel blockers
3. beta blockers

23

list 3 drugs that increase oxygen supply

1. calcium channel blockers (any vasodilator)
2. statins
3. thrombotics