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Flashcards in ischemia5 Deck (28)
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1

what are the cardiac effects of beta blockers

decrease oxygen demand
decreasing HR, FOC, and BP

2

what is the resting HR goal?

50 bpm

3

what are the drugs of choice in exercise induced angina

beta blockers

4

bb effect on heart rate can lead to what adverse effect

decrease in perfusion

5

some studies showed beta blockers are better than CCB's with improvement to what

symptomactic improvement

6

why should BB's not be used with nonDHPs

both work at SA and AV nodes

7

what are two common adverse cardiac effects with beta blockers?
how is this avoided?

1. increased end-diastolic volume (increases oxygen demand)
2. increased ejection time (increases oxygen demand)
avoided by concomitant use with nitrates

8

increased end diastolic volume refers to what

more blood in the heart, increasing oxygen demand

9

what are some contraindications with beta blockers

1. bradycardia
2. asthma
3. AV block
4. unstable left ventricular failure
5. raynauds syndrome

10

why can beta blockers impair exercise tolerance?

decrease sympathetic response to exercise; no increase in HR cutting back time someone can exercise

11

what are some adverse effects noted with BB's

1. fatigue
2. erectile dysfunction
3. hypoglycemia
4. impaired exercise tolerance

12

why is hypoglycemia common with BB's

masks the tremors associated with low blood sugar

13

what is the only symptom of hypoglycemia when taking BBs

sweating

14

what are two types of drugs that can be used for variant angina

nitrates and Ca channel blockers

15

what is a second line agent for chronic stable angina

ranolazine (Ranexa)

16

when is ranolazine used

in pt's who experience continued angina despite max medical management and revascularization

17

ranolazine has cardiac effects how?
what is not effected

it decreases oxygen demand

no effect on oxygen supply, HR and BP

18

what are some adverse effects are associated with ranolazine

1. dizziness
2. constipation
3. QT prolongation (K levels off)

19

what should be monitored when on ranolazine

ECG and K levels

20

what drug interactions are important to note with ranolazine

CYP3A4 inhibitors (verapamil and diltiazem)
digoxin
Simvastatin
Digoxin

21

what is the max dose of ranolazine if taking verapamil or diltiazem

500 mg BID

22

what is the max dose of simvastatin given in combo with ranolazine

20mg per day

23

arterial relaxation results in:
a. increased afterload
b. decreased afterload
c. increased preload
d. decreased preload

b. decreased afterload

24

which type of ischemic heart diseased is characterized by plaque rupture but normal tropronin levels?
a. stable angina
b. unstable angina
c. NSTEMI
d. STEMI

b. unstable angina

25

list 3 acute coronary syndromes

1. unstable angina
2. STEMI
3. NSTEMI

26

what is a common adverse effect of sublingual nitroglycerin?
a. bradycardia
b. headache
c. hypertension
d. impotence

b. headache

27

which would cause the greatest increase in oxygen supply to the heart?
a. amlodipine
b. diltiazem
c. verapamil

a. amlodipine

28

how does ranolazine work in myocardial ischemia
a. decrease HR
b. decrease BP
c. Na channel blocker
d. Ca channel blocker

c. Na channel blocker