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Fuchs > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

Nitroglycerin MOA

A

production of NO –> relax smooth muscle
NO –> activates guanylyl cyclase –> cGMP –> myosin light chain phosphatase –> dephosphorylation of myosin light chain –> relaxation
- increase O2 supply: dilate epicardial coronary arteries
- decrease O2 demand: relax veins –> increase venous capacitance –> decrease ventricular preload; pulmonary pressure and heart size decreases, CO reduced

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2
Q

Nitroglycerin SEs

A

orthostatic hypotension, tachycardia, HA
reacts w/ hemoglobin –> methemoglobin –> tissue hypoxia/death
tolerance can develop

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3
Q

Isosorbide dinitrate & Isosorbide mononitrate MOA

A

similar to nitroglycerin, release NO

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4
Q

Sildenafil MOA

A

inhibits phosphodiesterase –> more cGMP –> more relaxation
(Viagra)

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5
Q

CCBs MOA

A 
inhibit L-type Ca2+ channels 
bind to open and inactivated channels --> increase time channels are closed
*decrease/prevent phosphorylation of myosin light chain --> relaxation of arterial smooth muscle; 
decrease afterload (but not preload)
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6
Q

Nifedipine

A

short acting, dihydropyridine, L-type Ca2+ channel blocker

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7
Q

amlodipine

A

long acting dihydropyridine

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8
Q

verapamil

A

non-dihydropyridine (no specific antiadrenergic effects –> peripheral vasodilation, decrease HR)

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9
Q

diltiazem

A

non-dihydropyridine (no specific antiadrenergic effects –> peripheral vasodilation, decrease HR)

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10
Q

verapamil SE

A

constipation

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11
Q

nifedipine SE

A

MI, breast cancer ris, GI bleeding

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12
Q

CCB SEs

A

HA, dizziness, lightheaded, flushing, peripheral edema

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13
Q

B-blocker MOA

A

negative chronotropic and inotropic

reduce angiotensin-II –> decrease vasomotor tone

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14
Q

propranolol

A

non-selective b1 and b2 blocker; decrease HR and CO, inhibit renin, decrease BP

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15
Q

propranolol uses

A

MI, arrhythmia, angina, HTN, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, anxiety, open angle glaucoma

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16
Q

propranolol SEs

A

*contraindicated with asthma/COPD

Bradycardia, cardiac failure, hypotension, bronchospasm, fatigue, depression, increased plasma lipids

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17
Q

metoprolol

A

cardioselective b1 blocker; good for pt’s with asthma, DM, or peripheral vascular disease

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18
Q

atenolol

A

cardioselective b1 blocker; good for pt’s with asthma, DM, or peripheral vascular disease

19
Q

metoprolol metab.

A

metabolized by liver

20
Q

atenolol metab.

A

excreted unchanged in urine and feces

21
Q

Ranolazine MOA

A

reduced cardiac O2 demand

*inhibits funny channels in SA node –> increase duration of diastole/decrease HR

22
Q

Ranolazine uses

A

chronic heart failure with EF <35% in sinus rhythm with HR 70+ , on maximal b-blockers or have contraindications to b-blockers
(off label - stable angina)

23
Q

Ranolazine SEs

A

Bradycardia, HTN, A-fib, heart block, angioedema, rash, phosphenes (light flashes in eyes)

24
Q

Trimetazidine MOA

A

inhibits ketoacyl coenzyme-A thiolase –> decreases fatty acid metabolism, increases glucose metabolism –> more ATP produced

25
Q

Trimetazidine SEs

A

Parkinsonian symptoms, tinnitus, vertigo, restless leg syndrome

26
Q

Canakinumab MOA

A

monoclonal Ab binding interleukin-1 –> reduces inflammation

27
Q

Canakinumab SEs

A

Nasopharyngitis, diarrhea, risk of infection

28
Q

Heparin MOA

A

indirect thrombin inhibitor; binds/activates antithrombin III –> inhibits thrombin, Xa, XIIa, XIa, IXa

29
Q

Rivaroxaban MOA

A

factor Xa inhibitor; does not require monitoring

30
Q

Apixaban MOA

A

factor Xa inhibitor; does not require monitoring

31
Q

Rivaroxaban uses

A

DVT, PE treatment, reduce risk of recurrent; non-valvular A-fib, post op venous thrombus prophylaxes

32
Q

heparin SEs

A

Bleeding, alopecia, allergy, osteoporosis, thrombocytopenia, skin necrosis

33
Q

factor Xa inhibitor SEs

A

Rivaroxaban and Apixaban

Bleeding, edema, bruising, pain, agranulocytosis

34
Q

Hirudin MOA

A

direct thrombin inhibitor

bind catalytic site and substrate regonition site

35
Q

Bivalirudin MOA

A

direct thrombin inhibitor

bind catalytic site and substrate regonition site

36
Q

Argatroban MoA

A

direct thrombin inhibitor

binding only catalytic site

37
Q

Dabigatran

A

direct thrombin inhibitor

38
Q

Warfarin MOA

A

antivitamin K
Inhibits generation of vitamin K hydroquinone necessary for production of prothrombin (II), factor VII, IX, X, and proteins C and S

39
Q

Warfarin SEs

A

*not during pregnancy

Cutaneous necrosis, tissue infarction, bleeding

40
Q

Streptokinase MOA

A

fibrinolytic

promotes activation of plasminogen –> plasmin to induce lysis of thrombus

41
Q

Urokinase MOA

A

fibrinolytic

promotes activation of plasminogen –> plasmin to induce lysis of thrombus

42
Q

tPA MOA

A

fibrinolytic

promotes activation of plasminogen –> plasmin to induce lysis of thrombus

43
Q

Alteplase, Tenecteplase, Reteplase, Lanoteplase

A

tPA

Fuchs (3 decks)

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