Ischemic Heart Disease Drugs

Question 1

Nitrates

Answer 1

Pmcol: Conversion to NO -> venous vesodilation (some coronary)
Indications: First line acute treatment (long acting for prophylaxis)
Adverse Effects: HA, flushing, hypotension/light headedness, reflex tachycardia, contact dermatitis
Contraindications: hypotension
Other: Nitrate tolerance (need nitrate free intervals)

Question 2

B-blocker

Answer 2

Pmcol: Competitive B-receptor antagonists
Indications: Ischemia prophylaxis, post acute MI, HF, first line HTN
Adverse Effects: Initial worsening HF, fatigue, lethargy, depression, nightmares, hypotension, bradycardia, AV block, bronchospasm, PVD, sexul dysfunction, masked hypoglycemia
Contraindications: Asthma, bradycardia, AV block, severe PVD, Prinzmetal’s angina

Question 3

Ca Channel Blockers

Answer 3

Pmcol: Competitive antagonist of L-types
Indications: Prophylaxis of coronary ischemia
Adverse Effects: P450 interactions, constipation, HA, flushing, dizziness, hypotension, CHF, bradycardia, heart block, peripheral edema
Contraindications: hypotension, heart block, CHF

Question 4

All Patients

Answer 4

ASA, Statin, ACE-I and nitrates as needed