Other Caridiac Drugs

Question 0

Isosorbide/ isordil

Answer 0

Long acting nitrate vasodialator
Similar to NTG
For angina and it’s prophylaxis

Question 1

Nitroglycerin(NTG)/ nitrostat

Answer 1

Nitrate vasodialator
Converted to NO in the body, causes vasodialation of the arteries & veins
Anti-angina,, prophylaxis of angina prior to exertion, emergent care of HTN crisis
May cause HA, hypotension, tachycardia, bradycardia, cerebral ischemia, contact dermatitis

Question 2

Morphine sulfate

Answer 2

Analgesic
Opiate receptor agonist, mild vasodialator
For pain relief, esp for unstable angina
Potential for respiratory depression & severe hypotension
Reversed by naloxone

Question 3

Aspirin/ ASA

Answer 3

Anti-thrombotic
Salicylate with anti-inflammatory, analgesic & anti-pyretic properties
Irreversibly inhibits COX- prevents formation of thromboxane A2 & prostaglandins with resultant diminished platelet agg.
Reduces risk of MI in unstable angina or prior infarction. Reduces risk of TIA, or stroke
May cause GI ulceration, bleeding, salicylism w/hyperventilation, tinnitus, dizziness, n/v, inc risk of Reye’s syndrome in children

Question 4

Clopidogrel/ plavix

Answer 4

Anti-thrombotic
Platelet aggregation inhibitor
ADP receptor blockade- diminished platelet aggregation- irreversible for life of platelet
Reduces thrombotic events, dec incidence of MI & stroke
May cause bleeding, nausea, HA, neutropenia
Use cautiously, if at all, in pts using coumadin

Question 5

Abciximab/ reopro

Answer 5

Anti-thrombotic
Glycoprotein IIB/IIA inhibitor
Inhibits receptor sites on platelets- prevents binding of fibrinogen & Von willebrands factor
Reduces risk of MI
Increases bleeding- strictly contraindicated in pts with active internal bleeds, head trauma, or hx of intracranial trauma/bleeds

Question 6

Enoxaparin/ lovenox

Answer 6

Anti-thrombolytic
Low molecular weight heparin
Binds & inactivates FACTOR Xa- prevents conversion of fibrinogen to fibrin
For unstable angina, acute MI, prophylaxis & tx of DVT & PE
Caution for hemorrhage, with pts whom have liver dz
SQ or IV
Reversed with protamine sulfateheparin antagonist

Question 7

Warfarin/ Coumadin

Answer 7

Anti-thrombolytic
anticoagulant
Antagonizes vit. K- interferes with synthesis of vit. K dependent clotting factors(II, VII, IX, X)
Prophylaxis & tx of DVT, PE & thrombo/embolytic events assoc. with atrial fib &/or cardiac valve replacement
CATEGORY X
reversed by vit. K

Question 8

Streptokinase

Answer 8

Throbolytic(clot buster)
Activated plasminogen to plasmin digests fibrin & fibrinogen forming degradation products
Plasmin inactivator- aminocaprotic acid(AMICAR)- counteracts streptokinase- antifibrinolytic
For acute MI, ischemic stroke, acute DVT or PE
Risk of bleeding- enhances aspirin, NSAIDS, heparin, Coumadin, and anti-platlet agents
IV- isolated from streptococcus species- C beta hemolytic strep

Question 9

Treatment of unstable angina:

Answer 9

M- morphine
O- oxygen
N- nitroglycerin
A- aspirin