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CVR Biweekly 2 > Rx for Ischemic Heart Disease > Flashcards

Rx for Ischemic Heart Disease Flashcards

(62 cards)

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1
Q

plaque rupture followed by thrombosis leads to

A

MI

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2
Q

main Rx of Prinzmetal angina (supply angina)

A

vascular CCB’s
nitrates

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3
Q

main Rx of stable angina (demand angina)

A

cardiac CCB’s
beta-blockers

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4
Q

main Rx for thromboembolic angina

A

t-PA
PCI
CAGB

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5
Q

PCI

A

percutaneous coronary intervention (stent)

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6
Q

CABG

A

coronary artery bypass graft

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7
Q

Ranolazine

A

Na+ channel blocker used to treat angina

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8
Q

Nicorandil

A

K+ channel opener used to treat angina

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9
Q

Ivabradine

A

funny current (HCN) channel blocker used to treat angina

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10
Q

1st line Rx for all patients with stable angina

A

nitrates
beta-blockers
aspirin

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11
Q

what not to use for vasospasm

A

beta blockers (will exacerbate a1 mediated constriction)

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12
Q

2nd line treatment for stable angina

A

long acting nitrates
Ivabradine
P2Y12 blockers

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13
Q

invasive treatment for stable angina

A

PCI (stents)
CABG

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14
Q

angina at rest; vasospasm

A

Prinzmetal Angina

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15
Q

to diagnose Prinzmetal angina

A

Ergonovine (reproduces chest pain)

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16
Q

to Rx Prinzmetal angina

A

nitrates
CCB (NIFEDIPINE)

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17
Q

Ca2+ channel blocker used to Rx Prinzmetal angina

A

NIFEDIPINE

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18
Q

what is contraindicated in Prinzmetal angina

A

beta-blockers (will exacerbate vasoconstriction)

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19
Q

how to administer nitroglycerin for acute angina attacks

A

sublingual or buccal spray

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20
Q

drug that is 100% destroyed by the liver, so must be administered not in pill form

A

nitroglycerin

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21
Q

how NTG decreases O2 demand

A

venodilation—-decrease EDV—–decrease wall stress

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22
Q

how NTG increases O2 supply

A

coronary artery dilation

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23
Q

some people can develop tolerance to nitroglycerin

A

tachyphylaxis

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24
Q

used for angina attacks and cyanide poisoning

A

Amyl Nitrate

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25
enriched in venous smooth muscle; NO release by this
mtALDH2 (mitochondrial aldehyde dehydrogenase 2)
26
binds to heme proteins; causes vasodilation, decrease in platelet aggregation, helper T cell differentiation
NO
27
long acting nitrate for angina that is not broken down by the liver
ISOSORBIDE MONONITRATE
28
SE of nitrates
profound vasodilation (HA, lightheadedness, palpitations)
29
do not combine nitrates w/ _____
PDE5 inhibitors (hypotension)
30
do not use what if patient already experiencing hypotension
nitrates
31
do not use _____ in RV MI (preload is already very little)
nitrates
32
1st line chronic therapy for IHD (CAD)
beta blockers
33
Metoprolol Esmolol Atenolol
B1 selective inhibitors
34
Propranolol Pindolol Sotalol
B1,B2 blockers
35
MoA of beta blockers
decrease HR, contractility and increase diastolic filling time (O2 demand decreases, O2 supply increases)
36
what can mask the sign of hypoglycemia (tachycardia) in insulin-treated patients
beta blockers
37
SE of beta blockers
asthma erection dysfunction fatigue heart block heart failure masking palpitations (insulin) nightmare
38
The Heart is Blocked1, and then it’s Failin’2, Masking3 palpitations of GLIPIZIDE, INSULIN Asthma4 always Fatigues5 you fast It’s a Nightmare6 – Erection7 doesn’t last!
SE of beta blockers
39
SA nodal cell Ca2+ channel blocker=
decreases HR
40
VERAPAMIL DILTIAZEM
cardiac Ca2+ channel blockers
41
cardiomyocyte Ca2+ channel blocker=
decrease in contractility
42
SE's of cardiac Ca2+ channel blockers
bradycardia constipation edema
43
AMLODIPINE NIFEDIPINE NICARDIPINE
vascular CCB's
44
3 ways vascular Ca2+ channel blockers work
decrease afterload increase O2 supply decrease preload
45
SE's of vascular CCB's
HA flushing ankle edema
46
NCX channel on cardiomyocyte
Na+ in and Ca2+ out
47
blocks Na+ channel in cardiomyocytes and decreases contractility
RANOLAZINE
48
ischemia ____ Na+ influx and ____ Na+ influx in NPX, decreases Ca2+ efflux, increase intracellular Ca2+=
increases, decreases, increase contractility
49
used only as an adjunct drug
RANOLAZINE
50
NICORANDIL
K+ channel opener (difficult to undergo contraction)
51
funny current channel blocker (HCN)
IVABRADINE
52
start with what drugs for anti-anginal therapy
aspirin statin NTG (sublingual) beta blocker
53
add these drugs in later if needed for anti-anginal therapy
CCB's long acting nitrate
54
initial Rx of unstable angina and NSTEMI
(anti-platelet + anti-coagulant) aspirin + ticagrelor AND heparins or bivalirudin
55
Rx of STEMI:
PCI fibrinolytic therapy CABG
56
______Therapy Salvages Most Myocardium
early reperfusion
57
greatest reduction of mortality if reperfusion happens when
w/in 2-3 hours after onset of sx's
58
how many hours after symptom onset is PCI warranted
<12 hours or 12-48 hours
59
meets the patient at the door with these things to control pain and discomfort of STEMI
Morphine O2 Nitroglycerine Aspirin (MONA)
60
reduces pain and reduces risk of reinfarction
METOPROLOL
61
stroke w/in 1 yr intracranial neoplasm recent head trauma active internal bleeding suspected aortic dissection
absolute contraindications to fibrinolytic therapy
62
acute anti-coagulant therapy in STEMI
-RUDINs -PARINs Aspirin

CVR Biweekly 2 (15 decks)

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