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Pharmacy > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

types of ischemic heart disease

A 
Angina Pectoris
Chronic stable angina
Unstable Angina
Vasospastic (Prinzmetal's angina)
Myocardial Infarction
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2
Q

angina caused by paroxysmal chest squeezing or pressure (can have sensation of smothering or impending doom)

A

angina pectoris

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3
Q

angina exacerbated by physical activity and relieved by rest or SL nitrogen

A

chronic stable angina

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4
Q

angina- increasing pattern of pain in previously stable patients (less responsive to meds, lasts longer, occurs with rest or little exertion)

A

unstable angina

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5
Q

angina occurring in pts due to a spasm of the coronary artery (more likely in morning, at rest. NOT brought on by exertion or emotional stress) Seen in young pts, smokers, or illicit drug users

A

Prinzmetal’s angina

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6
Q

how do you diagnose stable ischemic heart disease?

A

stress testing

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7
Q

drugs that decrease myocardial O2 demand

A

nitrates
calcium channel blockers
beta blockers

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8
Q

this drug increases myocardial O2 delivery by reversing coronary spasm

A

nitrates

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9
Q

these drugs relax resistance vessels (decrease afterload)

A

nitrates
CCB
beta blockers

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10
Q

these drugs relax capacitance vessels (decrease preload)

A

nitrates

CCB

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11
Q

these drugs block sympathetic influence on the heart (decrease contractility, HR, and O2 demand)

A

BB

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12
Q

these drugs dilate coronary arteries, increasing oxygen supply

A

nitrates

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13
Q

these drugs cause all segments of the vascular system to relax, resulting in pooling of blood in the veins (decreasing preload and work). They also dilate coronary vasculature and increase blood supply to the heart. Also decreases platelet aggregation

A

nitrates

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14
Q

this class has significant first pass effect in the liver, so you should distribute it transdermally or sublingually

A

nitrates

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15
Q

acute adverse effects of this drug include HA, orthostatic hypotension, facial flushing, and tachycardia

A

nitrates

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16
Q

tolerance with this drug occurs rapidly and manifests as tachyphylaxis (should be given 8 hours off per day)

A

nitrates

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17
Q

this drug interacts with sildenafil (viagra)

A

nitrates

18
Q

mainstay formulation of nitroglycerin for immediate relief

A

sublingual

19
Q

these are long acting nitrates, preferred for chronic stable angina

A

isosorbide dinitrate

isosorbide mononitrate

20
Q

this class decreases myocardial O2 demand at rest and during exercise by decreasing HR and contractility, decreased CO

A

beta blockers

21
Q 
this class decreases sympathetic outflow
inhibits release of renin from kidneys (decreased BP, afterload, and preload)
A

beta blockers

22
Q

can be used for angina, post MI, HTN, anxiety

avoid in asthma/COPD, CHF, PVD, and vasospastic angina

A

beta blockers

23
Q

adverse effects include sexual dysfunction, fatigue, insomnia, bradycardia, altered HLD and TG, and rebound HTN for abrupt withdrawal

A

beta blockers

24
Q

this class can be used in angina (vasospastic and classic), HTN, supraventricular arrhythmias

A

CCB

25
Q

contraindicated in pts with unstable angina

A

CCB

26
Q

this class blocks inward movement of ca by binding to L-type calcium channels. Decreases TPR and afterload, increases coronary flow

A

CCB

27
Q

ADRS: hypotension, effects related to vasodilation, gingival hyperplasia,

A

CCB

28
Q

this CCB increases constipation, give with a stool softener. Also worsens CHF (negative inotropic effects)

A

verapamil

29
Q

these CCBs can cause myocardial depression

A

verapamil

diltiazem

30
Q

these CCBs cause tachycardia

A

nifedipine

nicardipine

31
Q

this is a late CCB. it is primarily metabolized by CYP3A, so you cant use it with inducers or strong inhibitors or CYP3A

A

ranolazine

32
Q

treat angina, no concomitant disease

A

long acting nitrate, BB, CCB

33
Q

treat angina, pt had a recent MI

A

long acting nitrate, BB

34
Q

treat angina, pt has asthma, COPD

A

long acting nitrate, CCB

35
Q

treat angina, pt has HTN

A

(long acting nitrate), BB, CCB

36
Q

treat angina, pt has DM

A

long acting nitrate, CCB

37
Q

treat angina, pt has CRF

A

long acting nitrate, (beta blocker), CCB

38
Q

should you combine nitrates with CCB or BB?

A

Yes
nitrates can cause increase in HR or contractility, and CCB and BB prevent this. BB and CCB can increase work, and nitrates decrease LVEDV

39
Q

All pts with angina pectoris should be on

A 
ASA
BB
ACEI
LDL lowering therapy
SL Nitroglycerin
CCB or long acting nitrates
40
Q

this drug shuld be used routinely in pts with acute and chronic ischemic heart disease. It exhibits an anti-thrombotic effect and reduces the risk of adverse events by 33% or risk of MI

A

ASA

Pharmacy (22 decks)

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