Term
| Myocardial Ischemia: Categories |
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Definition
Chronic coronary artery disease:
-Stable Angina
Acute Coronary Syndromes:
-unstable angina
-non-ST elevation MI
-ST elevation MI |
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Term
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Definition
Symptoms:
-pain beneath sternum may proceed to
sever crushing pain
associated with arthersclerosis
ECG changes include ST depression
***Exercise induced***
Stable and unstable angina |
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Term
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Definition
lumen narrowed by plaque
inappropriate vasoconstriction |
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Term
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Definition
plaque ruptured
platelet aggregation
thrombus formation
**unsupressed vasoconstriction |
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Term
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Definition
type of ACS
no troponin detectable |
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Term
| non-ST elevation MI (NSTEMI) |
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Definition
plaque rupture
artery partially occluded
high risk of recurrence of ischemia |
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Term
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Definition
epicardial artery occlusion
sudden cardiac death
unremitting chest pain with dyspnea |
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Term
| Clinicical Management of CAD AND ACS: Goals |
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Definition
CAD:
-modulating balance between myocardial oxygen supply and demand
ACS:
-re-establishing and maintaining the patency of the epicardial coronary artery |
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Term
| Beta-adrenoceptor antagonists |
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Definition
reduce oxygen demand by decreasing heart rate and contractility
AE: fatigue, lethargy, insomnia, impotence |
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Term
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Definition
-Decreasing systemic vascular resistance
-decreasing cardiac contractility
***effective in tx of vasopastic angina |
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Term
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Definition
dilation of peripheral capacitance veins
mildly dilate arteriolar resistance vessels
decreasing demand while increasing supply |
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Term
| Applications of nitrates: Isosorbide dinitrate and mononitrate |
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Definition
effective for prophylaxis and tx of exertional angina
AE: Headache |
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Term
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Definition
for angina pt.'s who remain symptomatic despite being on one or more drugs
shifting ATP produc. away from fatty acid oxidation in favor of glucose oxidation |
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Term
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Definition
anti-platelet agent
prevent arterial thrombosis
50% reduction in death and nonfatal MI |
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Term
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Definition
APC:
-anticoagulant and cytoprotective activ.
APC-2Cys:
-cytoprotectivity
APC E170A:
-anticoagulant activity |
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Term
| Eptifibatide and Tirofiban |
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Definition
Glycoprotein IIb/IIIa antagonists
reduce risk of fatal and nonfatal MI in patients with UA
reduce risk of recurrent MI and urgent revascularization in pt.'s with NSTEMI |
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Term
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Definition
glycoprotein IIb/IIIa antagonists
inhibits platelet aggregation
binds to vitronectin receptor found on platelets and vessel wall endothelium |
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Term
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Definition
Platelet ADP-receptor antagonist
reduce current coronary events in patients with NSTEMI/UA who undergo percutaneous coronary intervention
also in pt.'s with a noninvasive approach |
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Term
| Thrombolytics: Streptokinase |
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Definition
derived form bacteria
can only use once due to antibodies |
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Term
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Definition
restoring the patency of occluded coronary arteries
limiting cardiac dysfunction
reducing mortality following STEMI |
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Term
| Thrombolytics: Tenecteplase |
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Definition
genetically engineered variant of t-PA
more fibrin specific relative to t-PA
longer half-life than t-PA |
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Term
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Definition
recombinant non-glycosylated form of t-PA
longer half life
binds fibrin with lower affinity than alteplase, ***improving ability to penetrate into clots*** |
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Term
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Definition
-aspirin, ACEI, antianginals, and aldosterone antagonists
-Beta-antagonists and BP control
-Cholesterol lowering
-Diet and diabetes control
-education and exercise |
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