Shared Flashcard Set

Details

Pharm Anti-Angina
KYCOM Block 14
37
Pharmacology
Graduate
02/06/2014

Additional Pharmacology Flashcards

 


 

Cards

Term
what are 2 different ways to say coronary artery disease
Definition
ischemic heart disease
athlerosclerosis of epicardial vessels
Term
when does coronary artery disease begin
Definition
begins early in life, manifests middle aged and beyond
Term
what are 5 manigestations of coronary artery disease
Definition
heart failure
arrhythmia
stroke
peripherial vascular disease
acute coronary artery disease
Term
what are the 4 types of coronary artery disease
Definition
angina syndrome
stable (exercise induced) angina
prinzmetal (vasospastic) angina
unstable angina
Term
what is angina syndrome
Definition
describes variation in manigestation of agonia and its symptoms
Term
what are the symptoms of angina due to
Definition
ischemic pain (angina equlivaents) and accumulation of metabolites in striated muscle
Term
where is the pain in angina from most to least common 4
Definition
anterior chest
left upper arm
left lower arm
neck pain
Term
what causes vasospasm in CAD
Definition
imbalance of oxygen use and delivery
Term
what is stable angina
Definition
when myocardial requirement increases (like exercise0 coronary flow does not increase proportionally causing ischemia and pain
Term
what is prinzmetal angina
Definition
oxygen delivery decreased due to reversible coronary vasospasm
not brought on by exertion or emotional stress not relieved by rest
Term
EKG signs of prinzmetal angina
Definition
ST elevation (injury marker)
Term
cause of prinzmetal angina
Definition
altered vasodilators (NO, prostacyclin) or vasoconstrictors (entothelial, ANG II)
Term
what is unstable angina
Definition
change in stable angina or angina at rest
Term
cause of unstable angina
Definition
increased coronary tone or platelet clots on athlerosclerosis
Term
what is the general approach to angina treatment
Definition
tissue ischemia is thwarted using vasodilator or anti-vasoconstrictor drugs
Term
what is the order of treatment and theory behind each in treatment/prevention of stable angina
Definition
1. BB: decrease myocardial O2 demand
2. CCB: vasodilation decreases coronary/peripherial resistance and heart O2 demand
3. nitrates: venodilation decreases proload and myocardial O2 demand
Term
what are the tx of variant angina
Definition
nitrates: relax coronary vessels, reduces spasm
CCB: relax coronary vessels, reducing spasm
Term
tx of unstable angina
Definition
aspirin, heparin
DOC: nitroglycerin
BB
CCB
Term
what is the tx of angina post MI
Definition
BB
Term
what is the tx of angina with DM
Definition
ACEI
Term
what is the tx of angina with LV dysfunction
Definition
ACEI
Term
what is the tx of angina with CAD or LDL>130
Definition
statins
Term
what is the tx of angina with increased platelets
Definition
aspirin
clopidogerl
pasugrel
Term
MOA nitroglycerin
Definition
converte nitrate ions to NO
activates guanylyl cyclase
increases cAMP
increases protein kinase G
activates phosphatases
dephosphyorlyate myosin light chain
vasodilation
Term
how is notroglycerin different at different doses
Definition
moderate: dilates large veins > pooling of blood > decreases proload

all doses: dilate coronary vessels > increased blood to heart muscle
Term
administration and time of onset of nitroglycerin
Definition
sublingual 2 min
transdermal 12h on 12h off prophylaxis
Term
SE of nitroglycerin
Definition
headache: migraine caused by vasodilation
orthostatic hypotension
reflex tachycardia
rolerance/tachyphylaxis (avoid with 6-8h nitrate free interval)
Term
how is isorbide mononitrate and isorbide dinitrate different from nitroglycerin
Definition
oral administration
longer onset and duration
Term
interactions with nitro drugs
Definition
NEVER COMBINE WITH PHOSPHODIESTERASE INHIBITORS (slidenafil, vardenafil, tadalafil)
causes extreme hypotension and death

erectile dysfunction is common in people with CAD
Term
what 3 BB are used for angina
Definition
propranolol
metoprolol
atenolol
Term
what BB are not good for angina, why
Definition
partial agonists (sympathomimetric) are less efective (pindolol, acebutolol)
Term
MOA of BB on angina
Definition
decrease sympathetic tone, HR, contractability
block B1 receptors
reduce frequency and severity of angina
Term
what are the CCB that work on angina and how
Definition
dihydropyridines: work on vessels, causes reflex tachycardia
verapmil and diltiazem: work on heart (preferred)
Term
MOA CCB
Definition
stop influx of Ca via L-Ca channels which stops calmodulin from turning Ca into Ca-calmoulin so it cannot activate myosin LC kinase and thus cannot cause contraction
vasodilation reduces coronary vasospasm and myocardial O2 demand
also used in raynaud's (vasospasm in cold)
Term
MOA ranolazine
Definition
who knows, dosent reduce HR and BP
Term
use of ranolazine
Definition
adjunct therapy to BB, CCB, nitrates
Term
SE ranolazine
Definition
prolonged QT syndrome (causes torsades)
Supporting users have an ad free experience!