Term
|
Definition
| increase liver's ability to remove LDL's from blood |
|
|
Term
|
Definition
|
|
Term
| What is HMG CoA reductase? |
|
Definition
| Enzyme that controls rate of cholesterol production in the body |
|
|
Term
| What is rosuvastatin's mechanism? |
|
Definition
| it increases liver LDL receptors and inhibits LDL synthesis |
|
|
Term
| What does statin's reduce? |
|
Definition
| mortality and morbidity in pt's with coronary artery dz; also helps pt's who have regular cholesterol levels yet have a previous MI |
|
|
Term
|
Definition
|
|
Term
| Are statin's a safe drug? |
|
Definition
|
|
Term
| What are the SE of statins? |
|
Definition
GI: diarrhea or constipation
may cause arrhythmias
myalgia/muscle cramps/tendonitis
abnormal liver fxn
rhabdomyolysis |
|
|
Term
| What is the avg time for SE to take hold in statins? |
|
Definition
|
|
Term
| What muscle groups are more prone to pain when on statins? |
|
Definition
|
|
Term
| What statin SE can kill a pt? |
|
Definition
|
|
Term
| What is a rare, fatal SE of statins? |
|
Definition
| rhabdomyolysis- skeletal muscle breakdown |
|
|
Term
|
Definition
|
|
Term
| What is a bile acid binder? |
|
Definition
| binds with cholesterol containing acids so that they are passed with the stool |
|
|
Term
| What are commonly Rx'd along with bile acid binders? |
|
Definition
|
|
Term
| What are the SE of bile acid binders? |
|
Definition
Can eliminate lipid soluble meds
GI: gas, bloating, constipation |
|
|
Term
|
Definition
| inihibit development of cholesterol, facilitate lipid metabolism. |
|
|
Term
| What kind of cholesterol does fibrates increase? |
|
Definition
|
|
Term
| What are the SE of fibrates? |
|
Definition
| gallstones, anemia, bleeding, gas and bloating |
|
|
Term
| What are common fibrates? |
|
Definition
gemfibrozil, fenofibrate (these both incrase myopathy if taking statins)
and fenofibric acid |
|
|
Term
| What are common bile acid binders? |
|
Definition
| cholestryamine, colestipoll, colesevelam |
|
|
Term
|
Definition
| It decreases LDL's and triglycerides, and increases HDL's EXTREMELY effectively |
|
|
Term
|
Definition
| a water soluble B vitamin |
|
|
Term
|
Definition
flushing, pruritis, hot flashes
N & V
liver damage, gout
hyperglycemia
toxic amblyopia
macular edema |
|
|
Term
| Why can niacin cause liver damage? |
|
Definition
| because it is very high levels that the liver has to clear out |
|
|
Term
| Can niacin exacerbate diabetes? |
|
Definition
|
|
Term
| What do statin's do to the eyeball? |
|
Definition
| increase retinal circulation, therefore may be useful for tx of ischemic retinal dz's. May protect against AMD? May decrease incidence of diabetic neuropathy (35%). |
|
|
Term
| What do fibrates do to the eyeball? |
|
Definition
protect against diabetic neuropathy (45% reduction)
decrease need for laser tx in DR |
|
|
Term
|
Definition
|
|
Term
| Look at slide 69 and redo! |
|
Definition
|
|
Term
| Who is least likely to survive a myocardial infarction? |
|
Definition
|
|
Term
| What are the physiological differences between men and women related to MI? |
|
Definition
| women have smaller coronary arteries, more prone to endothelial dysfxn |
|
|
Term
| What are the risk factors for ischemic heart dz? |
|
Definition
low estrogen levels (men)
elevated testosterone and/or polycystic ovary syndrome |
|
|
Term
| What is endothelial dysfunction? |
|
Definition
| nitric oxide release is reduced which leads to less vasodilation under stress. During MI this is very bad |
|
|
Term
| What are the prodromal symptoms of women in ischemic heart dz? |
|
Definition
fatigue, sleep disturbance, dyspnea
No previous history of chest pain |
|
|
Term
| What are the diagnostic tests for heart dz in women? |
|
Definition
endothelial function
stress echocardioraphy and SPECT
intravascular ultransonography |
|
|
Term
|
Definition
| transient myocardial ischemia that presents as chest pain |
|
|
Term
| Where can angina induce pain? |
|
Definition
|
|
Term
| What is stable angina also called? |
|
Definition
|
|
Term
|
Definition
| exercise or emotional stress |
|
|
Term
| How long does a typical angina attack last? |
|
Definition
|
|
Term
|
Definition
| clenching fist to chest during myocardial ischemia |
|
|
Term
|
Definition
| rest or sublingual NTG (nitroglycerin) |
|
|
Term
|
Definition
| nitroglycerin is a potent vasodilator |
|
|
Term
|
Definition
|
|
Term
| What are the s/sx of variant angina? |
|
Definition
vasospasm w/ fixed stenoses
mostly in women*
common at night or in early morning hours
associated with cigarette smoking
raynaud's phenomenon, migraine |
|
|
Term
| How is prinzmetal's treated? |
|
Definition
|
|
Term
| How is angina pectoris managed? |
|
Definition
activity and weight loss
control HTN, DM, triglycerides, smoking
treat any comorbid thyroid dz or anemia |
|
|
Term
| What is a warning sign that an angina attack requires medical attention? |
|
Definition
| if 2-3 NTG tablets taken 5 minutes apart does NOT relieve the stress |
|
|
Term
| What is medical therapy for AP? |
|
Definition
ASA 81 mg q.d.
Beta blockers
CCB |
|
|
Term
| What is a difference between men and women on aspirin regimens? |
|
Definition
| while both have reduced stroke risk, the risk of FIRST MI is NOT reduced in women while it is in men. However, both men and women benefit for subsequent MI |
|
|
Term
| What are nitrates used for? |
|
Definition
| venodilation in AP management |
|
|
Term
|
Definition
percutaneous coronary intervention
it is a less invasive than bypass
stenting almost always performed
glycoprotein IIB/IIIA inhibit platelet aggregation drugs to stop clotting are used for this procedure |
|
|
Term
| What has a faster recovery time, PCI or CABG? |
|
Definition
|
|
Term
|
Definition
coronary artery bypass grafting
transplanted vessels "bypass" blockage
Donor: pt's saphenous vein OR mammary arteries |
|
|
Term
| What is the % of CABG's that must be repeated in 5 years? |
|
Definition
|
|
Term
| Why are mammary arteries used instead of saphenous veins for CABG? |
|
Definition
| mammary arteries have a higher success rate |
|
|
Term
| What is acute coronary syndrome(ACS)? |
|
Definition
| An unstable, severe form of angina |
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|
