Meds for CV lecture

morauch630's version from 2017-12-11 06:58

Section 1

Question Answer
Mechanism of action: nitratesstimulates cGMP production, leads to dilatation of venous bed which decreases venous return. Reduced preload.
Mechanism of action: aspirininhibition of cyclo-oxygenase in platelets and endothelial cells, prevent synthesis thromboxane A2
Mechanism of action: clopidogrel (plavix)inhibits binding adenosine diphosphate to platelet receptor preventing platelet aggregation
Mechanism of action: dipyridamoleincrease in adenosine levels producing vasodilation, decreased cAMP levels = decreased platelet aggregation
Mechanism of action: ranolazinemodulates myocardial metabolism, generates more ATP per molecule of oxygen consumed
Mechanism of action: heparinblocks antithrombin III which decreases clot formation
Mechanism of action: low molecular weight heparininhibit clot formation higher up in clotting cascade
Mechanism of action: glycoprotein IIb/IIIa inhibitorsprevents platelet aggregation
Mechanism of action: thrombolyticsactivates tissue plasminogen, increased conversion of plasminogen to plasmin- which digests existing clots
Mechanism of action: warfarinblockage of vit K binding sites, inhibition of synthesis of coagulation factors and proteins C & S

Section 2

Question Answer
Cautions with nitratespostural hypotension, open-angle glaucoma
Cautions with clopidogrelliver disease, other anticoagulant/antiplatelet drugs
Cautions with abciximab, tirofiban, eptifibatiderenal disease, those with low platelet count
Contraindications for using thrombolyticsprevious hemorrhagic stroke, stroke/CVA in last year, known intracranial neoplasm, active bleeding, aortic dissection
Cautions with warfarinother blood thinners, severe hypertension, severe renal disease, hepatic dysfunction, fall risk

Section 3

Question Answer
Examples of nitratessildenafil, tadalafil, vardenafil, isosorbide dinitrate
Examples of dipyridamolespersantine, aggrenox
Examples of LMW heparinenoxaparin, dalteparin, tinzaparin
Examples of glycoprotein IIb/IIIa inhibitorsabciximab, tirofiban, eptifibatide
Examples of thrombolyticstPA, alteplase, reteplase, streptokinase, tenecteplase, urokinase, anistreplase

Section 4

Question Answer
Adverse effects of sildenafil, tadalafil, vardenafilheadache, flushing, nausea/vomiting, tachycardia, severe hypotension, syncope, rash, blurred vision
Adverse effects of aspirinGI upset, thrombocytopenia, bleeding
Adverse effects of clopidogrelbleeding, TTP, nausea/vomiting, rash, fatigue, palpitations, chest pain
Adverse effects of persantine, aggrenoxbleeding, hypotension, dizziness, nausea, flushing, rash
Adverse effects of heparinbleeding, thrombocytopenia, clotting, fever, chills, pruritis, anaphylaxis (due to pork derivation)
Adverse effects of enoxaparin, dalteparin, tinzaparinbleeding, thrombocytopenia, pulmonary edema, fever, peripheral edema
Adverse effects of abciximab, tirofiban, eptifibatidebleeding, thrombocytopenia, agranulocytosis, anaphylaxis, elevated LFTs, injection site pain/hematoma
Adverse effects of tPA, alteplase, reteplase, streptokinase, tenecteplase, urokinasebleeding, nausea, hypotension, allergic rxns, arrhythmias
Adverse effects of warfarinhemorrhage, rash, gangrene, skin ulcers, myalgia

Section 5

Question Answer
Beta blocker effectsdecrease HR, decrease contractility, decrease BP, reduce myocardial oxygen demand
CCB effectsvasodilation of arterioles & coronary arteries. Decreased conduction SA & AV node.
Ranolazine effectslacks effects on hemodynamics, contractile/conduction parameters, less effective in men

Section 6

Question Answer
Calcium channel blockers are especially good for variant (prinzmetal's) anginaTrue
Clopidogrel inhibition of platelet aggregation is reversibleFalse
Ticlopidine is not used commonly d/t life-threatening agranulocytosisTrue
Heparin breaks down existing clotsFalse
Heparin overdose is treated with protamineTrue
Fondaparinux (arixtra) is a direct Anti-Xa inhibitorTrue
Thrombolytics should be given within 1 hour of patient presenting to ER for cardiac eventFalse
Warfarin interacts with drugs that are metabolized in the liverTrue