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Coronary Heart Disease
Drugs
21
Astronomy
8th Grade
02/09/2014

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Term
used in all patients for risk modification; decreases morbidity and mortality 25-30%
Definition
Aspirin 81-325 mg daily (if CI use Plavix 75 mg daily)
Term
Used to manage hypertension (risk factor modification)
Definition
ACE inhibitors and Beta Blockers
Term
converted to nitrous oxide --> Vasodilation of the coronary arteries (help increase oxygen supply)
Definition
Nitroglycerine PRN
Term
blocking beta1 activity --> decrease HR and contractility, which helps to decrease oxygen demand
Definition
Metoprolol (B1), Propranolol (B1, B2)
Term
target myocardial tissue
Definition
beta 1 selectivity (metoprolol, atenolol)
Term
contraindicated in patients with HR < 50 bpm, CHF, heart block or acute bronchospasm
Definition
beta blockers
Term
preferred for angina with variable thresholds
Definition
calcium channel blockers
Term
works on peripheral vascular smooth muscle --> systemic vasodilationo; preferred in patients with conduction issue or EF < 35%
Definition
amlodipine (DHP)
Term
works on both systemic vasculature and myocardial smooth muscle
Definition
diltiazem and verapamil (non-DHPs)
Term
5-10 mg daily; used for chronic stable and variant angina, hypertension; ADRs: HA, flushing, edema, reflex tachycardia, decreased BP
Definition
Amlodipine
Term
used for chronic stable and variant angina, hypertension, A fib, A flutter, PSVT; ADRS include HA, flushing, decreased HR, decreased BP, CYP 3A4 inhibitor
Definition
Diltiazem
Term
adjust in hepatic and renal impairment; uses include chronic stable and variant angina, A fib, A flutter, PSVT, and unstable angina; ADRS: syncope, decreased BP, decreased HR, heart block, asystole, CYP-3A4 inhibitor
Definition
Verapamil
Term
not preferred due to tolerance issues; vasodilation of coronary arteries (increased oxygen supply);
Definition
Long acting NTG
Term
inhibits cardiac later stage sodium channels, only approved for chronic angina
Definition
Ranolazine- Ranexa
Term
ADRs include HA, dizziness, N/V, constipation, angioedema, dyspnea, confusion, QTc prolongation, CYP3A4 inhibitor, avoid in hepatic impairment
Definition
Ranolazine
Term
40% restenosis within 1 year
Definition
Balloon angioplasty only
Term
30% restenosis within 1 year
Definition
Bare metal stents (BMS)
Term
less restenosis (<10%) but see late stenosis when anti-platelet therapy is discontinued (60-70%)
Definition
Drug eluding stents (DES)
Term
DO NOT USE in Prinzmetal Angina
Definition
Beta Blockers
Term
preferred over nitrates in Prinzmetal Angina
Definition
calcium channel blockers
Term
add to calcium channel blockers in Prinzmetal Angina
Definition
nitroglycerin
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