Term
|
Definition
| metabolized by mtALH2 to NO and S-nitrothiols, activate gualylyl cyclase to dephosphorylate myosin light chains, not affected by K+/NE, no direct effect on cardiac/skeletal muscle, dilate venules/veins at low doses and arterioles/arteries at high doses, dilates coronary arteries to reduce coronary vasospasm and decrease resistance, cause headache/flushing/hypotension/light-headedness, contraindicated if currently taking PDE5 inhibitors (-afils) for erectile dysfunction |
|
|
Term
|
Definition
| sublingual, for acute attacks/prophylaxis, 2-5min onset, heat/light sensitive |
|
|
Term
| Nitromist/nitrolingual (Nitrates) |
|
Definition
| spray, 3 sprays in 15min, 2-3yr shelf life |
|
|
Term
| Nitrodur/minitran (Nitrates) |
|
Definition
| trasndermal, 30min onset, long-last, use 12h on and then 12h off to avoid nitrate tolerance |
|
|
Term
| Isosorbide dinitrate (Nitrates) |
|
Definition
| oral, 15-30min onset, limited effectiveness due to tolerance, dose-dependent increase in exercise tolerance |
|
|
Term
| Isosorbide mononitrate (Nitrates) |
|
Definition
| oral, longer half-life due to no first-pass metabolism |
|
|
Term
|
Definition
| decrease myocardial O2 demand (decreased HR/contractility/LV wall stress), avoid ISA due to increases in HR, increases exercise tolerance and survival, decreases ST depression/frequency of angina/necessity for nitrates |
|
|
Term
| Amlodipine/nicardipine (CCBs) |
|
Definition
| more selective for smooth m (less negative inotropy and bradycardia), vasodilation, decreased coronary resistance, increase perfusion, long-lasting forms to avoid reflex tachycardia |
|
|
Term
|
Definition
| decreases contractiliy/HR/afterload, less vasodilation causes less headache/flushing/edema, can exacerbate HF/AV block, DO NOT COMBINE WITH A BB |
|
|
Term
|
Definition
| potent coronary dilator, improves blood flow, may cause bradycardia/AV block |
|
|
Term
|
Definition
| inhibits late inward sodium channels (INa), prevents electrical instability/mechanical dysfunction/O2 imbalance due to excess Ca2+, decreases angina symptoms and improves exercise capacity, can cause increased QT interval, contraindicated in pre-existing long QT/liver and kidney disease/CYP3A4 inhibitors |
|
|
Term
| Nitrates, BBs, CCBs, antiplatelets, ranolazine |
|
Definition
| treatment for stable angina |
|
|
Term
| Nitrates, CCBs, Low dose aspirin |
|
Definition
| treatment for variant angina |
|
|
Term
|
Definition
| causes venodilation and increased vagal tone, can cause severe respiratory depression |
|
|
Term
| Aldosterone antagonists, ACEI |
|
Definition
| treatment for unstable angina if MI/LV systolic dysfunction/diabetes |
|
|
Term
| Nitroglycerin/morphine/BBs/CCBs/antiplatelets/anticoagulants |
|
Definition
| treatment for unstable angina |
|
|
Term
|
Definition
| inhibit HMG-CoA Reductase, activate SREBP to upregulate LDL-R, DECREASE LDL, decrease triglycerides, increase HDL, decrease coronary events/CHD mortality/procedures/stroke, improve endothelial function with NO, decrease CRP/platelet aggregation, stabilize plaques, cause GI/hepatic/neural/myopathic side-effects, cause myaliga/myositis/rhabdomyolysis, MONITER CK AND ALT, contraindicated in liver disease/pregnancy/CYP3A4 inhibitors, 20-30% CV risk after 10yr therapy |
|
|
Term
| Statins, bile acid sequestrant, niacin |
|
Definition
| initial treatment for dyslipidemia, decrease LDL |
|
|
Term
| Red Yeast Rice (monacolins |
|
Definition
| inhibit HMG-CoA reductase, contain plant sterols/isoflavones/monounsaturated fatty acids, content varies with strain of rice, can cause myalgia/myopathy |
|
|
Term
|
Definition
| highly unsaturated omega-3 fatty acids, found in cold-water fish and plant sources, decrease triglycerides, increase HDL, reduced hepatic TG production and increased TG clearance, alternative to fibrinates, does not prevent pancreatitis |
|
|
Term
| Cholestyramine, colestipol, colesevelam (Bile Acid Sequestrants) |
|
Definition
| bind bile acids in intestine, liver converts cholesterol to replace bile acids, decrease LDL, increase triglycerides, reduce coronary events/CHD mortality, cause constipation/heartburn/nausea/gas/bloating, not for biliary obstruction/hypertriglyceridemia |
|
|
Term
|
Definition
| inhibits intestinal absorption of dietary and biliary cholesterol, decreased delivery/storage of cholesterol in liver, increased cholesterol clearance in blood, causes abdominal pain/diarrhea/arthralgia/myalgia/rhabdomyolysis/hepatitis, can cause allergic reactions, INCREASE TRIGLYCERIDES |
|
|
Term
|
Definition
| water-soluble vitB3, mechanism not understood, blocks fatty acid release, inhibits hepatic fatty acid synthesis, decreases triglycerides, decreases VLDL, INCREASES HDL, reduces coronary events/mortality, causes flushing/hyperglycemia/hyperuricemia/upper GI distress/hepatoxicity, not for liver disease/gout/peptic ulcer |
|
|
Term
| Fenofibric acid (Fibric Acid) |
|
Definition
| active metabolite of fenofibrate |
|
|
Term
| Gemfibrozil (Fibric Acid) |
|
Definition
| inhibits statin metabolism |
|
|
Term
| Fenofibrate (Fibric Acid) |
|
Definition
| micronized and non-micronized forms |
|
|
Term
|
Definition
| activate transcription factor for PPAR-a, decrease liver triglyceride synthesis/VLDL secretion, DECREASE TRIGLYCERIDES, increase HDL, reduce coronary events/lesion progression, cause GI/hepatitis/myositis/cholelithiasis, not for renal/hepatic disease |
|
|
Term
|
Definition
| treatment if HDL<40 (TG>200) |
|
|
Term
|
Definition
| act on thrombotic and anti-fibrinolytic components, MAJOR TOXICITY IS HEMORRHAGE, for acute MIs/pulmonary embolism/venous catheters/strokes/occlusive disease, improve neurological outcome (but not survival) of strokes, prevent future R. ventricular dysfunction in pulmonary emboli, improved clinical response to pleural effusions, 50-70% salvage of digits in frostbite |
|
|
Term
| Streptokinase (Thrombolytic) |
|
Definition
| produced by B-hemolytic streptococci, non-covalent 1:1 complex with plasminogen, conformational change cleaves Arg560 and activates plasmin, systemic lytic state due to activation of circulating plasminogen, not inhibited by a-antitrypsin, renal excretion, 80min half-life, 1.5M units/60min (MI), 250K units/30min (pulmonary embolism), used worldwide due to low cost, causes systemic bleeding/antigenic reaction, pre-existing antibodies require a higher dose, can only be used once |
|
|
Term
|
Definition
| two-chain serine protease, directly activates plasminogen, non-antigenic, causes systemic lytic state, hepatic metabolism, renal/fecal excretion, 13min half-life, for pulmonary embolism, loading does over 10min, 12h infusion |
|
|
Term
|
Definition
| high fibrin affinity, high plasminogen conversion at site of thrombus, more efficacy, less bleeding |
|
|
Term
|
Definition
| hepatic metabolism, 3-6min half-life, weight-adjusted loading dose |
|
|
Term
|
Definition
| deletion 1-172, missing EGF domain (not targeted to liver), missing kringle-1 domain, missing fibronectin finger (less affinity for fibrin), hepatic metabolism, hepatic/renal excretion, , 13-16min half-life, for acute MI |
|
|
Term
|
Definition
| Thr103Asn increases half-life, Asn117Gln decreases hepatic clearance, KHRR296-299AAAA decreases PAI-1 inhibition, hepatic metabolism, 22min half-life, for acute MI |
|
|
Term
| Direct fibrinolytic agents |
|
Definition
| degrade fibrin without requiring plasminogen activation, not more effective than indirect fibrinolysis |
|
|
Term
|
Definition
| may increase effectiveness of lower doses of tPA, potent anti-fibrinolytic enzyme, activated by thrombin/thrombomodulin |
|
|
Term
|
Definition
| inhibitor of fibrinolysis, similar structure to lysine, competitive plasminogen inhibitor, thrombi formed during therapy are not lysed |
|
|
Term
|
Definition
| used to maintain ductal patency for TGA/Common ventricle |
|
|
