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stable angina
| Question | Answer |
|---|---|
| when does chest pain occur | imbalance between myocardial oxygen demand and supply |
| For stable angina what is the sodium cutoff? | <2,300 mg/day |
| Can chronic NSAIDS be used in stable angina? | no |
| What is the treatment approach for stable angina? | ABCDE |
| what does the ABCDE treatment approach mean | Antiplatelet and antianginal drugs, blood pressure, cholesterol, Diet/diabetes, and exercise/education |
| Should an ACE/ARB be used for stable angina? | yes for HTN & CAD |
| What type of statin should a patient with stable angina be on? | high intensity |
| What antiplatelet medication is preferred for stable angina? | aspirin |
| what aspirin coating is preferred for ACS? | non-enteric coated chewable aspirin |
| for long-acting nitrates can you just decrease the tolerance quick? | no it requires a 10-12 hour nitrate-free interval |
| In stable angina, when do you avoid BB | avoid in vasospastic angina |
| CI to ranolazine | liver cirrhosis |
| when is DAPT reasonable for stable angina? | not useful for secondary prevention in patients with stable angina and is recommended only after recent ACS or PCI |
| what are the medications in the DAPT that are indicated to reduce the risk of cardio events in select patients with CAD or PAD | low-dose xarelto and aspirin |
| what is the purpose of using antianginal treatment for stable angina? | decreases myocardial oxygen demand or increase myocardial oxygen supply |
| which mechanism of aspirin contributes to the platelet aggregation component | Since aspirin irreversibly inhibits COX-1 and COX-2 it results in decreased PG and thromboxane A2 production which is a potent vasoconstrictor and inducer of plt aggregation |
| what is a sign of aspirin overdose? | tinnitus |
| what if the only aspirin available is the enteric-coated aspirin and not the non-enteric? | then use only enteric-coated aspirin and it should be chewed 325mg |
| what can be used to protect the GIT from chronic aspirin use? | PPI |
| with what 2 PPI should you not use clopidogrel with? | omeprazole/esomeprazole |
| which antianginal medication option is preferred for vasospatic angina? | CCB |
| which CCB do you avoid in stable angian? | nifedipine IR |
| All CCBs do what? | increase myocardial oxygen supply, increase blood flow through collateral (non-atherosclerotic) arteries |
| does ranolazine have effect on HR or BP? | no, has little to no effect on either or |
| how do nitrates reduce myocardial oxygen demand? | decrease preload (free radical nitric oxide produces vasodilation of veins more than arteries) |
| both the CCB and nitrates do what? | reduce myocardial oxygen demand and increase myocardial oxygen supply |
| what are the warnings to using nitrates in stable angina? | hypotension, tachyphylaxis (tolerance/ decreased effectiveness) |
| what do the long-acting nitrates require? | a 10-12 hour nitrate-free interval to decrease tolerance |
| how often in the nitroglycerin 2% ointment dosed? | BID, 6 hours apart |
| how is the isosorbide mononitrate IR dosed? | BID, 7 hours apart |
| is isosorbide mononitrate or dinitrate the one in combination with hydralazine preferred for HFrEF? | dinitrate |
| Do no use Ranolazine with what type of medications? | CYP3A4 inhibitors |
| what are side effects of aspirin? | dyspepsia, heartburn, bleeding |
| for the shrot-acting nitrates what is the limit to take within 15 mins? | no more than 3 doses |
| what is the preferred application site for nitroglycerin patch? | chest |
| can the nitroglycerin ointment stain clothing? | yes |
Created by:
KaHerre12