High ________ contributes most to atherosclerotic disease. Therefore, we pick the cholesterol drug based on the amount we want to lower their ________
Most effective drugs for lowering LDL!
Can also: elevate HDL and reduce triglycerides
Other benefits: plaque stability, reduce risk for CV events, increased bone formation
Regardless of cholesterol level, a patient post-MI will be on a ________ to reduce mortality r/t CHD!
AE: Headache, rash, GI, myopathy, rhabdomyolysis, hepatotoxicity
Contraindications: Use with other cholesterol drugs, Category X!
All cholesterol meds are considered _________ because cholesterol is needed for the developing baby
Cholesterol med dosing should be once daily in the ________ because cholesterol synthesis occurs mainly at night
Water soluble vitamin used mainly to lower triglyceride levels, but it can also lower LDL and raise HDL
Can make HDL a "negative risk factor"
Considered the "hot flash pill"; pretreat the patient with Aspirin before giving the immediate release form of __________
Bile Acid Sequestrant that can lower LDL and raise HDL (but not as effective)
- "Bulking agent" which can reduce diarrhea
- Can reduce the absorption of other drugs (give 1 hr before or 4 hrs after other meds
Biggest side effect of cholestyramine.
Since BAS are not absorbed from the GI tract, adverse effects are limited to GI effects
Preferred bile acid sequestrant because:
- Better tolerated
- Dose not decrease absorption of fat soluble vitamins
- Does not reduce absorption of other drugs
MOA: Increases LDL receptor hepatocytes on the liver and preventing reabsorption of bile acids
Use: Reduce LDL
Primary Indication: Hypertriglyceridemia
Interactions: Displaces warfarin from albumin which increases risk of bleeding
- GI disturbance
- Gall stones d/t increased biliary cholesterol
- Myopathy and Rhabdomyolysis
Three families to treat ________ by lowering O2 demand:
2) Beta Blockers
3) Calcium Channel Blockers
O2 ______ is determined by:
- heart rate
- myocardial contractility
- preload/afterload (most important!)
O2 ______ is determined by:
- Myocardial blood flow
- Myocardial perfusion (only in DIASTOLE)
Chronic stable angina is AKA _________ angina because the pain results from increased O2 demand which can result from excitement, large meals, or cold exposure
Tx Goal: Decrease O2 demand
Printzmetal's Vasospastic Angina is AKA _________ because the S/S may occur at any time, even during sleep, because the pain is d/t decreased O2 supply.
It does not matter what your activity level is!
_________ angina is a medical emergency! Symptoms result from severe CAD complicated from vasospasm
Anti-Ischemic Therapy for unstable angina is similar to how we treat MI's, with ______________
Part of anticoagulant therapy given for a patient with unstable angina is SubQ low molecular weight _________
Act directly on VSM to promote vasodilation mainly in the veins to decrease PRELOAD
Uses: stable angina, variant angina, vasodilator
*DOC for acute anginal attack
Most common adverse effect of IV Nitro
- Dizziness/Orthostatic Hypotension
- Reflex Tachycardia
There is an absolute contraindication against taking phosphodiesterase type 5 inhibitors (like Viagra) with ________because it will intensify the effects of hypotension
Make sure the patient has at least 8 hours of drug free hours per day to prevent the development of __________
If the patient does not have relief within 5 min of 3rd dose of nitro, he probably has _________
Beta blockers are only used for long term management of ________ angina
**Beta Blockers are not effective against vasospastic angina (Printzmetal's/Variant)!!
CCB's dilate coronary arteries to decrease _________ and dilate peripheral arteries to decrease BP
New class of antianginal agents
Unlike most other angi-anginal meds, _________ does not reduce HR, BP, or vascular resistance!