ACS Medications

Antiplatelet agent 1

Aspirin: The cornerstone of ________ therapy; used in acute management and primary prevention in specific patients.

Antiplatelet agent 2

Clopidogrel: a P2Y12 inhibitor used for dual _______ therapy (DAPT) with aspirin.

Antiplatelet agent 3

Glycoprotein IIb/IIIa Inhibitors. Used particularly in high-risk patients undergoing PCI (percutaneous coronary intervention)

Glycoprotein IIb/IIIa Inhibitors 1

Abciximab

Glycoprotein IIb/IIIa Inhibitors 2

Eptifibatide

Glycoprotein IIb/IIIa Inhibitors 3

Tirofiban

Statin 1

Atorvastatin

Statin 2

Rosuvastatin

Statins (Definition)

recommended to lower LDL cholesterol and reduce recurrent cardiovascular events. High- intensity _____ therapy is initiated early in the course of ACS.

Cholesterol absorption inhibitor

Ezetimibe: used as an adjunct to statins to further reduce LDL cholesterol levels by ____________ in the small intestine

Beta blockers (definition)

Used to reduce myocardial oxygen demand and improve outcomes in ACS patients

Beta blockers 1

carvedilol

Beta blockers 2

metoprolol

Fibrinolytics

Alteplase: dissolves thrombus to restore blood flow in coronary artery

Nitrates

Nitroglycerin: dilate coronary arteries to increase blood flow into ischemic areas of heart; dilate peripheral blood vessels → decrease venous return → reduced cardiac workload → reduced myocardial oxygen demand

Calcium Channel Blockers (definition)

Reduce HR and myocardial contractility; increase coronary and peripheral vasodilation

CCB 1

Amlodipine (Norvasc)

CCB2

Verapamil (Mylan-verapamil SR)

ACE-I (definition)

Help to prevent ventricular remodelling and prevent/slow progression of heart failure;

ACE 1

Lisinopril (Apo-lisinopril)

ACE 2

Ramipril (Altace)

PCSK9 Inhibitor (definition)

Improve clearance of LDL → lowering the LDL cholesterol level in the blood

PCSK9-I 1

Alirocumab

PCSK9-I 2

Evolocumab

Anticoagulants (definition)

prevents cascade of clot forming (e.g., prevents conversion of fibrinogen to fibrin)

Anticoagulants 1

Heparin

Fibrinolytic medication suffic

-plase (recall that it acts on the fibrinolytic pathway to dissolve clots by convering PLASminogen to PLASmin)

Aspirin irreversibly inhibits ________, the enzyme required to help platelets create thromboxane (which plays a key role in platelet aggregation)

Cyclo-oxygenase

Clopidogrel

Inhibits P2Y12 receptor on platelets, preventing aggregation. Lasts 7-10 days after last dose, nonreversible but can be given with aspirin. Risks of bleeding, thrombocytopenia (low # of platelets in blood).

Glycoprotein IIb/IIIa Inhibitor

Considered most effective antiplatelet agent; administered via IV usually along with ASA & heparin. Without these, they would otherwise bind to fibrinogen and lead to increased platelet aggregation & adhesion

Examples: Tirofiban ◦ Eptifibatide ◦ Abciximab

These medications prevent platelet aggregation by blocking the glycoprotein IIb/IIIa receptors on platelets, which are essential for platelet cross-linking and clot formation.

Dyslipidemia

abnormal levels of lipids in the bloodstreamwhich can include high levels of cholesterol and triglycerides, increasing the risk of cardiovascular disease.

Synonym for -statins

HMG-CoA reductase inhibitor

HMG-CoA reductase

an enzyme in the liver needed to make cholesterol

Inhibiting HMG-CoA inhibits cholesterol synthesis → more LDL receptors on hepatocytes → increased LDL removal

PCSK9 inhibitors administration

SC injection every 2-4 weeks for lowering LDL cholesterol levels.