Chronic Stable Angina and MI

Drug used first for acute angina

Nitroglycerin SL

Nitroglycerin works by

venodilation → decreases preload

Common nitroglycerin side effects

2

Headache

hypotension

Major contraindication medication to nitrates

PDE-5 inhibitors (viagra)

How is nitrate tolerance prevented

10-12 hour nitrate free interval

MONA stands for

Morphine, oxygen, nitrates, aspirin

Dual antiplatelet therapy usually includes which two meds together

Asprin + Clipidorgrel

Which medications improve survival after MI?

Think BASA

Statin

ACEI

Beta blocker

Aspirin

Classic sx of stable angina

Chest pain with exertion

How long does stable angina usually last

less than 15 minutes

How many nitroglycerin tablets can be taken for chest pain

1 tablet every 5 minutes, up to 3 doses

When are CCBs used for angina

If beta blockers are contraindicated or sx persist

What medication reduces myocardial oxygen demand without affecting heart rate or blood pressure

Ranolazine

Why are ace inhibitors started after an MI

to prevent ventricular remodeling

Chew aspirin during suspected

MI

Monitor what with Nitroglycerin

Blood pressure

Monitor what with Beta Blockers

HR

BP

Monitor what with statins

liver function

What medication class is used to prevent chronic angina attacks

Beta blocker

Drug class added when angina persists despite beta blocker

CCB

Never combine nitrates with what medication

Sildenafil