Cardiovascular System Disorder Drugs: Angina, Thromboembolics, and PVD

Flashcards covering medications for angina pectoris, thromboembolic disorders, and peripheral vascular disease, including mechanisms, monitoring, and antidotes.

Angina pectoris

Chest pain resulting from partial occlusion of the blood vessels in the heart, leading to an imbalance where oxygen demand exceeds supply and causes ischemia.

Ischemia

Tissue deprivation of oxygen caused by reduced blood flow; the manifestation of this in heart tissue is pain.

Nitroglycerin

A first-line nitrate drug used to treat angina pectoris by causing vasodilation, which opens vessels and relieves ischemia.

Reflex tachycardia

An adverse effect of nitroglycerin and other vasodilators where the heart rate increases in response to a drop in blood pressure.

Nitrate Tolerance

A condition prevented by providing an 'off time' for nitrate patches, typically involving removing the patch for $12$ hours (e.g., from $6\text{PM}$ to $6\text{AM}$).

Sublingual Nitroglycerin Protocol

The administration of a maximum of $3$ tablets, $5$ minutes apart, under the tongue at the onset of chest pain; if the first or second dose is ineffective, $911$ should be called.

Beta Blockers

Drugs such as atenolol and metoprolol that treat angina by suppressing the sympathetic response, decreasing heart rate, and reducing the workload of the heart.

Propranolol

A beta blocker that blocks $\text{beta-2}$ receptor sites and should not be given to patients with COPD or asthma due to the risk of bronchoconstriction.

Calcium Channel Blockers

A class of drugs including amlodipine and diltiazem that treat angina as routine medication by decreasing the workload of the heart.

ACE Inhibitors

Drugs like Lisinopril and Captopril that decrease the heart's workload by reducing angiotensin II production, blood pressure, and sodium/fluid retention.

Ranolazine

A myocardial cell sodium channel blocker that produces myocardial relaxation to reduce the symptoms of angina.

Deep Vein Thrombosis (DVT)

A condition characterized by blood clot formation in the calves, often presenting with redness, swelling, and pain.

Pulmonary Embolism (PE)

A life-threatening condition where a blood clot dislodges and occludes a vessel in the lungs.

Atrial Fibrillation (AFib)

A condition involving heart quivering and stasis of blood, putting the patient at high risk for clot formation.

Antiplatelets

Drugs like aspirin and clopidogrel (Plavix) that inhibit platelet aggregation to prevent clot formation in patients at risk for stroke or MI.

Factor Xa Inhibitors

Anticoagulants such as apixaban and rivaroxaban that inhibit a single clotting factor, resulting in a lower risk of bleeding than broader anticoagulants.

Enoxaparin

A low molecular weight heparin often given subcutaneously in the abdomen to prevent or treat venous clots like DVT.

Heparin

A potent anticoagulant used to treat DVT, PE, and MI; it requires frequent monitoring of PTT or aPTT.

PTT (Partial Thromboplastin Time)

The laboratory value monitored for heparin therapy; the therapeutic range is typically $1.5 \times$ to $2.5 \times$ the normal value, or $45$ to $75$ seconds.

Protamine sulfate

The specific antidote used to reverse the effects of heparin in the event of severe bleeding.

Heparin-Induced Thrombocytopenia (HIT)

A complication where heparin causes the body to use up platelets to form clots, resulting in low platelet counts and a subsequent high risk of bleeding.

Warfarin

An oral anticoagulant used daily to prevent clots in patients with conditions like AFib or mechanical heart valves; monitored using PT and INR.

INR (International Normalized Ratio)

The standard laboratory value for monitoring warfarin; the therapeutic goal is generally between $2$ and $3$. Values above $3$ indicate a risk of bleeding.

Vitamin K

The specific antidote used to reverse the effects of warfarin.

Dabigatran

A thrombin inhibitor that prevents the conversion of fibrinogen to fibrin to stop clot formation.

Thrombolytics

Also called fibrinolytics (e.g., alteplase), these potent drugs are used to dissolve and disintegrate existing clots during an MI or stroke.

Aminocaproic acid

The antidote for fibrinolytic or thrombolytic agents such as alteplase.

Herbal Bleeding Risks

Remedies such as ginger, ginkgo, and feverfew that can potentiate bleeding and should be avoided by patients on anticoagulants.

Pentoxifylline

A drug used for peripheral vascular disease that decreases blood viscosity and prevents platelet aggregation to improve blood flow in the legs.

Intermittent Claudication

Leg pain that occurs during walking but is relieved by rest, caused by ischemia in the lower extremities due to peripheral arterial disease.

Cilostazol

An antiplatelet agent used specifically to treat peripheral vascular disease by decreasing platelet aggregation.