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NAPLEX SIHD test with fully solved questions 2025 latest update.
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NAPLEX SIHD test with fully solved questions 2025 latest update.
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NAPLEX SIHD test with fullysolved questions 2025 latest
update
Prinzmetal's angina
chest pain caused by vasospasm, can occur at rest
meds used for cardiac stress test
adenosine, dipyridamole, dobutamine, regadenoson (Lexiscan)
treatment approach for SIHD
ABCDE
Antiplatelet/antianginal, Blood pressure/beta blockers, Cholesterol
(statins)/cigarettes (cessation), Diet/diabetes, Exercise/education
SIHD needs statin because
It is one of the ASCVDs. Patients should be treated with a high
intensity statin.
Use ACE or ARB to
Manage HTN in patients with CAD and diabetes
1st line in SIHD
Beta Blockers without ISA (metoprolol, carvedilol)
AVOID THESE IN PRINZMETAL'S ANGINA!!!!
aspirin contraindications
salicylate allergy, children and teenagers with viral infection due to
Reye's syndrome
aspirin warnings
bleeding, tinnitus (salicylate overdose)
forms of aspirin that should not be used when rapid onset is needed
, Durlaza (ER capsule), Yosprala (delayed-release tablet)
Type of aspirin preferred in ACS
Non-enteric coated, CHEWABLE aspirin; if only enteric-coated EC
aspirin is available, it should be CHEWED!!!!!
Yosprala aspirin
aspirin + omeprazole
Durlaza
Aspirin ER
Aspirin MOA
works by binding and irreversibly inhibiting COX-1 and COX-2
resulting in a decrease in prostaglandin synthesis and a decrease in
thromboxane A2 synthesis. Thromboxane A2 is a potent
vasoconstrictor and induces platelet aggregation
preferred antiplatelet in SIHD
aspirin
clopidogrel used if contraindication to aspirin
clopidogrel warnings
bleeding risk (stop 5 days prior to elective surgery), do not use with
omeprazole or esomeprazole (due to CYP2C19 inhibition), TTP. VERY
IMPORTANT POINT ABOUT NOT USING WITH THE OMEPRAZOLE AND
ESOMEPRAZOLE!!! CAN USE WITH OTHER PPIs like PROTONIX!!!!
first line antianginal drug in SIHD
beta-blockers
preferred beta-blockers
those without ISA (metoprolol, carvedilol)
when to avoid beta-blockers
Prinzmetal's angina
target resting HR with beta-blockers
55-60
preferred drug for Prinzmetal's angina
CCBs, when used with Beta Blockers DHP-CCBS are preferred
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