NR-565 Advanced Pharmacology Fundamentals Midterm Exam (Latest Update) Question: Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score What is it? Answer: ASCVD risk assessment is directed at determining the patient's absolute risk of developing cl inical coronary disease over the next 10 years. Defines high risk as 7.5% or greater. a calculation of your 10 -year risk of having a cardiovascular problem, such as a heart attack or stroke. Question: When is it used - ASCVD Risk Score Answer: In childre n a screening should be done between ages 9 and 11 and then again at ages 19 and 21. For adults every 5 years after the age of 20. Some people are at greater risk like those with diabetes and a risk score greater than 7.5% and should be screened more often Question: ezetimibe - when can it be used? Answer: pregnancy/breastfeeding can be use in monotherapy or as adjunct therapy with a statin or a fibrate Question: What is ezetimibe? Answer: Cholesterol Absorption Inhibitor - lowers cholesterol levels by decreasing the amount of cholesterol that is absorbed from the small intestine, so that there is less intestinal cholesterol delivered to the liver. Do es not affect triglycerides Question: lifestyle changes for high cholesterol Answer: Lifestyle changes are non drug measures used to lower LDL. Four main issues are diet, exercise, weight control, and smoking cessation Question: If a patient wanted to minimize side effects, which drug classification is a good choice? Answer: Non-statins - fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally well tolerated and side effects are uncommon. Some patients develop headache, flatulence, constipatio n, or GI disturbances, but these effects are usually mild and transient Question: Therapeutic action of organic nitrates (nitroglycerin) Answer: direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves oxygen suppl y to the myocardium. The dilation of peripheral veins, and in higher doses peripheral arteries, reduces preload and afterload, and thereby lowers myocardial oxygen consumption. promote vasodilation Question: Contraindications for ranolazine Answer: Agent s that inhibit CYP3A4 can increase the levels of ranolazine and thereby increase the risk of torsades de pointes. These things include: grapefruit juice, HIV protease inhibitors, macrolide antibiotics, azole antifungal drugs, and some CCB. Most CCB but not amlodipine can increase levels of ranolazine. Drugs that prolong the QT interval can increase the risk of torsades de pointes. (quinidine, sotalol). Question: At what age can statins be prescribed? Answer: avoid statin use in children under the age of 1 0 Question: CCB role with variant angina Answer: promote relaxation of coronary artery spasm, increasing cardiac oxygen supply Question: what medication can be added for patients with worsening symptoms of HF? Answer: aldosterone antagonist - promotes m yocardial remodeling and fibrosis, help with symptoms