ACS pt 5

Question 1

beta blocker should be started within ____

Answer 1

24 hours

Question 2

when shouldnt we give beta blocker ACS?

Answer 2

bradycardia, HF, risk cardiogenic shock, PR >0.24 s, second or third degree block, asthma

Question 3

metoprolol tartrate starting/maintenance

Answer 3

start: 25 mg BID
main: 50-100 mg BID

Question 4

metoprolol succinate maintenance

Answer 4

100-200 mg daily

Question 5

carvedilol starting/maintenance

Answer 5

start: 6.25 mg BID
main: 25-50 mg BID

Question 6

propranolol starting/maintenance

Answer 6

start: 40 mg BID-TID
main: 80 mg qid

Question 7

atenolol starting/maintenance

Answer 7

start: 25-50 mg daily
main: 100 mg daily

Question 8

patients with HF drugs of choice

Answer 8

metoprolol succinate, carvedilol, bisoprolol

Question 9

bisoprolol dose

Answer 9

5-10 mg daily

Question 10

when to consider IV beta blocker?

Answer 10

hypertensive, ongoing ischemia

Question 11

IV beta blocker of choice

Answer 11

metoprolol tartrate 5 mg IV q5min (up to 3 doses)

Question 12

beta 1 selective drugs

Answer 12

bisoprolol, metoprolol, atenolol

Question 13

non selective beta drug

Answer 13

propranolol

Question 14

beta blocker with alpha activity

Answer 14

carvedilol, labetalol

Question 15

beta blockers with ISA

Answer 15

pindolol, acebutolol

Question 16

beta blockers eliminated renally

Answer 16

bisoprolol and atenolol

Question 17

which beta blocker should be used in cocaine patients?

Answer 17

carvedilol

Question 18

should you give a beta blocker to a pt with HF?

Answer 18

no, do not start or increase but can keep same dose if they were already on one

Question 19

hold parameters for beta blockers

Answer 19

HR <50-60
BP < 90/60

Question 20

captopril starting and main

Answer 20

start: 6.25-12.5 mg TID
main: 25-50 mg TID

Question 21

lisinopril starting and main

Answer 21

start: 2.5-5 mg daily
main: 10+ mg

Question 22

ramipril starting and main

Answer 22

start: 2.5 mg BID
main: 5 mg BID

Question 23

trandolapril starting and main

Answer 23

start: 0.5 mg daily
main: 4 mg daily

Question 24

valsartan starting and main

Answer 24

start: 20 mg BID
main: 160 mg BID

Question 25

when to not use ACE inhibitors

Answer 25

hypotension / shock
renal stenosis
acute renal fail
angioedema

Question 26

ACE monitoring effects

Answer 26

increased SCr
increased K+
decreased BP
angioedema

Question 27

why does SCr increase?

Answer 27

efferent arteriole vasodilation

Question 28

SCr concerning increase

Answer 28

> 30% increase

Question 29

who needs triple anticoag?

Answer 29

afib or CHADSVASC 2+
stemi and asymptomatic LV thrombi
stemi and abnormal heart wall movement

Question 30

how long should pts with afib be on triple therapy?

Answer 30

stop ASA 1-4 weeks post PCI and continue P2Y12 and anticoag

Question 31

nitroglycerin tabs need to be replaced how often

Answer 31

ever 3-6 months once opened

Question 32

nitrolingual spray priming?

Answer 32

5 sprays

Question 33

nitromist spray priming?

Answer 33

10 sprays

Question 34

where to spray sublingual sprays?

Answer 34

under tongue