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Internal Medicine > Cardio Drugs and Treatments > Flashcards

Cardio Drugs and Treatments Flashcards

1
Q

Stage 1 hypertension. Tx

A

>130 over <80; Lifestyle changes + 1 med

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2
Q

Stage 2 hypertension. Tx

A

>140 over >90; 2 medications and lifestyle

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3
Q

Hypertensive urgency? Tx

A

>180 over >110; IV temporizing and PO meds

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4
Q

Hypertensive urgency? Tx

A

220/120 with end organ damage; Iv gtt decrease MAP by 25% in 4-6 hours then to normal in 24 hours

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5
Q

What are the medications for someone with CAD?

A

BB + Ace + ISMN and CCB

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6
Q

What are the medications for someone with CHF?

A

BB + ACE + ISDN + Hydralazine, spironolactone

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7
Q

What is the medications indicated for CVA?

A

Thiazide + CCB

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8
Q

What are the medications indicated for DM

A

ACE inhibitor for renal protective properties

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9
Q

What are the medications indicated for CKD?

A

ACE for renal protective properties unless CKD IV Thiazides dont work after Cr>1.5

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10
Q

What should you watch out for when using thiazides?

A

Hypokalemia

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11
Q

What should you watch out for when using loops?

A

Hypokalemia

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12
Q

Arterial dilator

A

Hydralazine

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13
Q

What are the Treatment modalities for CHF?

A

LMNOP Lasix (furosemide), Morphine, Nitrates, Oxygen, Position

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14
Q

What are the treatment modalities for acute MI

A

MONA BASH Morphine Oxygen Nitrates Aspirin Beta blockers Ace i Statin Heparin

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15
Q

High intensity statins

A

Atorva 40,80; Rosuva 20, 40

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16
Q

Moderate intensity statins

A

Atorva 10,20; Rosuva 5, 10

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17
Q

Risk factors for CAD

A

Diabetes, smoking, hypertension, dyslipidemia, age over 55 in women and 45 for men

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18
Q

What do you do if there is statin toxicity

A

Stop the statin until it goes away and restart at a lower dose

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19
Q

What is required before starting a statin drug? What should be monitored?

A
  • Baseline lipids, A1c, CK, and LFTs
  • Monitor lipids q1y and if DM A1c every 3 months
  • Dont monitor CK and LFTs
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20
Q

What are the second line meds to statins?

A

Fibrates good at getting LDLD down and HDL up but cause the same side effects

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21
Q

What should you prophylax the patient with when giving niacine

A

Aspirin to prevent flushing

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22
Q

What is the utility of bile acid resins and ezetimibe?

A

Block reabsorption of fatty related stuff meaning stool is fattier and more prone to diarrhea but it can lower LDL

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23
Q

Who gets a statin?

A
  • People with vascular disease = MI, CVA, PVD, CS
  • LDL over 190
  • LDL between 70-189 with age 40-75 and diabetes
  • LDL between 70-189 with age 40-75 and 10% risk factor
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24
Q

Treatment of pericarditis

A

NSAIDs and colchicine

25
Q

What is the treatment for constrictive pericarditis? Tamponade? Recurrent effusion

A
  • Constrictive: Pericardectomy
  • Tamponade: Pericardiocentesis
  • Recurrent effusion: Pericardial window
26
Q

Symptoms and EKG findings of pericarditis

A

Pleuritic chest pain better with leaning FORWARD.

  • EKG finding: diffuse ST elevation and PR depression
27
Q

Infectious causes of pericarditis

A

Coxsackie

Strep/Staph

TB

FUngus

28
Q

Which rhythms do you give atropine

A

Sinus brady, primary block, secondary block type 2

29
Q

What rhythms do you not give atropine to and just pace?

A

Secondary type 2, tertiary, and idiopathic

30
Q

What do you do to treat cardiac arrest with drugs in VT/VF and in PEA?

A

2 minutes of CPR, pulse and rhythm check

  • VT/VF alternate between epi and amiodarone. 2 minutes CPR then shock
  • PEA: Give epi every other 2 minute cycle
31
Q

What is idioventricular rhythm?

A

No atrial conduction at all, just pace

32
Q

What is the treatment method for afib?

A

CHADS2 score.

  • C: CHF
  • H: HTN
  • A: Age over 75
  • D: DM
  • S: Stroke

Score

  • 0: Give aspirin
  • 1: Give aspirin or oral anticoagulation (Apixaban and dabigatran
  • 2: Anticoagulation (warfarin)
33
Q

What is the treatment for stable afib?

A
  • Rate control (verapamil or diltiazem)
  • If under 48 hours then cardiovert
  • If Older than 48 hours, TTE then TEE to check for clots
    • If no clots, cardiovert, amio or shock
    • If clots, Warfarin x 3 weeks
34
Q

SVT responds to what?

35
Q

V Tach responds to what?

A

Amiodarone or lidocane

36
Q

What is the treatment for mitral valve prolapse?

A

Expanding the intravascular voliume and allowing the heart to fill which will streth the annulus and make the leaflets fit better. In other words, increase preload

37
Q

What is the treatment for HOCM?

A

Increase preload (DO the thing that makes the murmur less loud)

38
Q

Consequences of mitral stenosis?

A

CHF, SOB, Afib

39
Q

What is the cause of mitral stenosis?

A

Rheumatic fever

40
Q

Opening snap means:

A

Mitral stenosis

41
Q

What is the major treatment methods for mitral stenosis

A
  • Baloon valvotomy or valve replacement is definitive
  • If there is Afib then you need to anticoagulate and cardiovert after the lesion is identified
42
Q

Reasons for mitral regurg

A

Papilary muscle rupture, infective endocarditis, or direct trauma

43
Q

Treatment for preload reduction in CHF?

A
  • Diuretics such as furosemide
  • Nitrates such as isosorbide dinitrate
  • Dietary modifications
44
Q

Afterload reduction in CHF patients

A
  • ACE-i or ARB
  • Hydralazine
  • Spironolactone
45
Q

Everybody with CHF gets these treatments?

A
  • Salt restriction (under 2 g per day)
  • Water restriction (under 2 L per day)
  • ACE or ARBs
  • Beta blockers
46
Q

Does digoxin help CHF?

A

ONLY SYMPTOMS NOT MORTALITY

47
Q

What are the last resort drugs to use in CHF?

A
  • Inotropes (dobutamine) while preparing for transplant or ventricular assist device
48
Q

What do you do if you notice any CHF symptoms

A

ECHO will show either

  • Diastolic dysfunction (no relaxation)
  • Decreased EF (systolic dysfunction)
49
Q

What are the details of stable angina?

A
  • Pain: Exercise
  • Relief: rest + motrates
  • Biomarkers: none
  • ST changes: None
  • Pathology: 70% blockage
50
Q

What are the details of unstable angina

A
  • Pain: Rest

Relief: None

Biomarkers: none

ST changes: None

Pathology: 90% blockage

51
Q

What are the details of NSTEMI?

A
  • Pain: Rest
  • Relief: None
  • Biomarkers: Elevated
  • ST changes: None
  • Pathology: 90% blockage
52
Q

What are the details of STEMI

A
  • Pain: Rest
  • Relief: None
  • Biomarkers: Elevated
  • ST changes: Elevated
  • Pathology: 100% blockage
53
Q

What is the order of things you test for with chest pain?

A
  1. EKG (if positive go to cath emergently)
  2. Next Biomarkers (if positive go urgently to cath)
  3. If cardiac chest pain do a stress test (if positive treat with meds then cath)
54
Q

Acute MI treatment

A
  • Morpine
  • Oxygen
  • Nitrates
  • Asprin
  • Beta blocker
  • ACE
  • Statin
  • Heparin + Clopidogrel (dual antiplatelet)
55
Q

When do you go for angioplasty?

A

St elevation or + stress showing 1 or 2 vessel disease

56
Q

What do you do if you have no percutaneous intervention for MI available? What if you cant use that?

A

tPA or Heparin if contraindication for tPA

57
Q

What is the LDL, A1C, and blood pressure goal for ACS patients?

A
  • LDL under 70
  • A1C under 7
  • Blood pressure under 140.90
58
Q

Clopidogrel treatment for different types of stents?

A
  • Drug eluding stent: 12 months
  • Bare metal stent: one month
  • Angioplasty alone: None

Internal Medicine (7 decks)

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