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Pharmacology > Cardio: Drugs for Myocarditis, Endocarditis, and Pericarditis > Flashcards

Cardio: Drugs for Myocarditis, Endocarditis, and Pericarditis Flashcards

1
Q

Suffix of all ACEi?

A

-pril

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2
Q

Suffix of all ARBs?

A

-sartan

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3
Q

Black box warning of all ACEi and ARBs?

A

Embryotoxic!

-do not give if pt pregnant or if breastfeeding

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4
Q

What should you monitor for all ACEi?

A
  1. Blood pressure: check for decrease
  2. Serum Creatinine/BUN: can cause early rise
  3. Serum K+: can increase
  4. Serum Na+: can decrease
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5
Q

Adverse reactions to ACEi?

A

Alopecia, angioedema, angina, anaphylactoid reactions

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6
Q

Contraindications to ACEi?

A

Angioedema, Aortic stenosis, Black patients may tolerate worse

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7
Q

What can all ACEi be used to treat?

A

Heart failure and HTN

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8
Q

Which of the ACEi have a sulfa allergy associated with them?

A

Captopril

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9
Q

Which of the ACEi would you prescribe in someone for stroke prophylaxis?

A

Enalapril

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10
Q

Which of the ACEi drugs be used in renal syndromes, such as proteinuria and diabetic neuropathy?

A

captopril, enapril, fosinopril

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11
Q

Fosinopril is used in combo with what drug to increase efficacy?

A

Thiazide diuretics

-ie Hydrochlorothiazide

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12
Q

Which ACEi is given post-MI to reduce mortality?

A

Lisinopril

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13
Q

When prescribing lisinopril, what drug-drug interactions should you watch out for?

A

Diuretics
-can drastically reduce BP

Anti-diabetics
-can increase glucose lowering, causing hypoglycemia

NSAIDs
-combo can cause AKI

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14
Q

Indications for ARBs?

A

HTN

-lowering BP reduces CV events like strokes and MI

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15
Q

Which of the ARBs is used in children?

A

Losartan

-can be used to lower BP in children as young as 6yo

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16
Q

Adverse effects of all ARBs?

A

Hypotension, impaired renal fxn, impaired hepatic fxn

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17
Q

What should you monitor when prescribing an ARB?

A

BP,
LFTs
Serum Bilirubin

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18
Q

MOA of Carvedilol?

A

Mixed a1 and non-selective B-blocker

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19
Q

Indications for all B-Blockers?

A

Heart Failure,
HTN
Left ventricular dysfunction in stable pts

20
Q

Which B-blockers could you give for A-fib and A-flutter?

A

Bisoprolol and Metoprolol

-probably others, but this is what he lists

21
Q

Which B-blocker can you give for unstable angina?

A

Metoprolol

22
Q

When taking a patient off a B-Blocker, what is important to remember?

A

Taper them off

-abrupt cessation can exacerbate CAD

23
Q

Would you give a B-blocker in someone with Asthma, COPD or bronchospasm?

A

NOPE

-the cardioselective ones would be your best bet if you HAD to use a B-blocker though

24
Q

What would you monitor when giving a B-blocker?

A

BP, HR

Serum creatinine/BUN (bisoprolol)

25
Q

Which of the B-blockers can cause HF and LV dyfunction following MI?

A

Carvedilol

Also look out for hyperglycemia, asthenia, and bradycardia

26
Q

Which drugs would you give for edema?

A

Furosemide (very effective!) and Spironolactone

27
Q

What do you need to watch out for when giving furosemide?

A

Water/electrolyte depletion

-so look for signs of dehydration, hypotension, hypocalemia, hyponatremia!, muscle cramps, etc

28
Q

Furosemide and aminoglycosides can cause what?

A

Ototoxicity, especially in those with renal impairment

29
Q

Would you give furosemide with ethacrynic acid?

A

Nah fam, can cause ototoxicity

-both do the same thing anyway

30
Q

MOA of spironolactone?

A

Aldosterone antagonist

31
Q

MOA of furosamide?

A

Inhibits NKCC2 transporter

32
Q

Indications for Spironolactone?

A

HF, edema, HTN, Primary hyperaldosteronism

33
Q

What do you need to look out for when prescribing spironolactone?

A

Hyperkalemia (peaked T waves??)
Hypotension/worsening renal fxn
Electrolyte disturbances
Gynecomastia

34
Q

A 55yo male comes into your office complaining of impoetence and “growing boobs” after taking a drug for his ascites due to cirrhosis. What drug is he taking?

A

Spironolactone

-aldosterone inhibitor that isn’t specific, so inhibits testosterone as well

35
Q

What drugs does spironolactone interact with?

A

Lithium (toxicity)
NSAIDs reduce effect of aldosterone
–increases K+ more?

36
Q

When would you se Glucocorticoids for pericarditis?

A

If contra to NSAIDs

37
Q

What should you be considerate of when giving NSAIDs?

A

Active bleeds, Ulcers, and gastritis, especially in elderly

NSAIDs would be contraindicated if any of these present!

38
Q

Warnings when prescribing NSAIDs?

A

HF, HTN
GI irritation
Renal toxicity, especially if on diuretics

39
Q

What is first line in treating pericarditis?

A

Indomethacin and Colchicine

-from Selby

40
Q

What is the label and off label use of Colchicine?

A

Label: gout
Off: pericarditis

41
Q

What drug-drug interactions should you be mindful of with colchicine?

A

those that interact w CYP3A4

42
Q

Would you prescribe colchicine in those with renal/hepatic impairment?

A

NO

43
Q

Adverse effects of colchicine?

A

GI Upset (diarrhea, N/V)

44
Q

If a patient has signs and symptoms of infectious endocarditis, what should you treat with?

A

Vancomycin until you find out the specific bug

45
Q

How long does it take to treat infectious endocarditis?

A

4-6 weeks

46
Q

Adverse reactions to vancomycin?

A

Anaphylaxis, “red man” syndrome, AKI, hearing loss, neutropenia

Watch out for infusion reactions (phlebitis), ototoxicity and C. diff

Pharmacology (50 decks)

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