Cardiology Flashcards
contraindications of statins
pregnancy, breastfeeding
liver disease
CYP3A4 inhibitors - simvastatin and lovastatin
Vascepa generic name
icosapent ethyl
Zetia generic name
ezetimibe
Lovaza generic name
omega-3
Possible side effects of Lovaza include:
a. burping
b. arthralgias
c. dyspepsia
d. taste perversions
e. rhabdomyolysis
a, c, d
Which of the following can cause LDL to increase?
a. Tacrolimus
b. Niaspan
c. Lovaza
d. Dexamethasone
e. Welchol
F. Risperidone
a, c, d, f
Which of the following should be avoided with lovastatin?
a. Lopid
b. Voriconazole
c. Theophylline
d. Plavix
e. Biaxin
a, b, e
What are the max doses per day of simvastatin and lovastatin when used in combination with non-DHP CCBs?
simvastatin 10 mg
lovastatin 20 mg
Which statin is the least potent?
fluvastatin
For cholestyramine or colestipol, take all other meds at least ______ hours before or _______ hours after.
1-4; 4-6
Elevated TGs are most likely to cause what?
pancreatitis
Which statin should be taken with an evening meal?
lovastatin IR
Which of the following will help to lower TG?
a. Lovaza
b. Trilipix
c. TriCor
d. Vascepa
e. Welchol
a, b, c, d
What is a key counseling point for ER niacin administration?
Take at bedtime after a low fat snack
Select the correct MOA of cholestyramine.
a. Reduces cholesterol absorption at the brush-border
b. Peroxisome proliferator receptor alpha activator
c. Increases HDL synthesis
d. Inhibits the enzyme HMG-CoA reductase
e. Bind to bile acids in the gut
e
What drugs increase TG only?
IV lipid emulsions, propofol, bile acid sequestrants
When combined with simvastatin, which of the following increases the risk of myalgias?
a. Niacin 1 g daily
b. Colesevelam
c. Red yeast rice
d. Fenofibrate
e. Rifampin
a, c, d
T/F: Formulations of niacin (IR vs ER) are interchangeable.
F
What other names is niacin known by?
vitamin B3, nicotinic acid
Welchol is approved for use in which of the following conditions?
a. RA
b. Diabetes
c. Gout
d. Hypertriglyceridemia
e. Crohn’s disease
b
What cholesterol meds increase bleeding risk?
fish oil
Which of the following effects do statins have on cholesterol values?
a. Raises HDL
b. Lowers HDL
c. Raises TG
d. Lowers LDL
e. Lowers TG
a, d, e
What is the MOA of ezetimibe?
inhibits the absorption of cholesterol in the small intestine
Which statins can be given at any time of the day? (5)
Crestor, Lipitor, Livalo, Lescol XL, Pravachol
What condition is a contraindication to using lomitapide?
active liver disease
What is the therapeutic range for digoxin when used to treat HF?
0.5-0.9
Which potassium chloride formulation can be opened and sprinkled on food?
a. Micro-K
b. Klor-Con 10
c. Khlor-Con M10
d. K-Tab
e. Khlor-Con M15
a
Which of the following natural products may have a beneficial effect on HF? SELECT ALL THAT APPLY
a. Ginkgo
b. Fish oils
c. Hawthorn
d. Ma huang
e. Coenzyme Q10
b, c, e
GW was brought to the ER for difficulty breathing and notable swelling of the face, lips, and tongue. His medical hx is significant for diabetes and HFrEF. He currently takes rosuvastatin, metformin, spironolactone, carvedilol, fosinopril, bumetanide, and digoxin. Which medication should be discontinued and why?
Fosinopril - ACEs and ARBs can cause angioedema that presents as face swelling
What are the target doses of carvedilol IR for < 85 kg and > 85 kg?
25 mg BID and 50 mg BID
Which of the following meds could worsen HF? SELECT ALL THAT APPLY.
a. Itraconazole
b. Alogliptin
c. Ramipril
d. Procainamide
e. Carbamazepine
f. Acarbose
g. Daunorubicin
a, b, d, g
Which of the following regarding the dosing and administration of Toprol XL are true? SELECT ALL THAT APPLY.
a. The tablet should be swallowed whole and cannot be cut.
b. It should be taken with or immediately after meals.
c. It should be started at a dose of 200 mg daily for HF.
d. It can be converted to IV form using a 1:1 ratio.
e. The tablet can be cut in half at the score line if needed.
b, e
Which beta blockers reduce mortality in systolic HF?
metoprolol succinate, bisoprolol, carvedilol
Non-selective beta blocker that also blocks alpha 1
carvedilol
Which of the following physical exam findings are consistent with symptomatic HF? SELECT ALL THAT APPLY.
a. Asterixis
b. Dyspnea
c. Jugular venous distension
d. Peripheral edema
e. Rales
b, c, d, e
Ivabradine is indicated in HF patients with:
a. Afib
b. Bradycardia
c. Resting HR >/= 70 bpm
d. HTN
e. QT prolongation
c
Which of the following best describes safe dosing practices for the use of digoxin in treating HF?
a. Start at 0.5 mg daily; no renal adjustments required
b. Start 125 mg daily; reduce dose when CrCl < 50
c. Start at 0.25 mg daily; no renal adjustments needed
d. Start at 250 mg daily; reduce dose when CrCl < 30
e. Start at 0.25 mg daily; reduce dose when CrCl < 50
e
Which of the following is most appropriate to decrease fluid volume in a patient with a sulfa allergy?
a. Ethacrynic acid
b. Torsemide
c. Bumex
d. Lanoxin
e. Furosemide
a
What are the main pathways activated in HF?
RAAS system, sympathetic nervous system, vasopressin
Activation of the sympathetic nervous system in HF causes what physiologic effects?
increase in HR, contractility, and vasoconstriction
In HF, what are the initial medications for all patients without contraindications?
ACEs, ARBs, ARNI
Beta blockers
Loop diuretics
ACEs, ARBs, and loop diuretics can decrease renal clearance and increase the toxicity of what medication?
lithium
The combination of hydralazine and isosorbide dinitrate is a suitable alternative to which medications in a patient with HF and bilateral renal artery stenosis?
ACEs and ARBs
Which of the following is a common side effect of BiDil?
a. Rash
b. Headache
c. Hair growth
d. Sore, painful joints
e. Increased appetite
b
Which of the following is the correct MOA of ACE inhibitors?
a. Blocks aldosterone receptors in the distal convoluted tubule
b. Prevents the conversion of angiotensin I to angiotensin II
c. Blocks angiotensin II by binding directly to the AT1 receptor
b
EK has systolic HF and is taking quinapril, carvedilol, torsemide, spironolactone, and BiDil. He presents to the clinic with a mild fever, sore finger and arm joints, and muscle aches. He reports being more tired than usual and feels miserable. What adverse drug effect is EK likely experiencing?
drug-induced lupus erythematous
What drug causes DILE?
BiDil
Which of the following meds require monitoring of serum potassium?
a. Candesartan
b. Carvedilol
c. Lanoxin
d. Vasotec
e. Hydralazine
f. Entresto
g. Eplerenone
a, c, d, f, g