Cardiology

Question 1

What are some medications that increase Warfarin’s therapeutic effect?

Answer 1

1. Alter intestinal flora - Metronidazole, quinolones
2. CYP2C9 inhib - Azole, Amiodarone
3. Dec Vit K recycling - Acetaminophen

Question 2

What are some meds that decrease Warfarin’s therapeutic effect?

Answer 2

1. CYP2C9 induc - Rifampin, phenytoin, SJW
2. Inc Coag fx - Oral contraceptives
3. Inc Vit K - Green vegetables

Question 3

What is the initial treatment of acute aortic dissection

Answer 3

Pain control
IV B-blockers
+/- Sodium nitroprussid
Emergent surgical repair

Question 4

What are side effects of amiodarone?

Answer 4

1. amiodarone induced pulmonary toxicity
   - -CXR = diffuse or focal interstitial or alveolar opacities
   - -corticosteroids used in severe dz
2. photosensitivity
3. skin discoloration
4. bone marrow suppression
5. thyroid dysfxn
6. abnormal LFT’s

Question 5

What medications taken concurrently with digoxin can cause digoxin toxicity?

Answer 5

Verapamil - inhibits renal tubular excretion
Quinidine
Amiodarone
Spironolactone

Question 6

What is considered imparied LV ejection fraction?

Answer 6

LVEF =60 is considered impaired

Question 7

How should a patient with aortic stenosis and a LVEF of 35%, asymptomatic be managed?

Answer 7

Initiate ACE-i

–Pt has Stage B HF, high risk for heart failure