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NAPLEX 2022 > CHRONIC HEART FAILURE > Flashcards

CHRONIC HEART FAILURE Flashcards

1
Q

WHAT EF INDICATES SYSTOLIC DYSFUNCTION

A

EF < 40%

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2
Q

SYSTOLIC HEART FAILURE IS ALSO KNOWN AS

A

HF REDUCED EF
HFrEF

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3
Q

ACC/AHA STAGING SYSTEM FOR HF

A

A AND B INDICATE NO PHYSICAL SYMPTOMS OF HF
C AND D INDICATE SYMPTOMS PRESENT, D BEING MORE SEVERE

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4
Q

NYHA FUNCTIONAL CLASS FOR HF

A

1-4
1 INDICATING NO LIMITATIONS TO PHYSICAL ACTIVITY
4 INDICATING SYMPTOMS PRESENT EVEN AT REST

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5
Q

WHICH LABS/BIOMARKERS ARE IDENTIFIED IN HF

A

BNP
NT-proBNP

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6
Q

CARDIAC OUTPUT DEPENDS ON?

A

HR AND SV
CO = HR X SV

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7
Q

WHAT COMPENSATORY MECHANISMS OCCUR DUE TO HF? (TARGET SYSTEMS FOR HF)

A

SNS
RAAS
VASOPRESSIN
NATRIURETIC PEPTIDES

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8
Q

RAAS AND VASOPRESSIN ACTIVITY IN HF

A

ANGIOTENSIN II CAUSES VASOCONSTRICTION
ALDOSTERONE CAUSES NA AND H2O RETENTION
VASOPRESSIN CAUSES VASOCONSTRICTION AND H2O RETENTION

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9
Q

NATURAL PRODUCTS FOR HF

A

FISH OILS
HAWTHRON
COQ10

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10
Q

DRUGS THAT CAN WORSEN HF

A

DRUG INFORMATION NATION
DPP4 INHIBITORS
IMMUNOSUPPRESSANTS
NON DHP CCB
ANTIARRHYTHMICS
THIAZOLIDINEDIONES
ITRACONAZOLE
ONCOLOGY
NSAIDS

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11
Q

WHICH MEDICATION CLASSES ARE RECOMMENDED FOR ALL PATIENTS W/OUT CONTRAINDICATIONS

A

ACEi, ARB, ARNI
BB
LOOP DIURETICS

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12
Q

WHICH MEDICATION CLASSES DECREASE MORTALITY IN HF

A

RAAS MEDICATIONS
BB
ARA
SGLT2

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13
Q

WHICH MEDICATION CLASSES ARE ADDED ON IN SELCT PATIENTS?

A

ARA
SGLT2
HYDRALAZINE AND NITRATES
IVABRADINE

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14
Q

WHEN IS ARA ADDED ON TO INITIAL HF THERAPY?

A

NYHA CLASS II - IV

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15
Q

WHEN IS SGLT2 INHIBITORS ADDED ON TO INITIAL HF THERAPY?

A

NYHA CLASS II - IV
W/ OR W/OUT DIABETES

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16
Q

WHEN IS HYDRALAZINE AND NITRATES ADDED ON TO INITIAL THERAPY?

A

PERSISTENTLY SYMPTOMATIC BLACK PATIENTS WITH NYHA CLASS III - IV DESPITE TREATMENT WITH ARNI, BB, ARA, SGLT2

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17
Q

WHEN IS IVABRADINE ADDED ON TO INITIAL THERAPY

A

NYHA CLASS II - III IN NORMAL SINUS RHYTHM W/ RESTING HR ≥ 70 BPM ON MAX TOLERATED DOSE OF BB

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18
Q

WHAT BENEFIT WOULD DIGOXIN BRING TO HF TREATMENT

A

SMALL INCREASE IN CO
IMPROVE SX AND ↓ CARDIAC HOSPITALIZATIONS

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19
Q

WHICH LOOP DIURETICS ARE INDICATED IN HF

A

FUROSEMIDE
BUMETANIDE
TORSEMIDE
ETHACRYNIC ACID

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20
Q

WHAT IS THE PURPOSE OF LOOP DIURETICS IN HF THERAPY

A

SYMPTOM CONTROL
DOES NOT IMPROVE SURVIVAL

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21
Q

WHAT ALLERGY TO LOOK OUT FOR BEFORE USING LOOP DIURETICS

A

SULFA ALLERGY
EXCEPT ETHACRYNIC ACID

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22
Q

LOOP DIURETIC SIDE EFFECTS

A

↓K, MG, NA, CL, CA
↑ HCO3, UA, BG, TG, TC
OTOXICITY
PHOTOSENSITIVITY

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23
Q

WHICH LOOP DIURETIC HAS THE HIGHEST CHANCE OF OTOTOXICITY

A

ETHACRYNIC ACID

24
Q

ORAL EQUIVALENT DOSES FOR LOOP DIURETICS

A

FUROSEMIDE 40
TORSEMIDE 20
BUMETANIDE 1
ETHACRYNIC ACID 50

25
Q

FUROSEMIDE IV:PO RATIO

A

IV 1 : PO 2

26
Q

BUMETANIDE IV:PO RATIO

A

1:1

27
Q

ETHACRYNIC ACID RATIO

A

1:1

28
Q

WHAT IS CAPTOPRIL’S DOSING FREQUENCY

A

TID

29
Q

WHAT IS THE TARGET DOSE FOR ENALAPRIL

A

10 - 20 MG BID

30
Q

WHAT IS THE TARGET DOSE FOR LISINOPRIL

A

20 - 40 MG QD

31
Q

WHAT IS THE TARGET DOSE FOR QUINAPRIL

A

20 MG BID

32
Q

WHAT IS THE TARGET DOSE FOR RAMIPRIL

A

10 MG QD

33
Q

WHAT IS THE WASHOUT PERIOD FOR ACEi BEFORE USING ENTRESTO

A

36 HOURS

34
Q

WHAT IS THE TARGET DOSE FOR LOSARTAN

A

50 - 150 MG QD

35
Q

WHAT IS THE TARGET DOSE FOR VALSARTAN

A

160 MG BID

36
Q

WHAT IS THE WASHOUT PERID FOR ARBs BEFORE USING ENTRESTO

A

NONE

37
Q

WHICH BB ARE INDICATED FOR HF

A

METOPROLOL SUCCINATE
BISOPROLOL
CARVEDILOL

38
Q

WHEN WOULD BB BE DISCONTINUED?

A

ONLY DURING ACUTE DECOMPENSATED HF IF HYPOTENSION OR HYPOPERFUSION IS PRESENT

39
Q

WHAT IS THE TARGET DOSE FOR METOPROLOL SUCCINATE

A

200 MG QD

40
Q

WHAT IS THE TARGET DOSE FOR CARVEDILOL IR

A

< 85 KG = 25 MG BID
> 85 KG = 50 MG BID

41
Q

WHAT IS THE TARGET DOSE FOR CARVEDILOL CR

A

80 MG QD

42
Q

METOPROLOL SUCCINATE IV:PO RATIO

A

1 : 2.5

43
Q

WHAT IS THE TARGET DOSE FOR SPIRONOLACTONE

A

25 MG DAILY OR BID

44
Q

WHICH SGLT2s ARE INDICATED IN HF

A

DAPAGLIFLOZIN
EMPAGLIFLOZIN

45
Q

WHEN WOULD SGLT2s NOT BE INITIATED

A

DAPA = eGFR < 30
EMPA = eGFR < 20

46
Q

WHAT IS THE THERAPEUTIC RANGE FOR DIGOXIN IN HF

A

0.5 - 0.9

47
Q

WHAT IS THE TYPICAL DIGOXIN DOSE IN HF

A

0.125 - 0.25 MG DAILY

48
Q

AT WHAT CRCL WOULD DOSE ADJUSTMENTS BE NEEDED?

A

CRCL < 50
EITHER ↓ DOSE OR FREQUENCY

49
Q

WHAT ARE THE SIGNS OF DIGOXIN TOXICITY

A

INITIAL: N/V, LOSS OF APPETITE, BRADYCARDIA
SEVERE: BLURRED/DOUBLE VISION, GREENISH-YELLOW HALOS

50
Q

DIGOXIN ANTIDOTE

A

DIGIFAB

51
Q

IVABRADINE TARGET HR

A

BETWEEN 50 - 06 BPM

52
Q

IVABRADINE WARNINGS

A

BRADYCARDIA
↑ RISK FOR QT PROLONGATION
↑ RISK FOR AFIB

53
Q

WHAT ARE THE CONVERSIONS FOR POTASSIUM CHLORIDE ORAL SOLUTIONS

A

10% = 20 mEq / 15 mL
20% = 40 mEq / 15 mL

54
Q

WHAT ARE THE HEMODYNAMIC EFFECTS OF DIGOXIN

A

POSITIVE INOTROPE (INCREASE CONTRACTION FORCE)
NEGATIVE CHRONOTROPE (DECREASE HR)

55
Q

WHAT IS THE MOA OF CARVEDILOL

A

NON SELECTIVE BB
BETA 1, BETA 2, ALPHA 1 BLOCKER

56
Q

ONE SHOULD NOTIFY THEIR DOCTOR WHEN THEIR WEIGHT CHANGE IS…

A

3 - 5 LBS INCREASE WITHIN A WEEK
2 - 4 LBS INCREASE WITHIN A DAY

57
Q

WHAT ARE THE BRAND NAMES FOR POTASSIUM CHLORIDE CAPSULE PRODUCTS

A

KLOR-CON SPRINKLE
MICRO-K

NAPLEX 2022 (37 decks)

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