Cumulative Final Exam Material Flashcards
What electrolyte changes can occur with Loop Diuretics?
DECREASE Potassium and Magnesium
INCREASE Uric Acid
What electrolyte changes can occur with Thiazides?
DECREASE Potassium, Magnesium, and Sodium
INCREASE Calcium, Glucose
What electrolyte changes can occur with Potassium Sparing Diuretics?
INCREASE Potassium
What electrolyte changes can occur with Spironolactone?
INCREASE Uric Acid
Coumadin
Warfarin
1. AE: Bleeding
2. DDI: BAMIF
3. CI: Pregnancy
Pradaxa
Dabigatran
1. Store in original container
2. Swallow whole
3. AE: Dyspepsia
4. DDI: Pgp + 3A4 Inhibitors = increase concentrations
Xarelto
Rivaroxaban
1. 10 mg = take without regard to food
2. 15-20 mg = take with evening MEAL
3. AE: Bleeding
4. DDI: Pgp + 3A4 Inhibitors = increase concentrations
Eliquis
Apixaban
1. AE: Bleeding
2. DDI: Pgp + 3A4 Inhibitors = increase concentrations
Savaysa
Edoxaban
1. AE: Bleeding
2. DDI: Limit dosage to 30 mg/day when using specific pg inhibitors
HTN Therapy Options for Patients with CKD
- ACE
HTN Therapy Options for Patients with DM
- ACE
- ARB
- Thiazide
- CCB
HTN Therapy Options for Patients with CAD
- BB
- RAAS Inhibitor
- CCB
HTN Therapy Options for Patients with HF
- Loops
- BB
- ACE
- ARB
- ARA
HTN Therapy Options for Patients with CVB
- ACE
- ARB
- Thiazide
HTN Therapy Options for Patients with AFib
- CCB
What is first line therapy for Chronic Stable Angina?
- Short Acting Nitrates (Nitrostat) – ACUTE exacerbation ONLY
- Beta Blockers – only if they are uncomplicated
- CCB – AVOID Non-DP CCBs
What Beta Blockers can be used for Chronic Stable Angina?
- Propranolol
- Atenolol
- Metoprolol Succinate
- Metoprolol Tartrate
What CCBs CANNOT be used for Chronic Stable Angina?
- NON-DP CCBs
- Felodipine
What is second line therapy for Chronic Stable Angina?
- Long Acting Nitrates (Isorbide Dinitrate)
- Ranolazine
- Ivabridine
For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age <75 yrs
What is the recommended therapy?
High Intensity Statin
For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age <75 yrs
4. On maximal statin therapy
5. LDL >70
What is the recommended therapy?
Add Ezetimibe
For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age >75 yrs
What is the recommended therapy?
Start Moderate to High Intensity Statin OR
Continue High Intensity Statin if reasonable
For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
What is the recommended therapy?
High Intensity Statin
For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
3. On maximal statin therapy
4. LDL >70
What is the recommended therapy?
Add Ezetimibe
For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
3. On maximal statin therapy
4. On maximal ezetimibe therapy
5. LDL >70
What is the recommended therapy?
Add PCSK9-Inhibitor
For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD 5%
What is the recommended therapy?
Lifestyle Modifications
For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD 5-7.5%
What is the recommended therapy?
Discussion, could start moderate intensity statin if needed
For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD 7.5-20%
What is the recommended therapy?
Start Moderate Intensity Statin
For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD >20%
What is the recommended therapy?
Start High Intensity Statin
For patients with PRIMARY PREVENTION:
1. LDL >190
What is the recommended therapy?
Start High Intensity Statin
For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. Diabetes
What is the recommended therapy?
Start Moderate Intensity Statin
Moderate Intensity Statin should reduce LDL by what percentage?
30-49%
High Intensity Statin should reduce LDL by what percentage?
> 50%
What is the amount of time needed to achieve maximal lowering of LDL?
4-5 weeks
For patients with ASCVD and TG 150-499 mg/dL
1. LDL > 100
2. Adherent to max tolerated statin therapy
What is the recommended therapy?
Add on Ezetimibe
For patients with ASCVD and TG 150-499 mg/dL
1. LDL 70-99
2. Adherent to max tolerated statin therapy
What is the recommended therapy?
LDL or TG lowering non statin therapy, discussion
For patients with ASCVD and TG 150-499 mg/dL
1. LDL <70
2. Adherent to max tolerated statin therapy
What is the recommended therapy?
Start Icosapent Ethyl
For patients with DM and TG 140-499 mg/dL
1. Age <50 OR
2. Age >50 w/o ASCVD Risk Factors
3. Adherent to max tolerated statin therapy
What is the recommended therapy?
Add Ezetimibe
For patients with DM and TG 140-499 mg/dL
1. Age >50 WITH >1 ASCVD Risk Factors
2. Adherent to max tolerated statin therapy
What is the recommended therapy?
Start Icosapent Ethyl
For patients with DM and TG 140-499 mg/dL
1. TG 500-999
What is the recommended therapy?
- Optimize statin therapy
- Add on Fenofibrate
For patients with DM and TG 140-499 mg/dL
1. TG >1000
What is the recommended therapy?
Add on Fenofibrate
(alternative: Iscosapent Ethyl or Omega-3-Acid Ethyl Esters)
What are the preferred agents for VTE?
DOACs
Pradaxa and Savaysa should be started how many days after parenteral?
5-10 days after
What are the first line therapy options for HTN?
- ACEs
- ARBs
- CCBs
- Thiazides
What drugs can be utilized in the treatment of AFib?
- Amiodarone
- Digoxin
- Dofetilide
- Metoprolol Tartrate
- Flecainide
DOACs can also be utilized as therapy in what type of AFib?
Nonvalvular
Warfarin can also be utilized as therapy in what type of AFib?
Valvular
What drugs have Symptom Benefit in the treatment of HFrEF?
Loop Diuretics
What drugs have Hospitalization Benefit in the treatment of HFrEF?
- Digoxin
- Ivabradine
What drugs have Mortality Benefit in the treatment of HFrEF?
- ACE
- ARB
- ARNI
- BB
- SGLT2
- ARA
- Isosorbide/Hydralazine
Humalog
Lispro - Rapid Acting
Onset: 15-30 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat
Admelog
Lispro - Rapid Acting
Onset: 5 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat
Novolog
Aspart - Rapid Acting
Onset: 15-30 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat
Fiasp
Aspart - Rapid Acting
Onset: 5 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat
Afrezza
Rapid Acting
Onset: 10-15 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat
Which rapid acting insulin has a U-200 formulation?
Humalog
Humulin R
Short Acting
Onset: 30-60 mins
Peak: 2-3 hrs
Duration: 6-8 hrs
Dosing: Before you eat
Novolin R
Short Acting
Onset: 30-60 min
Peak: 2-3 hrs
Duration: 6-8 hrs
Dosing: Before you eat
What short acting insulin has a U-500 formulation?
Humulin R
Humulin NPH
Intermediate Acting
Onset: 2-4 hrs
Peak: 4-6 hrs
Duration: 8-12 hrs
Dosing: BID
Novolin NPH
Intermediate Acting
Onset: 2-4 hrs
Peak: 4-6 hrs
Duration: 8-12 hrs
Dosing: BID
Lantus
Glargine - Long Acting
Onset: 2 hrs
Peak: PEAKLESS
Duration: 24 hrs
Dosing: QD
Levemir
Detemir - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 24 hrs
Dosing: QD
Toujeo
Glargine - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 36 hrs
Dosing: QD