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1-EOR-EMED > Drugs > Flashcards

Drugs Flashcards

1
Q

ramipril

A

ACEi; treats hypertension

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2
Q

abciximab

A

(GP IIb/IIIa inhibitor)

Platelet aggregation inhibitor mainly used during and after coronary artery procedures like angioplasty

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3
Q

Patients with aortic regurgitation may benefit from which long-acting vasodilators?

Acute aortic regurg: endocarditis, dissection, trauma

Chronic: rheumatic heart disease, prior endocarditis

–loud S3, short diastolic murmur–

A

Nifedipine XL

or other long acting calcium channel blockers

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4
Q

Torsades de pointes treatment? UNstable

(anti-psychotic agents that can cause it: thioridazine, pimozide, droperidol, and ziprasidone)

can also be caused by HYPOcalcemia

A

cardioversion

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5
Q

What type of STEMI is the use of nitroglycerin relatively contraindicated for?

A

Inferior ST elevation (II, III, aVF)

–these may be indicative of a right ventricular infarct which are preload dependent and can lead to a precipitous drop in blood pressure

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6
Q

chlorthalidone

A

thiazide diuretic; hypertension

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7
Q

Carvedilol

A

Beta-blocker; Dilated cardiomyopathy (heart failure)

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8
Q

Which class of common over the counter drugs can worsen heart failure?

A

NSAIDs

(e.g. ibuprofen)

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9
Q

What is the treatment of hemodynamically UNstable ventricular tachycardia?

A

Electrical cardioversion

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10
Q

Wolff-Parkinson-White + tachycardia + hemodynamically UNstable treatment?

10

A

Cardioversion

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11
Q

Sinus bradycardia

A

Atropine

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12
Q

nicardipine

A

calcium channel blocker; vasodilator

used to treat chronic stable angina, hypertension, and Raynaud’s phenomenon

**more selective for cerebral and coronary vessels**

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13
Q

Flecainide

A

anti-arrhythmic drug

–supraventricular tachycardia

–ventricular tachycardia

NOT RELATED TO ACUTE ISCHEMIA

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14
Q

Alendronate

A

biphosphonate that acts as an osteoclast inhibitor to inhibit bone resorption

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15
Q

What common drug class reduces cardiac contractility?

A

beta-blockers

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16
Q

Pulseless electrical activity treatment?

A

chest compressions

Causes:

  1. Hypovolemia
  2. Hypoxia
  3. Hypothermia
  4. Hyperkalemia
  5. Tension pneumothorax
  6. Thrombus (PE, MI)
  7. Toxicologic
  8. Tamponade
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17
Q

Capture beats and fushion beats confirm the diagnosis of which cardiac dysrhythmia?

A

Ventricular tachycardia

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18
Q

What antipsychotic drug has a black blox warning for the development of pericarditis and myocarditis?

A

Clozapine

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19
Q

Salmeterol

A

long-acting beta-2 agonist; bronchospasm and COPD

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20
Q

Ibuprofen

A

NSAID

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21
Q

metaproterenol

A

Beta-2 agonist

acute management of asthmatic bronchospasm

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22
Q

A common side effect of calcium channel blockers is pedal edema; what can be added to the patient’s regimen to offset this?

Calcium channel blockers:

  • Amlodipine
  • Felodipine
  • Nicardipine
  • Isradipine
  • Nifedipine
  • Diltiazem
  • Verapamil
A

Edema side effect can be lessened by adding an ACEi or ARB to patient’s regimen

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23
Q

Sinus bradycardia + hemodynamically UNstable

A

atropine

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24
Q

Cardiomegaly, Kerley B Lines, effusions

with exertional dyspnea, orthopnea, paroxysmal noctural dyspnea, pitting edema and S3 heart sound

A

Acute decompensated heart failiure

  1. BiPAP
  2. Nitroglycerin
  3. Furosemide
  4. Hypotension, no shock: dobutamine
  5. Hypotension, yes shock: norepinephrine
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25
Q

What is the treatment of choice in antidromic, atrioventricular reciprocating tachycardia in a hemodynamically STABLE patient?

25

A

procainamide

(WPW syndrone)

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26
Q

Wolff-Parkinson-White + tachycardia + hemodynamically STABLE

treatment?

A
  1. Vagal maneuver first; then
  2. Adenosine
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27
Q

isradipine

A

Calcium channel blocker

PINE

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28
Q

esmolol

A

short-acting beta blocker; hypertension in setting of aortic dissection

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29
Q

ST elevations V3, V4

A

Anterior

Left anterior Descending (LAD)

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30
Q

In patients with myocardial infarction, which three drugs have been shown to decrease mortality?

A

Aspirin, beta-blockers, ACEi

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31
Q

furosemide

A

diuretic; used in acute decompensated heart failure

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32
Q

Pregnancy induced hypertension tx?

i.e. first choice for control of hypertension in pregnancy

A

Methyldopa (centrally acting alpha agonist)

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33
Q

What is the most commonly used first line agent to treat hypertension?

A

Thiazide diuretics, like hydrochlorothiazide or chlorthalidone

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34
Q

What is the initial treatment for a STEMI in leads II, III, and aVF?

A

Intravenous hydration

Inferior leads; may be right ventricular infarct which is preload dependent

Right coronary artery

Also, aspirin

NITROGLYCERIN IS CONTRAINDICATED

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35
Q

Which class of medications are CONTRAINDICATED with cocaine related chest pain?

A

Beta-blockers; can cause unopposed alpha effects leading to worsening symptoms and blood pressure

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36
Q

Bisoprolol

A

Beta-blocker; Dilated cardiomyopathy (heart failure)

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37
Q

Ketorolac

A

(toradol) NSAID (poor anti-inflammatory effects, but good for analgesic)

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38
Q

Hypertensive emergency tx

A

(hypertension with acute end-organ system injury)

  1. Reduce MAP 25% in first hour;
  2. Normalize BP over next 8-24 hours;
  3. Treatment: labetalol (first), nicardipine (second)

labetalol=short-acting beta blocker and alpha blocker

nicardipine=calcium channel blocker; vasodilator

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39
Q

Which medications are contraindicated in Wolff Parkinson White syndrome?

A

A–adenosine

B– beta-blockers

C– calcium channel blockers

D– digoxin

why? slows AV nodal conduction

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40
Q

Young patient +dizziness+palpitations+ hyperthyroidism/caffeine/drugs

A

Paroxysmal Supreventricular Tachycardia (PSVT) caused by reentrant conduction pathway (conduction reentry)

tx: reduction of offending agent, can also treat with vagal maneuvers

Hemodynamically stable: can use adenosine or calcium channel blocker

Hemodynamically unsable: cardioversion

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41
Q

losartan

A

ARB (angiotensin receptor blocker); blood pressure

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42
Q

Verapamil

A

calcium channel blocker; hypertension

Edema side effect can be lessened by adding an ACEi or ARB to patient’s regimen

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43
Q

Acute decompensated heart failure (hypotension; no signs of shock)

A
  1. BiPAP
  2. Nitroglycerin
  3. Furosemide
  4. Add: dobutamine
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44
Q

Acute decompensated heart failure (hypotension; yes signs of shock)

A
  1. BiPAP
  2. Nitroglycerin
  3. Furosemide
  4. Add: norepinephrine
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45
Q

What is the INR range in a patient taking warfarin for atrial fibrillation?

A

INR range is 2-3

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46
Q

Prednisone

A

Corticosteroid with anti-inflammatory properties

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47
Q

Adenosine

A

atrioventricular (AV) nodal blocker; used for supraventricular trachycardias

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48
Q

Temporal (giant cell) arteritis treatment?

A

high-dose steroids

dx: temporal artery biopsy

–monocular vision loss, jaw claudication, headache, women >50

ESR>50

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49
Q

What is indicated for the treatment of unstable tachydysrhythmias, including certain supraventricular dysrhythmias as well as monomorphic ventricular tachycardia

A

Synchronized cardioversion (200J)

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50
Q

phentolamine

A

IV ; used for hypertensive emergency due to pheochromocytoma

alpha-blocker which can be used to block the catecholamine effects of a pheochromocytoma

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51
Q

Acute rheumatic fever treatment

A

(diffuse inflammation of the heart following an infection with group A beta-hemolytic streptococcal infection)

Treat with:

  1. NSAIDS
  2. antibiotics: penicillin V or penicillin G or amoxicillin
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52
Q

Nifedipine

A

calcium channel blocker

PINE

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53
Q

which bile acid sequestrant medication can lower A1C by 0.5% in patients with type 2 diabetes and dyslipidemia?

A

colesevelam

54
Q

Reteplase

A

Fibrinolytic agent; used to treat ST-elevation myocardial infarctions when catheterization lab is not readily available

55
Q

Diltiazem

A

calcium channel blocker; used in tachydysrhythias

56
Q

Deep Vein Thrombosis

A

IV heparin and switch to warfarin

57
Q

Which class of medications should be given initially for acute pulmonary edema?

A

nitrates

58
Q

dipyridamole

A

Vasodilator and blood thinners; used to treat TIA

59
Q

nitroprusside

A

vasodilator

60
Q

Timolol

A

Beta-Blocker; glaucoma

61
Q

Mitral stenosis requires what treatment?

A

Result of rheumatic heart disease

–antibiotic prophylaxis for procedures prone to bacteremia–

**loud S1, opening snap, low-pitched, rumbling diastolic apical murmur, best with left lateral decubitus position**

62
Q

enalapril

A

ACEi; blood pressure

63
Q

ST elevations I, aVL, V5, V6,

A

lateral

Left circumflex

64
Q

Cor Pulmonale treatment

A

right heart catheterization

HTN+ RVH (right ventricular hypertrophy)

most common chronic cause: COPD

most common acute cause: PE

65
Q

Hypertension and aortic dissection; treatment of choice?

In patients with aortic dissection, what is the recommended blood pressure goal?

A

Negative ionotropes (short-acting beta blockers) labetalol, esmolol, and propranolol

Systolic 110 mm Hg

66
Q

What is the role of beta-adrenergic blocking agents in acute myocardial infarction?

A

Beta-adrenergic blockers given within 24 hours of presentation reduce the risk of developing ventricular dysrhythias

67
Q

Felodipine

A

Calcium channel blocker

PINE

68
Q

Which virus is most responsible for pericarditis?

A

coxsackie

69
Q

ST elevation; patient is being prepared for transfer to the interventional cardiac unit for primary percuntaneous cardiac reperfusion

–Already given oxygen, nitroglycerin, and aspirin

What else do you give this patient?

A

abciximab

(GP IIb/IIIa inhibitor)

Platelet aggregation inhibitor

70
Q

Hypertension + COPD+ cardiact arrythmyia

A

Multifocal atrial tachycardia (MAT)

treat with calcium channel blockers

71
Q

Hydralazine

A

peripheral vasodilator;

often added to methyldopa for refractory cases of pregnant hypertension

72
Q

Metoprolol

A

Beta-blocker; Dilated cardiomyopathy (heart failure) and hypertension

73
Q

Ranolazine

A

Anti-angina medication that is used ONLY AFTER calcium channel blockers, beta-blockers, and nitrates have failed to control angina

74
Q

What drug is safe to administer in a patient with a wide complex irregular tachycardia?

A

procainamide

75
Q

What are some common electrolyte abnormalities associated with hydrochlorothiazide?

A
  1. HYPOkalemia
  2. HYPOnatremia
  3. HYPOmagnesemia
  4. hypercalcemia

Hypo: MagNaK

Hyper: Ca

76
Q

Torsades de pointes treatment? STABLE

(anti-psychotic agents that can cause it: thioridazine, pimozide, droperidol, and ziprasidone)

can also be caused by HYPOcalcemia

A

IV magnesium sulfate

77
Q

What is the best treatment for first degree heart block?

A

no treatment is necessary

78
Q

Procainamide

A

antiarrhythmic; used in tachydysrhythmias

–supraventricular tachycardia

–ventricular tachycardia

79
Q

Methyldopa

A

(centrally acting alpha agonist)

first choice for control of hypertension in pregnancy

80
Q

Nitrate therapy works by which mechanisms?

A

reducing both preload and afterload

81
Q

witnessed ventricular fibrillation

A

immediate defibrillation with 200 joules biphasic (360 joules monophasic)

82
Q

amlodipine

A

calcium channel blocker; blood pressure and angina

83
Q

Community acquired pneumonia treatment

A

ceftriaxone and azithromycin

84
Q

Hypotension and aortic dissection; fluid of choice?

A

Crystalloids

85
Q

Torsades de pointes treatment? PULSELESS

(anti-psychotic agents that can cause it: thioridazine, pimozide, droperidol, and ziprasidone)

can also be caused by HYPOcalcemia

A

defibrillation

86
Q

Pain

Pallor

Paresthesias

Pulselessness

Paralysis

Poikilothermia

A

Arterial thrmboembolism

Most common source=left heart

Most common site= femoral artery bifurcation

87
Q

labetalol

A

short-acting beta blocker and alpha blocker;

hypertension in setting of aortic dissection

Malignant hypertension

hypertension in pregnancy (after Methyldopa)

88
Q

Acute decompensated heart failure (no hypotension)

A
  1. BiPAP
  2. Nitroglycerin
  3. Furosemide
89
Q

Low-output heart failure treatment

Systolic dysfunction– EF <40%

(causes: ischemic heart disease, HTN, cardiomyopathy, valvular heart dx)

A

O2, BiPAP, nitrates, furosemide

90
Q

Hemodynamically stable ventricular tachycardia

A

procainamide

amiodarone

(if refractory-synchronized cardioversion)

bidirectional ventricular tachycardia indicates digoxin toxicity

91
Q

hydrochlorothiazide

A

thiazide diuretic; hypertension

92
Q

Transient ischemic attack treatment

A

administer aspirin and dipyridamole; admit to stroke unit

if allergic to aspirin: clopidogrel

93
Q

varicose veins

(lower leg edema, dilated veins)

A

compression stockings

94
Q

patient vignette with artherosclerosis+new murmur described as mid-systloic murmur heard best at the second intercostal space near right sternal border; decreases with isometric handgrip and Valsalva maneuvers

“crescendo-decrescendo”

paradoxically split S2, S4 gallop

A

aortic stenosis

95
Q

Clopidogrel

A

platelet P2Y12 receptor blocker (antiplatelet therapy)

96
Q

ventricular fibrillation unwitnessed

A

CPR for 2 minutes, then defibrillation

97
Q

ST elevations in V4R and V5R

A

Right ventricular

CONTRAINDICATED: nitrates

This is preload dependent–> fluids!!

98
Q

Which medication is used in the treatment of hemodynamically stable atrial fibrillation with concomitant Wolff-Parkinson-White syndrome?

(pre-excied atrial fibrillation)

A

Ibutilide, an anti-arrhythmic drug (prolongs refractoriness of AV node)

99
Q

What medication is recommened for the treatment of atrial dysrhythmias associated with hyperthroidism?

A

propranolol

100
Q

Which calcium channel blocker has the greatest effect on the AV node?

A

verapamil

101
Q

Which drug used for the treatment of heart failure has been shown to reduce hospitalizations, but has no effect on mortality?

A

Digoxin

102
Q

which beta-blocker is contraindicated in prinzmetal’s angina?

A

propranolol

103
Q

what class of medications may help improve palpitations from mitral valve prolapse?

A

beta-blockers

104
Q

What is the treatment of choice for Prinzmetal angina?

A

Calcium channel blockers and nitrates

105
Q

Tachycardia (stable narrow-complex supraventricular tachycardia)

treatment?

A

Adenosine

106
Q

What is the mainstay of treatment for hypertrophic cardiomyopathy?

A

Management: long-term beta-blocker therapy. Can also use calcium channel blockers.

CONTRAINDICATED: positive inotropes and nitrates

107
Q

ST elevations V1, V2

A

Septal

Left anterior Descending (LAD)

108
Q

Infectious endocarditis: IV drug use (staph aureus)

A

Vancomycin and ceftriaxone

Vancomycin= glycopeptide antibiotic

ceftriaxone= cephalosporin antibiotic

109
Q

which electroly abnormality can cause increased blood pressure?

A

hypercalcemia

110
Q

When should nitrates be avoided?

A
  1. Systolic <90 mm Hg
  2. HR < 50/min
  3. HR>100/min
  4. Right ventricular infarction (inferior with leads II, III, aVF)
  5. Patient who took phosphodiesterase inhibitor (erectile dysfunction) in last 24 hours
  6. Hypertrophic cardiomyopathy
  7. Severe aortic stenosis
111
Q

Acute pericarditis

A

NSAID (ibuprofen, naproxen)

Also: Colchicine and corticosteroids if refractory

112
Q

Calcitonin

A

lower serum calcium concentration by inhibiting calcium absorption by the intestines, inhibiting osteoclast activity in bones, and inhibits renal tubular cell reabsorption of calcium (allowing it to be excreted via urine)

113
Q

ST depressions in V1, V2, large R waves

A

Posterior

114
Q

Wolff-Parkinson-White DEFINITIVE treatment

A

radiofrequency ablation of bundle of kent

115
Q

Naproxen

A

NSAID

116
Q

Infliximab

A

anti-tumor necrosis factor alpha antibody used in treatment of autoimmune dx

117
Q

propranolol

A

short-acting beta blocker; hypertension in setting of aortic dissection

118
Q

Mitral valve prolapse

(inherited with symptoms of anxiety, panic attacks, palpitations, exercise intolerance, syncope, etc)

MVP=apical mid-systolic click which may or may not be followed by a late-systolic murmur

A

Aysmptomatic: reassurance and serial echocardiograms

Symptomatic: beta-blockers, counseled on caffeine, alcohol, and tobacco abstinence, and given 24 hr cardiac monitor

119
Q

What is the first-line agent for reduction of triglycerides?

A

A fibrate, such as gemfibrozil

120
Q

Patient develops angioedema to aspirin, but you are concerned for acute coronary syndrome. which medication do you administer?

A

clopidogrel

binds to the platelet adenosine diphosphate (ADP) receptor to irreversibly inhibit activation and aggregation for the life of the platelet

121
Q

Increase in creatinine levels of a patient who recently started an ACEi. why?

Do ACEis cause HYPERkalemia or HYPOkalemia? why?

A

ACE i blocks the conversion of angiotensin I to angiotensin II and thus decreases glomerula blood flow

HYPERkalemia; reduction of aldosterone secretion

122
Q

Dilated cardiomyopathy (heart failure)

A

Bisoprolol, carvedilol, and metoprolol

123
Q

dobutamine

A

inotropic;

Short-term (<48 hr) management of heart failure caused by depressed contractility from organic heart disease or surgical procedures.

Stimulates beta1 (myocardial)-adrenergic receptors with relatively minor effect on heart rate or peripheral blood vessels.

Therapeutic Effect(s):

Increased cardiac output without significantly increased heart rate.

124
Q

Which antihypertensive agent is preferable for a hypertensive emergency caused by a PHEOCHROMOCYTOMA?

A

IV phentolamine;

alpha-blocker which can be used to block the catecholamine effects of a pheochromocytoma

125
Q

which medications are associated with periodic sinus arrest?

A

digitalis, procainamide, quinidine

126
Q

Pulseless ventricular tachycardia?

A

defibrillation

127
Q

Sinus bradycardia + hemodynamically STABLE

A

monitored closely

128
Q

For managing blood pressure, which two classes of medications should NOT be used together?

A

ACEis and ARBs

129
Q

ST elevations in II, III, aVF

A

inferior

Right coronary artery (right dominant)

Left circumflex (left dominant)

130
Q

Which diabetic medications should be avoided in heart failure?

A
  1. Thiazolidinediones (pioglitazone and rosiglitazone)
  2. Metformin: risk of lactic acidosis
131
Q

lisinopril

A

ACEi

1-EOR-EMED (3 decks)

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