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CPR II Week 2 > Drugs to Treat Endocarditis, Myocarditis, and Pericarditis > Flashcards

Drugs to Treat Endocarditis, Myocarditis, and Pericarditis Flashcards

1
Q

What are the classes of drugs used to treat myocarditis?

A

1) ACE inhibitors
2) Angiotensin II receptor blockers
3) Beta blockers
4) Diuretics
5) Aldosterone-Receptor blocker

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2
Q

What ACE inhibitors are used to treat myocarditis?

A

-pril:

1) Benazepril
2) Captopril
3) Enalapril
4) Fosinopril
5) Lisinopril

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3
Q

What are the Angiotensin II receptor blockers used to treat myocarditis?

A

-artan:

1) Losartan
2) Valsartan

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4
Q

In the treatment of myocarditis, what is benazepril indicated for?

A

Management of HTN and Tx of heart failure

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5
Q

What does benazepril not contain which makes it different from other ACE inhibitors with regard to safety profile?

A

Sulfhydryl group

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6
Q

What population is benazepril contraindicated for?

Why?

A

1) Black patients

2) Greater chance of causing angioedema

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7
Q

Captopril similarly to benazepril is indicated for treatment of HTN and congestive heart failure but also?

A

Diabetic neuropathy and scleroderma

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8
Q

What contraindication is common with captopril?

What should be used instead?

A

1) Sulphur allergy

2) Benazepril, enalapril, or fosinopril

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9
Q

Besides being used for the treatment of myocarditis, enalapril is indicated for?

A

Stroke prophylaxis

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10
Q

Fosinopril similarly to the other ACE inhibitors is indicated for treatment of HTN and heart failure but also?

A

Proteinuria

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11
Q

Fosinopril in combination with what other drug gives a blood pressure lowering effect greater than that seen with either agent alone?

A

Thiazide diuretics

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12
Q

Lisinopril similarly to the other ACE inhibitors is indicated for treatment of HTN and heart failure but also?

A

Acute MI

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13
Q

What drug-drug interaction is seen with lisinopril and patients on diuretic therapy?

A

Hypotension

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14
Q

What drug-drug interaction is seen with lisinopril and patients on antidiabetics?

A

Hypoglycemia

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15
Q

What drug-drug interaction is seen with lisinopril and patients on NSAIDs?

A

Damage renal function

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16
Q

What black box warning is associated with the ACE inhibitors?

A

Fetal toxicity

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17
Q

What contraindication is seen with the ACE inhibitors?

A

Angioedema

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18
Q

What parameters do you want to monitor when administering ACE-inhibitors?

A

1) BP
2) Creatinine/BUN
3) Potassium
4) Sodium

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19
Q

What is Valsartan indicated for?

A

Treatment of HTN, heart failure, and post MI

20
Q

What is Losartan indicated for?

A

1) Treatment of HTN in adults and children greater than 6
2) Reduce risk of stroke
3) Treatment of diabetic nephropathy

21
Q

What black box warning do the Angiotensin II Receptor Blockers have?

A

Fetal toxicity

22
Q

What warnings/precautions are associated with Angiotensin II Receptor Blockers?

A

1) Hypotension
2) Impaired hepatic function
3) Impaired renal function

23
Q

What beta blockers are used in the treatment of myocarditis?

A

1) Carvedilol
2) Bisoprolol
3) Metoprolol

24
Q

What receptors does carvedilol block?

A

Alpha-and nonselective beta-blocker

25
Q

What receptor does Bisoprolol block?

A

Beta-1

26
Q

What receptor does Metoprolol block?

A

Beta-1

27
Q

What warning is associated with beta blockers?

A

Avoid abrupt cessation of therapy

28
Q

What contraindication is seen with beta blockers?

A

Bronchospasm and asthma

29
Q

What diuretic used to treat myocarditis?

A

Furosemide

30
Q

What is furosemide indicated for?

A

Treatment of edema associated with CHF

31
Q

What warning is associated with furosemide?

A

Profound diuresis can cause water/electrolyte depletion

32
Q

When should parenteral furosemide be replaced with oral furosemide?

A

As soon as practical

33
Q

What drug-drug interaction does furosemide commonly have?

This may increase the potential of?

Especially in the presence of?

A

1) Aminoglycoside antibiotics
2) Ototoxicity
3) Impaired renal function

34
Q

Furosemide should also not be used concomitantly with what drug due to possibility of ototoxicity?

A

Ethacrynic acid

35
Q

What aldosterone antagonist is used to treat myocarditis?

A

Spironolactone

36
Q

What warnings/precautions are associated with spironolactone?

A

1) Hyperkalemia

2) Gynecomastia

37
Q

What is used as management for acute idiopathic or viral pericarditis?

A

NSAIDS in combination with colchicine

38
Q

The duration of treatment of pericarditis is based upon?

A

1) Resolution of symptoms

2) Normalization of CRP

39
Q

What should be used for initial treatment of acute pericarditis only in patients with contraindications to NSAIDs?

A

Glucocorticoids

40
Q

What contraindication is associated with ibuprofen?

A

Active gastric or duodenal ulcer

41
Q

What drug interactions are seen with colchicine?

A

CYP3A4 inhibitors

42
Q

What are necessary for effective treatment of endocarditis?

A

Bactericidal agents

43
Q

What is the critical first step in designing a management strategy for endocarditis?

A

Accurate diagnosis from blood cultures

44
Q

Empiric antibiotics should cover?

A

1) Staphylococci
2) Streptococci
3) Enterococci

45
Q

What is a reasonable initial therapy for endocarditis?

A

Vancomycin

46
Q

Concomitant administration of vancomycin and anesthetic agents has been associated with?

A

Erythema and histamine-like flushing

CPR II Week 2 (6 decks)

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