Drugs to Treat Myo-, Endo-, & Pericarditis

Question 1

What is a main contraindication of furosemide use?

Answer 1

anuria

Do not use if pt’s can’t produce urine.

Question 2

True or False: furosemide is a POTENT loop diuretic.

Answer 2

True; if given in excess, furosemide can cause profound diuresis w/ water and electrolyte depletion.

Question 3

What are some adverse effects of furosemide (a loop diuretic)?

Answer 3

• fluid/electrolyte imbalance
• hyponatremia
• hypochloremic alkalosis
• hypokalemia
• hypomagnesemia
• hypocalcemia (rarely)

Question 4

What is a consequence of drug-drug interaction when furosemide is given to pt’s on aminoglycoside abx (ex: gentamycin, streptomycin)?

Answer 4

-ototoxicity (especially when renal fxn is impaired)

Question 5

True or False: furosemide can be used w/ ethacrynic acid?

Answer 5

False, this combination causes ototoxicity.

Question 6

True or False: furosemide (a loop diuretic) is a sulfa drug.

Answer 6

True

Question 7

What drug can be used for diuresis in pt’s with sulfa allergies?

Answer 7

ethacrynic acid

Question 8

True or False: furosemide can be used even in pt’s with a low GFR.

Answer 8

True

Question 9

What is the main black box warning for all ACEi’s?

Answer 9

-fetal toxicity

Question 10

What are two indications for benazepril?

Answer 10

• HTN

- heart failure

Question 11

Is benazepril a sulfa drug?

Answer 11

No

Question 12

Is captopril a sulfa drug?

Answer 12

Yes

Question 13

What can enalapril be used for that makes it different from other ACEi’s?

Answer 13

Stroke prophylaxis

Question 14

Is enalapril a sulfa drug?

Answer 14

No

Question 15

Is fosinopril a sulfa drug?

Answer 15

No

Question 16

What could be the result of using lisinopril with anti-diabetic drugs?

Answer 16

an increased lowering of blood glucose

Question 17

True or False: spironolactone increases survival in heart failure pts

Answer 17

True

-also reduces the need for hospitalization

Question 18

In what order should you use diuretics to relieve congestion during heart failure?

Answer 18

1) loop diuretic (ex: furosemide)
2) K+ sparing diuretic (ex: spironolactone)
3) thiazide (ex: chlorthalidone)

Question 19

How do K+ losing diuretics interfere with digoxin?

Answer 19

-less K+ in the cell allows more digoxin to bind to the Na+/K+ ATP-ase and increases digoxin toxicity

Question 20

What are the therapeutic effects of digoxin?

Answer 20

• increases inotropy
• increases cardiac output
• decreased sympathetic tone
• increased urine production
• decreased renin release
• increases firing rate of vagal fibers
• increases SA node responsiveness to Ach

Question 21

What is the mechanism of action of digoxin?

Answer 21

-blocks the Na+/K+ ATP-ase

Question 22

How does the dosing of digoxin need to be done?

Answer 22

–digoxin needs a loading dose, b/c it has a long half-life of 36-48 hrs

Question 23

True or False: digoxin crosses the placenta and is thus not safe for use in pregnancy

Answer 23

False, it DOES cross the placenta, but has a long history of being “safe” for Tx of SVT during pregnancy

Question 24

What are side effects of digoxin?

Answer 24

• ST segment depression, PVC’s, or heart block
• dizziness, anxiety, and confusion
• rash
• N/V/D
• blurry, yellowed vision

Question 25

What is the Tx for too much digoxin?

Answer 25

• -KCl
• -lidocaine (blocks Na+ channels)
• -phenytoin (blocks Na+ channels)
• -anti-digitalis antibodies (DigiBind)