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PHM702 > Exam 2 - D-I Cardio > Flashcards

Exam 2 - D-I Cardio Flashcards

1
Q

What is a normal QTc?

A

< 470 men, < 480 women

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2
Q

What is abnormal QTc defined as? (2)

A

500 ms or more, or 60 ms from baseline or more

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3
Q

What drugs can cause prolonged QT intervals? (6; A-F)

A

antiarrhythmics, antibiotics (fluoroquinolones, macrolides), antipsychotics (FGAs), antidepressants (citalopram, TCAs), antiemetics, antifungals

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4
Q

What are non-modifiable risk factors for Torsades de Pointes? (4)

A

> 65, female, genetic predisposition, cardiac disease

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5
Q

What are modifiable risk factors for Torsades de Pointes? (4)

A

diuretic treatment, electrolyte abnormalities, >1 QT-prolonging agent, organ function

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6
Q

What should potassium and magnesium levels be maintained at to avoid QT prolongation?

A

K > 4, Mg > 2

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7
Q

What are the treatments for Torsade de Pointes? (4)

A

discontinue offending agents, magnesium PUSH IF NO PULSE AND INFUSION IF PULSE, transcutaenous pacing, isoproterenol infusion

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8
Q

What are alternatives for isoproterenol? (2)

A

epinephrine, atropine

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9
Q

What are the treatments for hemodynamically unstable patients? (2)

A

cardioversion, defibrillation

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10
Q

What drugs can cause HF due to sodium and volume retention? (3)

A

NSAIDs, steroids, thiazolidinediones

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11
Q

What drugs can cause HF due to cardiomyopathy? (3)

A

chemotherapeutic agents (anthracyclines, alkylating agents), biologics (trastuzumab), alcohol

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12
Q

What drugs can cause HF due to negative inotropy? (2)

A

nDHP CCBs, BBs

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13
Q

What is a boxed warning for TZDs?

A

avoid in patients with NYHA III-IV

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14
Q

What are the most common topoisomerase 2B agents that can cause cardiac myocyte death? (2)

A

daunorubicin, doxorubicin

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15
Q

What is a treatment for anthracycline induced cardiomyopathy?

A

dexrazoxane

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16
Q

What are treatment-related risk factors for anthracycline induced cardiomyopathy toxicity? (5)

A

cumulative doses > 400 mg/m^2, dosing schedules, previous anthracycline therapy, radiation therapy, co-admin of cardiotoxic agents

17
Q

What are patient-related risk factors for anthracycline induced cardiomyopathy toxicity? (4)

A

age, pre-existing CVD, obesity, smoking

18
Q

To what dose should anthracyclines be limited to to prevent cardiomyopathy?

A

550 mg/m^2 max

19
Q

By what mechanisms can trastuzumab induce cardiomyopathy? (4)

A

increased ROS, reduced NOS expression, reduced NO bioavailability, increased angiotensin II

20
Q

What is a boxed warning for trastuzumab?

A

symptomatic and asymptomatic reductions in LVEF and development of HF

21
Q

When should nDHPs be avoided?

A

EF < 40%

22
Q

When should BBs be avoided?

A

acute HF exacerbations

23
Q

What drugs/things can cause increased HR and contractility? (5)

A

cocaine, B-agonists, sympathomimetics, withdrawal of B-blockers, potent vasodilators

24
Q

What drugs can cause increased coronary resistance (vasospasms)? (2)

A

cocaine, triptans

25
Q

What drugs can cause coronary artery thrombosis/vasospasms? (5)

A

cocaine, triptans, OCPs, NSAIDs, estrogens

26
Q

What drugs can cause increased cardiovascular risk? (6)

A

cocaine, OCPs, NSAIDs, estrogens, HIV agents, rosiglitazone

27
Q

Explain a sympathomimetic crisis?

A

inhibition of reuptake of NE leading to increased NE concentrations and enhanced alpha-1 mediated vasoconstriction

28
Q

What are the treatments for chest pain in a cocaine-induced MI? (2)

A

aspirin, benzodiazepines

29
Q

What are the treatments for persistent HTN in a cocaine-induced MI? (2)

A

benzodiazepines, IV nitroglycerin

30
Q

Explain how COX inhibition can cause MI and stroke? (2)

A

vascular vasoconstriction and increased platelet aggregation

31
Q

What is a boxed warning for NSAIDs?

A

may increase risk of CV thrombotic events for those with CVD or at risk

32
Q

What are risk factors for acute MI with NSAIDs? (2)

A

recent initiation of therapy (within 7 days), higher doses

PHM702 (19 decks)

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