Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paige: CARDIO > Exam 2 - Pharm Blessings! :) > Flashcards

Exam 2 - Pharm Blessings! :) Flashcards

1
Q

*flash cards no longer under construction*

A

Your encounter begins now.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the “Stage 2” requirements for HTN for sytolic and diastolic pressures?

A

systolic pressure greater than 20ml

diastolic pressure greater than 10ml

so 160/100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the DOC for Stage 1 HTN?

A

Chlorthalidone (hygroton) or lisinopril (zestril)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Could you do dual therapy and prescribe both a thiazide drug like chlorthalidone [hygotron] and an ACE-I like lisinopril [zestril]?

A

YES!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When would dual therapy NOT be needed?

A

if lifestyle modifications are taken very seriously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In an african american, what is the DOC for stage 1 HTN?

A

HCTZ (microzide) or CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Whats the DOC in a person with stage 2 HTN?

A

ACE-I - lisinopril [zestril]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can you add to stage 2 htn treatment if the person isn’t responding well?

A

CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you add to HTN treatment for a person with angina?

A

add beta blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do you add to HTN treatment if a person is at high risk for a cardiac event?

A

ASA and/or statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does your treatment change for a patient in heart failure with HTN?

A

you’ll want to use a loop diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which disease is usually always correlated with HTN?

A

HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Could you do dual therapy and prescribe both a thiazide diuretic like chlorthalidone [hygotron] and an ACE-I like lisinopril [zestril]?

A

YES!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which drug classes work directly on the RAA axis?

A

ACE-I

ARBs

Direct Renin Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the main mechanism for all ACE-I?

A

decrease peripheral resistance

reduce Na and H2O retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the new guidelines for treating htn for patients 50+ regardless of comorbidities?

A

140/90 or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do ACE-I have an added effect of treating in diabetics?

A

diabetic neuropahty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can happen as a s/e with the first dose of an ACE-I?

A

hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When should a patient take an ACE-I for the first time?

A

in bed at night when already lying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you have a patient with diabetes, what drug in this section should they NOT be prescribed and why?

A

Beta blocker

Masks symptoms of hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What did one EKG machine say to the other EKG machine?

A

“you’re tachy”

(get ready for some killer jokes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If a person is started on an anti-hypertensive med, what should they be monitoring, even at home?

A

BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why are ACE-I good in diabetics?

A

Diabetics get plaque buildup in kidney vessels so it helps to protect against this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do you always give for treatment of a diabetic with HTN?

A

diuretic and ACE-I

dual therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the best thiazide diuretic?

A

chlorthalidone [hygroton]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which common OTC drug can cause HTN?

A

Ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what body chemical does Ibuprofen cut down on?

what does that chemical do?

A

prostaglandins

prostaglandins vasodilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which drug can cause decreased peripheral vascular resistance, leading to postural hypotension?

A

apha1 blockers -

prazosin [minipress]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

can a pregnant woman be on an ACE-I?

A

neggnog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

can a pregnant woman be on losartan [cozaar]?

A

kinda sorta yes! it’s a category B!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Your patient on Lisinopril [zestril] now has a cough. Why?

A

ACE-I cause couging from inc bradykinin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What do you do if your pt on an ACE-I can’t stand their cough?

A

tell him to suck it up

(in every deck there’s literally always one person who just needs to suck it up)

But you should actually be kind, rewind, and switch to an ARB like losartan [cozaar]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Can methyldopa be used in PG for HTN?

A

Yeah that’s what it’s indicated for but it’s literally never used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are C/I of ACE-I?

A

bilat renal artery stenosis

angioedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

30y/o black man with HTN. What shall you give him?

A

HCTZ [microzide]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Is HCTZ cheap or expensive?

A

Cheap!

4 dollar make ya hollerrrrrrrrrr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why is it that ACE-I don’t work well for blacks?

(related to MOA)

A

ACE-I work on the RAA system. Blacks don’t have high levels of renin, so it doesn’t really work.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Why does HCTZ work in the black population?

A

it works directly in the kidneys at the distal convoluted tubule (DCT) to inhibit NaCl reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How long does the diuretic effect work in HCTZ?

A

The NaCl thing is its MOA for 2 weeks, but then it becomes a vasodilator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Hey baby, are you my carotid artery?

A

Because I can’t live without you for more than 7 seconds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

So back to this black man who has HTN and is put on HCTZ [microzide]. What drug class is the 2nd line or can be used in combo with this?

A

CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What can you look to in the serum that indicates that someone is taking an nsaid?

A

elevated serum Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the max dose of lisinopril [zestril]?

A

40mg daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Your patient has a history of HTN, angina, and is in stage 3 kidney failure. No history of HF. What will you prescribe for his HTN?

A

ACE-I (adjust dose) and CCB (will also work with angina).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which beta blocker is stronger than the others?

What are s/e?

A

propanolol [inderal]

s/e = sedation, fatigue

46
Q

What is propanolol used for, mostly?

A

migraine prophylaxis

(lower dose, at night)

47
Q

are CCBs cheap or expensive?

A

$$$$$$$$$$$$$$$$$$$$$$$$

48
Q

What’s the rule of 6?

A

ITZ ALL ABOUT STATINZ

Every time you double a dose, you get a 6% decrease in LDL

so itz not worth it lolz

49
Q

How does HTN usually present?

A

asx

50
Q

What calculation do you make prior to starting someone on a statin?

A

10 year CVD risk

( >7.5%)

51
Q

What time of day should a patient take his/her statin?

A

at night

52
Q

What are you really looking for with s/e of a statin?

A

muscle pain or weakness

53
Q

If on a statin, what might muscle pain/weakness be indicative of?

A

myopathies or rhabidomylitis

(I know I probably didn’t spell that right but a girl can’t be awesome at <em>everything</em>)

54
Q

what do statins block?

A

it blocks the HMG-COA reductase enzyme

thus it blocks the synthesis of new cholesterol (“de novo synthesis”)

55
Q

what do statins decrease?

A

LDL and trigs

56
Q

What should you get as baseline tests when you put a patient on a statin?

A

CK

LFTs

57
Q

When should your patient follow up when you put them on a statin?

A

4-6 weeks

(when max effect happens)

58
Q

what kind of a pulse is indicative of afib?

A

irreg irreg

59
Q

Why did the female blood vessel not want to date the male blood vessel?

A

because he was a little vain

(slash vein, i really struggled with which spelling to put here so here’s both)

60
Q

which type of CCB helps with rate control?

A

nondihydropyridines

61
Q

are beta blockers good BP drugs?

A

no

62
Q

What drug do you want to use for a patient who has cirrhosis and hyperlipidemia? Why that drug?

A

Pravastatin [pravachol] because it is not metabolized by the liver

63
Q

What conditions put a patient in a high risk category for CVD, where lipid therapy should be considered?

A

afib and hx of angina

64
Q

what lipid drug would you consider for someone in the CVD high risk category?

A

atorvastatin [lipitor]

65
Q

Aren’t Paige’s jokes just hilarious?

A

Choose your own adventure:

if Yes - press 5 and never see this card again

if No - press 1 and see this card until you vote 5

66
Q

which herb decreases the effect of atorvastatin [lipitor]?

A

St. John’s Wort

67
Q

Yah or nah: pravastatin [pravachol] is metabolized by the CYP450 enzyme system

A

NAHHHHHH bro

(ps this is literally saying the same thing as ‘not metabolized in the liver’)

68
Q

What does niacin [niaspan] do?

A

reduces trigs

reduces LDL

increases HDL

69
Q

What are s/e of niacin?

A

flushing toilets +/- pruritis

(jk it’s not flushing toilets, it’s just regular flushing)

70
Q

How can a patient prevent himself from flushing toilets?

A

(again, if anyone is confused, we’re actually just talking about regular flushing)

take an ASA or ibuprofen 30 minutes before taking niacin [niaspan]

71
Q

What do you do if your patient develops muscle symptoms on a statin?

A

d/c until sx go away, then try again at a lower dose

(because it’s most likely dose related)

72
Q

What if a person can’t tolerate 10mg of atorvastatin [lipitor]?

A

could switch to fibric acid

OR could just push lifestyle modifications

73
Q

What are the 2 fibric acids on our table?

A

Gemfibrazil [lopid]

Fenofibrate [fibricor]

74
Q

which LDL lowering drug lowers mortality?

A

STATINZ

(also to avoid any further confusion, there’s not actually a “z” at the end of statins)

75
Q

what substance causes flushing?

A

prostaglandin!

(causes vasodilation)

76
Q

When you rx statins and fibrates as dual therapy, what does it put the patient at an inc risk for?

A

myopathies

77
Q

If you need to stop dual therapy with the statin and fibric acid, which one do you discontinue?

A

the fibrate

but would still lower the statin

78
Q

fibric acids are c/i in what disease?

A

biliary disease

79
Q

How should you instruct a patient to take their fibric acid in conjunction with other meds?

A

take fibric acid 1 hour before or 4 hours after other prescriptions

80
Q

Why was there a police officer at the heart’s house?

A

for a cardiac arrest

(ba-dn chhhh)

81
Q

What does Exetimibe [Zetia] do to cholesterol?

A

decreases LDL

82
Q

What is the MOA of Exetimibe [Zetia]?

A

cholesterol absorption inhibitor

decreases absorption of cholesterol in the GI tract

83
Q

what can happen to your pancreas if you have severe hypertriglyceridemia?

A

pancreatitis

84
Q

Between a statin and a fibric acid, which drug is most liley to reduce trigs?

A

fibric acid

85
Q

Fenofibrate [fibricor] and Warfarin [coumadin] have a drug-drug interaction. What happens?

A

increases INR

can increase gallstones

86
Q

What do you give for strep A 1st line?

A

penicillin

87
Q

What is 2nd line for Strep A?

A

cephalosporins

88
Q

What do you give for Strep A if someone has a penicillin allergy?

A

Macrolides (azithro)

89
Q

What is the problem with giving macrolides (other than resistance)?

A

can cause QT prolongation

90
Q

what populations are at an increased risk for drug-induced QT prolongation?

A

CAD

afib

other arrhythmias

91
Q

So what’s your 4th line choice for Strep A?

A

Clindamycin

92
Q

Can statins + azithromycin cause qt prolongation?

A

maybe! ongoing study

(I added this because I don’t read the articles but this sounded like a potential article topic)

93
Q

Your patient with non-valvular afib is on metoprolol [lopressor]. what should you add to the treatment regimen?

A

Dabigatran [pradaxa]

94
Q

Your patient on valvular afib is on metoprolol [lopressor]. What should you add to the treatment regimen?

A

Warfarin (coumadin)

95
Q

Do statins interact with dabigatran?

A

Yes

statin can dec [dabigatran] in serum

96
Q

When putting a patient on Warfarin [coumadin], when should that pt follow up?

A

1 week to check INR

97
Q

What is ALWAYS a component of afib treatment (not a drug, but a goal)?

A

rate control

98
Q

Let’s suppose that your patient is ALREADY on a max dose of a beta blocker for afib, but their rate is not controlled. What 3 options do you have to add to the treatment?

A

digoxin

verapamil

diltiazem

99
Q

What are negatives about digoxin?

A

Very low therapeutic index

lots of s/e

100
Q

Your 75y/o patient with COPD has developed afib. Treat with?

A

NDHP CCB like diltiazem [cardizem]

(technically you could also use a <strong>selective</strong> BB here too)

+ anticoag

(One class chose warfarin [coumadin], one class chose dabigatran [pradaxa]. Your move.)

101
Q

if a patient presents to you in the ER with super bad afib or PSVT, how will you treat her?

A

probably cardioversion

102
Q

What if you’re worried that your afib patient might have a blood clot?

A

get an echo and make sure there’s no clot

103
Q

What drug treatment is indicated for a patient presenting with unstable, new onset afib, often used post-MI or post-grafting?

A

amiodarone [cordarone]

104
Q

in what setting are you most likely to see a patient on amiodarone [cordarone]?

A

in the ICU

105
Q

Your patient has intermittent episodes of lightheadedness and fatigue. Heart is RRR. What does he have?

A

paroxysmal afib

106
Q

Assuming, being the great PA-S that you are, you have already given him a holter monitor to confirm that he has paroxysmal afib, how would you treat him?

A

selective, long-acting beta blocker soooo metoprolol [lopressor]

and anticoag soooo dabigatran [pradaxa]

107
Q

Your patient presents with a sudden onset of fluttering in her chest. Her boyfriend broke up with her and she hasn’t slept in 3 days. Pulse too rapid to count. What does she have?

A

PSVT

108
Q

How do you treat PSVT?

A

It’s adenosine [adenocard] but that doesn’t give you an accurate description of real life so if you wanna know what really happens..

  • push 6cc adenosine IV rapidly*
  • immediately flush with 10 cc saline*
  • wait 2 minutes, if not better then*
  • push 12cc adenosine rapidly*
  • immediately flush with 10 cc saline*

(way cooler, right?)

109
Q

What if you give someone adenosine for PSVT treatment, but they actually have afib?

A

You’re still a hero

it won’t treat the afib, but it will slow the rate enough so that you can dx the afib

110
Q

What do you prescribe for PA students who have just spent an entire month learning about cardio?

A

caffeine PRN P.O. or IV until monday

and happy pills too

111
Q

so keep calm…

A

and just remember that you have to get some PAC’s before you can become a PA-C.

…don’t worry, my terrible puns are all over.

love you all <3<3<3<3<3<3<3<3<3

GOOOOD LUCKKKK!

Paige: CARDIO (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions