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Paige: CARDIO > Exam 2 - Treatment for HF and CHD (lecture) > Flashcards

Exam 2 - Treatment for HF and CHD (lecture) Flashcards

1
Q

Which HF drug improves contractility?

A

digoxin

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2
Q

Would you give digoxin for systolic or diastolic heart failure?

A

systolic

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3
Q

which HF drugs slow deterioration and prevent remodeling?

A

ACE-I

BB

spironolactone

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4
Q

Which HF drugs improve diastolic function?

A

antihypertensives

(to decrease LVH)

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5
Q

Which HF drug do you give to blacks to prevent remodeling?

A

Hydralazine

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6
Q

What are some non-pharm tx for HF?

A

remove precipitating factors

bed rest (+ anticoags)

elastic stockings

low salt diet

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7
Q

Which HF drugs relieve symptoms and reduce preload?

A

loop diuretics

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8
Q

Which HF drugs are not loop diuretics, but have a diuretic effect?

A

ACE-I, ARBs

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9
Q

Which drugs decrease mortality in HF?

A

ACE-I

BBs

Hydralazine

vasodilators

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10
Q

Do ACE-Is reduce afterload, preload, or both?

A

both

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11
Q

Do ACE-Is dilate veins or arteries?

A

both :)

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12
Q

Can you give beta blockers in a HF patient who is unstable?

A

no!

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13
Q

What HF drugs decrease SVR, increase CO, and relieve symptoms?

A

vasodilators

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14
Q

How do you treat acute angina?

A

NTG sublingual

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15
Q

Does NTG vasodilate or venodilate?

A

venodilates

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16
Q

Does NTG decrease preload or afterload?

A

preload

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17
Q

How often can you repeat a dose of NTG?

A

every 3-5 minutes if symptoms haven’t left

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18
Q

What is prophylaxis for acute angina?

A

NTG sub-lingual

5 min before activity

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19
Q

What drugs prevent acute angina (5)?

A

BBs

Long acting nitrates (isoborbide)

CCBs

Ranolazine

Anti-platelets

20
Q

Which 2 beta blockers are best to give for acute angina prevention?

A

metoprolol

atenolol

21
Q

what do BBs do to the heart?

A

dec HR, contractility, BP

improves exercise tolerance

22
Q

With what dz should you avoid BBs?

A

lung disease

23
Q

do CCBs dilate arteries or veins?

A

arteries (peripheral)

24
Q

do CCBs decrease preload or afterload?

A

afterload

25
Q

Do CCBs decrease mortality after an MI?

A

NO

26
Q

Which CCB type goes well in adjunct with BBs?

A

dihydropuridines

27
Q

Which CCB type goes well in adjunct with nitrates?

A

nondihydropyridines

28
Q

Which type of CCB should you avoid in HF?

A

nondihydropyridines

29
Q

Which nondihydropyridine CCB should you especially avoid with a beta blocker?

What can happen?

A

veramapil

heart block

30
Q

When would you give ranolazine in acute angina?

A

When a pt is nonresponsive to other treatment

31
Q

What is the MOA of ranolazine?

A

decrease sodium –> decreases Ca –> decreases contraction and O2 need

32
Q

What will ranolazine cause to happen on EKG, which is totally fine?

A

Prolonged QT interval

33
Q

What agent is used in ALL patients with CHD?

A

ASA

34
Q

What can you give as an ASA alternative?

A

Clopidogrel

35
Q

Which angina patients are candidates for surgery (4)?

A

they have symptoms despite treatment

they have 3 vessel CAD

they have disease in L main artery

they have ischemia/acute MI

36
Q

Which type of revascularization surgery is indicated for 1-2 vessel disease and involves placing a stent?

A

Percutaneous Coronary Intervention

(a type of angioplasty)

37
Q

which type of revascularization surgery involves replacing the diseased vessel(s) with part of the saphenous vein or internal mammary artery?

A

coronary artery bypass grafting (CABG)

38
Q

How do you treat Prinzmetal’s angina?

A

nitrates

CCBs

39
Q

How do you treat unstable angina (non-STEMI)?

A

Hospitalize, bed rest, O2

fully anticoag and antiplatelet

(LMWH + ASA)

nitrates, BB, CCB all used to decrease 02 need

40
Q

What should you give to your STEMI patients within 1-3 hours of symptom onset (if they qualify)?

A

thrombolytics (tPA)

41
Q

How do you manage an acute STEMI?

A

Hospitalize + ASA

morphine IV

nitro IV

42
Q
A
43
Q

What management will you send your STEMI patient home with?

A

LMWH + ASA

BB

44
Q

If an elderly person has a STEMI, what treatment is preferred?

A

surgery

(percutaneous transluminal coronary angioplasty)

45
Q

What drugs might you also rx with large infarcts?

A

ACE-I and ARBs

46
Q

What drug should you NOT give with infarction?

A

nsaids!

Paige: CARDIO (11 decks)

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