Friday_2 Flashcards
lokelma
sodium zirconium cyclosilicate
What is different about the beta blockers carvedilol and labatalol?
Have B1 B2 and alpha blocking properties. Alpha blockers open vessels, work on BP
Name 4 ADRs for carvedilol
Low pulse, Low BP, sedation, sexual dysfunction (is there also a PDE5 inhibitor?), blunting hypoglycemia
Why should you not stop beta blockers abruptly?
Can get rebound HTN, ischemia. Drugs with shorter half-life are worse - propranolol. maybe carvedilol
Sinemet
Carbidopa/levadopa
Wegovy
semaglutide for weight loss
Irbesartan
Avapro
Cinacalcet
Sensipar
Stimate
desmopressin 150mcg
What’s the “best” insulin needle length
4mm pen needle – not likely to get to muscle so it’s the safest pen needle length (DMT1?)
Name dulaglutide doses
0.75 mg, 1.5 mg, 3 mg, 4.5 mg
What is the mechanism of action of salmeterol
Long Acting Beta2 Agonist. Causes smooth muscle to relax. B2 in lungs. B1 in heart.
What kind of inhaler is salmeterol?
DPI
What is a BBW for salmeterol
Can not be used for monotherapy in asthma. OK to use as monotherapy in COPD
Pepcid
Famotidine
Why would you use IR verapamil?
In cases of bariatric surgery where transit time is low and you can’t use common ER formatulations (ER tab 1 -2x per day or ER cap 1x per day)
What is verapamil MOA
Blocks calcium from entering voltage gated channels in the heart and smooth muscle (amlodipine is only in smooth muscle), causes relaxation, lowers BP and HR
MOA of entresto
sucuabtril Blocks degredation on BNP - Naturetic peptide – helps you pee out sodium. Pee out more sodium, diuretic benefit. Increases level of angiotensin – the valsartan helps with this
If a person is on an ARB, starting entresto, do you need a washout period?
No
In CHF, when do you need to stop the MRA?
AKI – stop MRAs when Cr 2.5 in men or 2.0 in women
If K is high (above 5), then start lokelma, patiromir
Why is adding an MRA important in CHF?
Proven mortality benefit. Some hesitancy if patient is already on a drug that increases K. However, in CHF the RAAS system is in overdrive and aldosterone can be 20x. Reverse cardiac remodeling. Anti-arrhythmic benefit.
SGLT2 counseling point about genital infections
If you have itching, its treatable and fixable, but need to let someone know.
What patients should you be cautious in starting a SGLT2 for CHF?
Watch out when starting in patients on diuretics. Especially if patients have low need for diuretics. Watch kidney function. Start at half dose
What is one initiation/titration schedule for CHF patients?
Start on low doses of these:
Start BB and SGLT2 - little impact on BP
Then ARNI -
Then MRA –
Caution: Hard to tell where any ADRs come from
