Friday_2

Question 1

lokelma

Answer 1

sodium zirconium cyclosilicate

Question 2

What is different about the beta blockers carvedilol and labatalol?

Answer 2

Have B1 B2 and alpha blocking properties. Alpha blockers open vessels, work on BP

Question 3

Name 4 ADRs for carvedilol

Answer 3

Low pulse, Low BP, sedation, sexual dysfunction (is there also a PDE5 inhibitor?), blunting hypoglycemia

Question 4

Why should you not stop beta blockers abruptly?

Answer 4

Can get rebound HTN, ischemia. Drugs with shorter half-life are worse - propranolol. maybe carvedilol

Question 5

Sinemet

Answer 5

Carbidopa/levadopa

Question 6

Wegovy

Answer 6

semaglutide for weight loss

Question 7

Irbesartan

Answer 7

Avapro

Question 8

Cinacalcet

Answer 8

Sensipar

Question 9

Stimate

Answer 9

desmopressin 150mcg

Question 10

What’s the “best” insulin needle length

Answer 10

4mm pen needle – not likely to get to muscle so it’s the safest pen needle length (DMT1?)

Question 11

Name dulaglutide doses

Answer 11

0.75 mg, 1.5 mg, 3 mg, 4.5 mg

Question 12

What is the mechanism of action of salmeterol

Answer 12

Long Acting Beta2 Agonist. Causes smooth muscle to relax. B2 in lungs. B1 in heart.

Question 13

What kind of inhaler is salmeterol?

Answer 13

DPI

Question 14

What is a BBW for salmeterol

Answer 14

Can not be used for monotherapy in asthma. OK to use as monotherapy in COPD

Question 15

Pepcid

Answer 15

Famotidine

Question 16

Why would you use IR verapamil?

Answer 16

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)

Question 17

What is verapamil MOA

Answer 17

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

Question 18

MOA of entresto

Answer 18

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

Question 19

If a person is on an ARB, starting entresto, do you need a washout period?

Answer 19

No

Question 20

In CHF, when do you need to stop the MRA?

Answer 20

AKI – stop MRAs when Cr 2.5 in men or 2.0 in women

If K is high (above 5), then start lokelma, patiromir

Question 21

Why is adding an MRA important in CHF?

Answer 21

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.

Question 22

SGLT2 counseling point about genital infections

Answer 22

If you have itching, its treatable and fixable, but need to let someone know.

Question 23

What patients should you be cautious in starting a SGLT2 for CHF?

Answer 23

Watch out when starting in patients on diuretics. Especially if patients have low need for diuretics. Watch kidney function. Start at half dose

Question 24

What is one initiation/titration schedule for CHF patients?

Answer 24

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