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ACNP 1 > Heart Failure and high cholesterol > Flashcards

Heart Failure and high cholesterol Flashcards

1
Q

Name the 5 hormone changes that occur during HF

A

RAAS activation- fluid retention

Sympathetic stimuli- adrenal surges

Aldosterone- renal sodium absorption

Endothin- vasoconstriction

Natriuretic peptide- salt removal, vasodilation

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2
Q

When will BNP not be accurate

A

In obese it will be falsely low

In renal dysfunction it will be falsely high

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3
Q

Name the meds that you give a HF patient

A 
ACEI/ARB
Diuretic
Beta blocker
Aldosterone antagonist
Bidil
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4
Q

What medication is recommended for all HF patients w/ EF of 40 or less

A

ACEI/ARB

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5
Q

What does an ACEI/ARB do for heart failure

A

Decreases morbidity and mortality by decreasing cardiac remodeling

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6
Q

What do you have to watch when giving an ACEI/ARB

A

Creatinine and potassium

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7
Q

What HF medication can you not stop giving rapidly due to reflex tachycardia

A

Beta blocker

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8
Q

Who is bidil good for?

A

African Americans will HF. Switch out Bidil for the beta blocker

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9
Q

What do you watch for with spironolactone?

A

Monitor electrolytes especially K

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10
Q

Name 3 inotropes

A

Dopamine, dobutamine and milronone

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11
Q

What are the things to know about dopamine?

A

It improves renal function
Causes vasoconstriction
Watch for ventricular ectopy

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12
Q

Things to know about dobutamine

A

Increases cardiac output
Can cause hypotension
Watch for tachyphilaxis with long term use

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13
Q

Things to know about milronone

A

Lowers pulmonary pressure
Less ventricular ectopy
Can use with beta blockers
Test dose before use

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14
Q

What fluid restriction should you put HF patients on?

A

1500-2000mL/day

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15
Q

What sodium restriction should you put HF patients on?

A

2g/day

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16
Q

What weight gain would you like a HF patient to report

A

3lbs in 3 days or 7lbs in 7 days

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17
Q

What OTC meds should the HF patient avoid?

A

NSAIDS

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18
Q

Who qualifies for a life vest?

A

EF

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19
Q

If the HF patient gets low output syndrome (cold and wet) what do you give?

A

Milronone or dobutamine

20
Q

Who are the 4 groups who benefit from a statin?

A
  1. People with know ASCVD
  2. LDL > 190
  3. Diabetes age 40-75 with
    a. LDL 70-189
    b. W/o ASCVD
  4. Age 40-75 w/ ASCVD risk of >7.5
21
Q

High intensity stains are:

A

Atorvastatin 40-80mg

Rosuvastatin 20-40mg

22
Q

Moderate intensity statins

A

Atorvastatin 10-20

Simvastatin 20-40

23
Q

Name the 5 hormone changes that occur during HF

A

RAAS activation- fluid retention

Sympathetic stimuli- adrenal surges

Aldosterone- renal sodium absorption

Endothin- vasoconstriction

Natriuretic peptide- salt removal, vasodilation

24
Q

When will BNP not be accurate

A

In obese it will be falsely low

In renal dysfunction it will be falsely high

25
Q

Name the meds that you give a HF patient

A 
ACEI/ARB
Diuretic
Beta blocker
Aldosterone antagonist
Bidil
26
Q

What medication is recommended for all HF patients w/ EF of 40 or less

A

ACEI/ARB

27
Q

What does an ACEI/ARB do for heart failure

A

Decreases morbidity and mortality by decreasing cardiac remodeling

28
Q

What do you have to watch when giving an ACEI/ARB

A

Creatinine and potassium

29
Q

What HF medication can you not stop giving rapidly due to reflex tachycardia

A

Beta blocker

30
Q

Who is bidil good for?

A

African Americans will HF. Switch out Bidil for the beta blocker

31
Q

What do you watch for with spironolactone?

A

Monitor electrolytes and no discharge of K 2.5

32
Q

Name 3 inotropes

A

Dopamine, dobutamine and milronone

33
Q

What are the things to know about dopamine?

A

It improves renal function
Causes vasoconstriction
Watch for ventricular ectopy

34
Q

Things to know about dobutamine

A

Increases cardiac output
Can cause hypotension
Watch for tachyphilaxis with long term use

35
Q

Things to know about milronone

A

Lowers pulmonary pressure
Less ventricular ectopy
Can use with beta blockers
Test dose before use

36
Q

What fluid restriction should you put HF patients on?

A

1500-2000mL/day

37
Q

What sodium restriction should you put HF patients on?

A

2g/day

38
Q

What weight gain would you like a HF patient to report

A

3lbs in 3 days or 7lbs in 7 days

39
Q

What OTC meds should the HF patient avoid?

A

NSAIDS

40
Q

Who qualifies for a life vest?

A

EF

41
Q

If the HF patient gets low output syndrome (cold and wet) what do you give?

A

Milronone or dobutamine

42
Q

Name the normal lipid levels

A

Cholesterol 60

LDL

43
Q

Who are the 4 groups who benefit from a statin?

A
  1. People with know ASCVD
  2. LDL > 190
  3. Diabetes age 40-75 with
    a. LDL 70-189
    b. W/o ASCVD
  4. Age 40-75 w/ ASCVD risk of >7.5
44
Q

High intensity stains are:

A

Atorvastatin 40-80mg

Rosuvastatin 20-40mg

45
Q

Moderate intensity statins

A

Atorvastatin 10-20

Simvastatin 20-40

ACNP 1 (12 decks)

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