HIGH YIELD PHARM SUMMARY POINTS

Question 1

Antianginal that only decreases afterload (SBP) and preload (LV volume)

Answer 1

nitrates

Question 2

antianginal that
* decreases HR, contractilty, afterload
* increases preload (by decreasing HR & increasing SV)

hint: it is also a HF med

Answer 2

BB

Question 3

antianginal that
* decreases HR but causes reflex tachy
* decreases afterload

Answer 3

DHP CCB

Question 4

antianginal that
* decreases HR, contractility, SBP

Answer 4

non-DHP CCB

Question 5

which class of antianginals has the greatest effect on contractility

Answer 5

non-DHP CCB

Question 6

which antianginal has NO effect on HR, contractility, afterload or preload? how does it work?

Answer 6

ranolazine
works by blocking late Na+ channel to decrease myocardial tension

Question 7

2 HF classes that
* decreases afterload & preload and does NOT cause reflex tachycardia

which one affects preload > afterload?

Answer 7

• ace/arb/arni
• AA– affects preload more than afterload

Question 8

2 HF meds that
* decreases afterload & preload + causes reflex tachycardia

Answer 8

hydralazine/isdn

Question 9

HF med that
* decreases HR
* increases contractility (the only positive oral chronotrope)
* increases LV volume

Answer 9

digoxin

Question 10

1st & 2nd line for prinzmetal angina

Answer 10

1. CCB
2. nitrates

Question 11

which formulation of NTG is tolerance a concern?

Answer 11

long acting? NTG

Question 12

how long should you wait between NTG tablets to avoid hypotension

Answer 12

5 mins

Question 13

3 things to assess antianginal efficacy

Answer 13

• how often SL NTG is being taken
• if theres less episodes
• if theres less or no angina w/ exercise

Question 14

effects of BB on exercise in SIHD

Answer 14

reduce exercise induced angina when dose is titrated to HR < 100 bpm during exercise

Question 15

which two CCBs do NOT worsen HF

Answer 15

amlodipine
felodipine

Question 16

which antianginal has ADR of high dose QT prolongation

Answer 16

ranolazine

Question 17

angioedema is an ADR of which 3 classes

Answer 17

ACE, ARB, ARNI

Question 18

bradycardia is an ADR of which 3 classes

Answer 18

BB, nonDHP, digoxin

Question 19

hyperkalemia is an ADR of which 4 classes

Answer 19

ACE, ARB, ARNI
aldosterone antagonist

Question 20

peripheral edema is a main ADR of which class

Answer 20

CCB

Question 21

reflex tachy is an ADR of which 2 classes

Answer 21

nitrates
CCB

Question 22

which med improves cardiac function in HFrEF by doing these things

• decreases remodeling after MI
• decreases HR
• inhibits NE
• prevents arrhythmiaas

Answer 22

evidence based beta blockers

Question 23

when would you want to switch from an ACE/ARB to an ARNI?

Answer 23

• stage C
• HFrEF w/ hemodynamic stability, no h/o angioedema

also needs to be able to afford it

Question 23

when would you want to switch from an ACE/ARB to an ARNI?

Answer 23

• stage C
• HFrEF w/ hemodynamic stability, no h/o angioedema

also needs to be able to afford it

Question 24

BB is indicated with HF but why would you not want to use it if a patient is hypervolemic?

Answer 24

BB first make it worse before it gets better so you should only start it if the patient is euvolemic

Question 25

how long is the washout period when switching from ACE to ARNI and why do we have a washout period?

Answer 25

• 36 hrs
• we do it bc of risk of angioedema
• we do NOT need one for ARBs

Question 26

2 ways that spironolactone is beneficial in HF

Answer 26

• decreases risk for afib
• prevents further cardiac fibrosis

Question 27

what electrolyte is important to monitor in pt taking digoxin

Answer 27

potassium

Question 28

which medication requires serum K+ < 5 mEq/L before initiation

Answer 28

spironolactone

Question 29

4 med classes used in HFpEF

Answer 29

• aldosterone antagonist
• SGLT2 inhibitor
• ARNI
• diuretics in stage C

Question 30

when do you use milrinone in HF

Answer 30

for palliation of sx in stage D

Question 31

which HF med does this

blocks PDE + increase cAMP = increase Calcium & contractility

Answer 31

milrinone

Question 32

Synthetic catecholamine that targets B1 (&B2, A1)
* increases contractility & peripheral vasodilation

Answer 32

dobutamine