Hyperlipidemia / Anti-Arrhythmic / Overdose Tx

Question 1

Which lipid-lowering drug is the most effective for Cardiovascular Event Prevention (i.e. stroke, MI) ?

Answer 1

STATINS!

(regardless of baseline lipid levels)

Question 2

A: Which Anti-Arrhythmics are associated w/ Torsades De Pointes? (6)

B: Tx for Torsades De Pointes

Answer 2

-All of Class 1A-

1. Quinidine
2. Procainamide
3. Disopyramide

+

• Class 3-
  4. iButilide
  5. Dofetilide
  6. Sotalol

B: Mg+

Question 3

A: QT Prolongation is a risk factor for which Abnormal Cardiac Arrhythmia?

B: What are the Drugs that can induce QT Prolongation?

Answer 3

A: TORSADES DE POINTES

B: Drug Induced - QT Prolongation = ABCDE

A: AntiArrhythmics (Class 1A and 3)

B: AntiBiotics (Macrolides)

C: AntiCychotics (haloperidol)

D: AntiDepressants (TriCyclic AntiDepressants)

E: AntiEmetics (Ondansetron)

Question 4

A: List the Order of MOST VASODILATORY (affects periphery mostly) to least Ca+ Channel Blockers

B: Which one could be used for HTN in a pt with [Prolonged PR interval]

Answer 4

A: Never Dilate Vessels

Nifedipine > Diltiazem > Verapamil (cardiogenic)

B: Nifedeipine

Question 5

Normal QRS Duration

Answer 5

80 - 120 ms

Question 6

CYP P450 Inhibitors (12)

Answer 6

” AAA RACKS IN GQ Magazine”

1. Acute Alcohol Abuse
2. Ritonavir (HIV Protease Inhibitor)
3. Amiodarone
4. [Cimetidine OR Cipro]
5. Ketoconazole
6. Sulfonamide Abx
7. [Isoniazid OR Itraconazole]
8. Grapefruit Juice
9. Quinidine
10. Macrolides ( NOT Azithro)

Question 7

CYP P450 Upregulators (8)

Answer 7

” Chronic alcoholics STeal Phen-Phen & NEver Refuse Greasy CARBs “

• Chronic alcohol
• ST. John’s wort
• Phenytoin OR Phenobarbital
• NEvirapine
• Rifampin
• Griseofulvin
• CARBamazepine

Question 8

CYP P450 Substrates

(things that need CYP P450 for metabolism)

Answer 8

” SWATO needs his CYP P450! “

Statins (NOT Pravastatin) (especially SAL)

Theophyline

Oral Contraceptive

Warfarin

Anti-Epileptics

Question 9

Contraindications for Statins (3)

Answer 9

” DON’T give Statins to Pregnant Lady Girls “

• Pregnant Women
• Liver Dz pts
• Gemfibrozil - taking pts

Question 10

Acetaminophen OVERDOSE

Tx

Answer 10

N-Acetylcysteine (replinishes Glutathione)

Question 11

[Acetylcholine Inhibitor / Organophosphate] OVERDOSE!

Tx (2)

Answer 11

Atropine > praLidoxime

Question 12

Amphetamine OVERDOSE!

Tx

Answer 12

NH₄Cl (acidify the urine)

Question 13

[Antimuscarinic / AntiCholinergic] OVERDOSE!

Tx (2)

Answer 13

1. Physostigmine salicylate
2. Control Hyperthermia

Question 14

Benzodiazepine OVERDOSE!

Tx

Answer 14

Flumazenil

Question 15

[Beta Blocker] OVERDOSE!

Tx

Answer 15

Glucagon

Question 16

[Carbon MONOxide] OVERDOSE!

Tx

Answer 16

[100% O2] vs. [Hyperbaric O2]

Question 17

[GAC - Gold / Arsenic / Copper] OVERDOSE!

Tx

Answer 17

Penicillamine

Question 18

Cyanide OVERDOSE!

Tx (2)

Answer 18

1. [Nitrite + thiosulfate]
2. HydroxoCobalamin

Question 19

Heparin OVERDOSE!

Tx

Answer 19

Protamine Sulfate

Question 20

Iron (Fe) OVERDOSE!

Tx (2)

Answer 20

1. DeFeroxamine
2. DeFeraSirox

Question 21

Lead OVERDOSE!

Tx (4)

Answer 21

“Treat Lead OD with PEDS”

1. EDTA
2. Dimercaprol
3. Succimer
4. Penicillamine

Question 22

[GAM - Gold / Arsenic / Mercury] OVERDOSE!

Tx (2)

Answer 22

1. [Dimercaprol BAL]
2. Succimer

Question 23

Salicylate OVERDOSE!

Tx

Answer 23

NaHCO₃ (alkalinize the urine)

Question 24

[TriCyclic Antidepressants] OVERDOSE!

Tx

Answer 24

NaHCO₃ (Alkalinize the Plasma)

Question 25

[tPA / Streptokinase / Urokinase] OVERDOSE!

Tx

Answer 25

Aminocaproic Acid

Question 26

Warfarin OVERDOSE!

Tx (2)

Answer 26

1. Vitamin K (delayed effect)
2. [Fresh Frozen Plasma] (IMMEDIATE EFFECT)

Question 27

Ivabradine

MOA

Answer 27

Selectively inhibits [I_f Sodium Funny channels] during [Phase 4 of SA Node] –> DEC HR ONLY