Ischemic Heart Disease/ACS/HF Flashcards
1
Q
Treatment for IHD
A
ABCDE A - Antiplatelet and antianginal B - Blood pressure and beta-blockers C - Cholesterol and cigarettes D - Diet and Diabetes E - Exercise and education
2
Q
Drug Treatment for ACS
A
MONA-GAP-BA M - Morphine O - Oxygen N - Nitrates A - Aspirin
G - GP IIb/IIIa antagonists
A - Anticoagulants
P - P2Y12 inhibitors
B - Beta-blockers
A - ACEi
3
Q
Drugs for Secondary Prevention of ACS
A
- ASA 81 mg indefinitely
- P2Y12i for at least 12 months (may go past this if tolerating dual therapy and not high risk bleeder)
- Nitroglycerin indefinitely
- B-Blocker: at least 3 years; indefinitely for HR
- ACEi - Indefinitely if EF < 40%, HTN, CKD, diabetes
- Aldosterone Antagonists - same stipulations as ACEi but if still symptomatic at target ACEi doses
- Statin - Indefinitely, high-intensity
4
Q
Unstable Angina
A
- Chest Pain
- No Cardiac Enzymes
- No ST elevation
- Partial Blockage
5
Q
NSTEMI
A
- Chest Pain
- Cardiac Enzymes
- No ST elevation
- Partial Blockage
6
Q
STEMI
A
- Chest Pain
- Cardiac Enzymes
- ST elevation
- Full Blockage
7
Q
Drugs that Cause/Worsen HF
A
DI NATION D - DPP4i I - Immunosuppressants N - Non-DHP CCBs A - Antiarrhythmics (Class I agents and dronedarone) T - Thiazolidinediones (-glitazone) I - Itraconazole O - Oncology drugs N - NSAIDs
8
Q
Initial HF Drugs
A
- ACEi, ARB, or ARNI - decrease mortality
- Beta-Blocker - decrease mortality
- Loop Diuretics - sxs relief
9
Q
Secondary HF Meds
A
- ARAs - additional diuresis and decreased mortality/morbidity
- SGLT2i - with or w/o diabetes
- BiDil (Hydralazine + Nitrates) - Black patients NYHA III-IV who can’t tolerate or are still symptomatic with ARNI/ACE/BB treatment
- Ivabradine - decreases hospitalization, sinus rhythm must be >= 70 bpm on max tolerated BB dose
10
Q
Additional HF Medications
A
- Digoxin - decrease cardiac hospitalization
- Vericiguat - decreases risk of hospitalization and CV death after hospitalization (not in guidelines yet)
11
Q
Target Enalapril Dose
A
10-20 mg PO BID
12
Q
Target Lisinopril Dose
A
20-40 mg PO QD
13
Q
Target Quinapril Dose
A
20 mg BID
14
Q
Target Ramipril Dose
A
10 mg QD
15
Q
Target Losartan Dose
A
50-150 mg QD
