Lecture 3: Cardiopulmonary

Question 0

What type of patient should you avoid prescribing thiazides (diuretic)?

Answer 0

Patients with poor renal function

Question 1

Which type of BP drugs have an effect of potassium depletion which can lead to cramping and arrhythmia?

Answer 1

Diuretics: Thiazides (-imides)

Question 2

What is another BP drug besides thiazides that can result in potassium depletion?

Answer 2

Loop diuretics

Question 3

What are the three major side effects of ACE inhibitors?

Answer 3

Cough- 30% of patients
Angioedema - swelling of face > airway closes
Hypotension

Question 4

When are ACE inhibitors used?

Answer 4

Used for CHF, hypertension and MI

Question 5

When would you most likely use angiotensin receptor blockers?

Answer 5

When patients have side effects with ACE inhibitors.

Question 6

What are the two type of beta blocker medications?

Answer 6

Beta 1 selective and beta 1 non selective

Question 7

What patients should be cautious when using beta 1 selective medications?

Answer 7

Asthmatics and patients with COPD. (Because higher doses will result in the drug acting on other beta receptors which may cause asthma/COPD medications to become less effective)

Question 8

What type of patients do you want to AVOID prescribing beta-1 nonselective drugs?

Answer 8

Avoid in asthma and COPD

Question 9

What are the two major side effects of beta blockers?

Answer 9

Hypotension and bradycardia

Question 10

What are three side effects of calcium channel blockers (non-dihydropyridine)

Answer 10

Hypotension
Bradycardia
Constipation

Question 11

What is a black box warning of clonidine (catapres) an alpha-2-agonist?

Answer 11

Avoid abrupt cessation

Question 12

What is he most common side effect of nitrates?

Answer 12

Severe headache

Question 13

What is a major side effect of alpha blockers? (-azosin)

Answer 13

Orthostatic hypotension

Question 14

What group of medications are proven to reduce CV events?

Answer 14

Statins

Question 15

What does MONA stand for?

Answer 15

Morphine
Oxygen
Nitroglycerin
Aspirin

Question 16

What does Mona therapy do?

Answer 16

Tx for acute chest pain

Question 17

What are the drug categories we need to know for this section? (7)

Answer 17

1. Diuretics
2. Beta sympathomimetic antagonists (beta blockers)
3. Renin angiotensin aldosterone system drugs
4. Calcium channel blockers
5. Alpha antagonist
6. Direct vasodilators
7. Nitrates

Question 18

What are the 3 diuretics?

Answer 18

Thiazides
Loops (mides)
Potassium sparing

Question 19

What are the 2 calcium channel blockers?

Answer 19

Dihydropyridine

Non-dihydropyridine

Question 20

What is the 1st choice when it comes to diuretics?

Answer 20

Thiazides are the 1st line of defense for hypertension

Question 21

What negative inotrope should be avoided in CHF patients?

Answer 21

Non-dihydropyridine (decreases HR and contractility)

Question 22

What type of patients are centrally acting and direct vasodilators helpful in?

Answer 22

Patients with resistant hypertension especially with renal/dialysis patients

Question 23

What did the ALLHAT study show with alpha blockers (-azosins)?

Answer 23

Increased risk of heart failure when these agents are used alone

Question 24

What is a major side effect if statins?

Answer 24

Muscle pain

Question 25

When are statins best taken?

Answer 25

In the evening

Question 26

What is a side effect of niacin?

Answer 26

Flushing

Question 27

What is a concern when taking bile acid sequestrants?

Answer 27

Doses must be separated from other medications because it will bind them too

Question 28

What type of medication type will be given to patients post MI with stent placement?

Answer 28

Antiplatelet therapy (plavix)

Question 29

What do rate controlling medications do for patients with end stage CHF? (Digoxin)

Answer 29

Only improves symptoms (ie quality of life not quantity of life)

Question 30

What do rate control medications do to the AV node? (Digoxin)

Answer 30

Slows conduction

Question 31

What is a major concern with digoxin?

Answer 31

Very toxic (arrhythmia, nausea, altered mental status, visual disturbance)

Question 32

What are the major issues with antirhythm drugs (amiodarone)?

Answer 32

Pulmonary fibrosis Thyroid disease Cataracts

Question 33

What is the CHADS2 score when it comes to stroke prevention in afib?

Answer 33

1. CHF 1. hypertension 1. Age greater than 75 1. Diabetes 2. Past Hx of stroke or TIA

Question 34

Furosemide (Lasix) is a loop diuretic. Which electrolyte is of particular concern with it's use that can lead to cramping and arrhythmias.

Answer 34

Potassium (K+)

Question 35

What is the class of diuretic is first line treatment for hypertension?

Answer 35

Thiazides

Question 36

The class lipid lowering medication is the only cholesterol treatment that has demonstrated decreased cardiovascular events.

Answer 36

Statins

Question 37

After percutaneous coronary intervention (PCI) with the placement of a stent, patients are placed in a combination of anti platelet medications. What are the potential combinations that the patient can be placed on.

Answer 37

Clopidogrel (plavix), prasugrel (effient), ticagrelor (brilinta)