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Therapeutics > lecture 6 > Flashcards

lecture 6 Flashcards

1
Q

when do we initiate B blockers for ACS

A

within 24 hrs

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2
Q

reasons not to start B blockers

A

Bradycardia
HF
risk for cardiogenic shock
asthma

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3
Q

metoprolol starting dose

A

25-50 q 6-12h

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4
Q

metoprolol target dose

A

100 mg BID (tartrate)
200 mg daily (succinate)

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5
Q

metoprolol brand name

A

toprol

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6
Q

carvedilol starting dose

A

6.25 mg BID

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7
Q

carvedilol target dose

A

25 mg BID

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8
Q

propanolol starting dose

A

40 mg BID-TID

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9
Q

propanolo target dose

A

80 mg QID

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10
Q

atenolol starting dose

A

25-50 mg qd

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11
Q

atenolol target dose

A

100 mg qd

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12
Q

atenolol brand name

A

tenormin

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13
Q

propanolol brand name

A

inderal, hemanegol

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14
Q

what B blockers do we use in the case of HFrEF

A

metoprolol succinate, carvedilol or bisoprolol

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15
Q

When to consider IV BB, whats the drug

A

Consider IV BB only when hypertensive ongoing ischemia

Matoprolol tartrate 5 mg IV q 5 min

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16
Q

Which B blockers are B1 selective

A

Atenolol, metoprolol, bisoprolol, nebivolol

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17
Q

which B blockers are ISA

A

Pindolol and acebutolol

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18
Q

What to do if pt is on B blocker and has asthma

A

switch to B1 selective

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19
Q

which P2Y12 could cause asthma? what to do about it?

A

ticagrelor could cause SOB, consider changing to clopidogrel

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20
Q

B blockers during HF

A

Avoid starting of increasing B blocker dose during acute HF exacerbation. Keep maintenance dose

21
Q

is it safe to continue B blocker dose during HF

A

Yes

22
Q

Patient counseling B blocker

A

lower BP and HR
can mask sx of hypoglycemia

23
Q

when to not take B blocker

A

if HR<50 and BP below 90/60

24
Q

WHat drugs are contraindicated in HFrEF

A

diltiazem and verapamil

25
Q

when not to use CCB

A

LV dysfunction
Increased risk for cardiogenic shock
2nd or 3rd degree atrioventricular block

26
Q

STatin dose after MI

A

always high dose statin

27
Q

what are the high dose statins

A

atorvastatin- 40-80
rosuvastatin 20-40

28
Q

atorvastatin and rosuvastatin brand

A

crestor and lipitor

29
Q

verapamil brand name

A

verelen, calan, isopt

30
Q

diltiazem brand name

A

cardizem

31
Q

ISMN brand

A

Imdur

32
Q

ISDN brand

A

Isordil

33
Q

carvedilol brand

A

coreg

34
Q

statin counseling

A

need to take lifelong to prevent future heart attack
continue to take even if cholesterol is low

35
Q

When are ACE/ARBs recommended?

A

recommended in all patients after ACS, but especially in HFrEF, DM or CKD

36
Q

do B blockers have a class effect? do ACE/ARBs have a class effect?

A

B blockers do not have a class effect
ACE/ARB do

37
Q

How to differentiate between ACE/ARB

A

ARB- sartan
ACE- pril

38
Q

captoptril starting and target dose. BRand name?

A

starting 6.25-12.5 TID
target- 25-50 tid
capoten

39
Q

lisinopril starting, target and generic

A

starting- 2.5-5 QD
target > or = 10 QD
zestril

40
Q

ramipril starting, target, brand

A

starting- 2.5 bid
target- 5 mg bid
altace

41
Q

trandolapril starting, target and brand

A

0.5 mg QID starting
target- 4 mg qd
mavik

42
Q

valsartan loading, starting and generic

A

starting- 20 mg BID
loading- 100 mg BID
diovan

43
Q

when not to use ACE

A

hypotension/shock
acute renal failure
drug allergy/ angioedema

44
Q

ACE monitoring

A

Scr (due to efferent arteriole vasodilation)
K+ (1-2 weeks after initiation)
BP
angioedema

45
Q

counseling on ace

A

can cause dry cough
may cause angioedema

46
Q

acceptable rise of scr on ACE

A

20-30%

47
Q

what are some patients that require oral anticoag in addition to DAPT

A

Patients with A fib (chadsvasc > or = 2)
STEMI and asymptomatic LV mural thrombus
STEMI and anterior apical akiness or dykines

48
Q

How to handle drugs in patients with a fib

A

dx aspirin after 1-4 weeks after PCI and continue P2Y12 inhibitor and anticoag (NOAC preferred over warfarin)

49
Q
A

Therapeutics (38 decks)

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