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Pharm CPR > Myocarditis, Endocarditis, Pericarditis > Flashcards

Myocarditis, Endocarditis, Pericarditis Flashcards

1
Q

Myocarditis meds?

A
  1. ACEi/ARB early on + B blockers
  2. Mineralocorticoid receptor antagonist added if LVEF < 35%
  3. Diuresis as needed
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2
Q

This ACEi is used for HTN, CHF, diabetic nephropathy, scleroderma

A

Captopril

Captain Scler

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3
Q

These two ACEi can be used for diabetic nephropathy

A

Captopril and Enalapril

EC to eat sugar

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4
Q

This ACEi is used for stroke prophylaxis

A

Enalapril

strokE

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5
Q

These ACEi are used for proteinuria

A

Enalapril and Fosinopril

EF in my pee

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6
Q

This ACEi is used for acute MI within 24 hours

A

Lisinopril

LIsten I got an MI

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7
Q

These ACEi are used for HF, HTN

A

All of them (Benazepril is the only one who can do only these)

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8
Q

Whice ACEi does have sulfa properties?

A

Captopril

Sulfa CAPsule

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9
Q

Do ACEi and ARBs and B blockers have lots of drug interactions?

A

Yes

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10
Q

What is the black box warning for all ACEi and ARBs?

A

Fetal death

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11
Q

What are the 4 main containdications for Captopril? Which one is unique to this drug?

A
  1. Sulfa allergies
  2. Angioedema
  3. ACEi hypersensitivity
  4. Aortic stenosis = unique
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12
Q

What are the 4 adverse reactions to myocarditis?

A
  1. Abdominal pain
  2. Agranulocytosis
  3. Alopecia
  4. Anaphylactoid reactions
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13
Q

What are the 4 main monitoring parameters for Captopril?

A
  1. BP
  2. Creatinine/BUN
  3. K+
  4. Na+
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14
Q

This ACEi is given with a thiazide to drop BP

A

Fosinopril

Falling BP = Fosinopril

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15
Q

What are the specific drug-drug interactions with Lisinopril?

A
  1. Diuretic Therapy: drops BP
  2. Antidiabetics: drops glucose
  3. NSAIDs: drop renal function

DAN

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16
Q

CI for this one: prior history of angioedema related to prior ACEi and in patients with hereditary/idiopathic angioedema

A

Lisinopril

LIsten I got an MI, angioedema so be careful!

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17
Q

This ARB is used for HTN in strokes and MIs, HF

A

Valsartan

Very necessary

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18
Q

Indications for Losartan

A

This ARB is used to drop BP in children >6 YO, reduce stroke in HTN patients, diabetic nephropathy

Kids LOse games and listen to the strokes

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19
Q

This ARB used for mild to severe HF, LV dysfunction post-MI, HTN

A

Carvedilol

20
Q

This ARB has no contraindications

A

Valsartan

Valliant Valsartan

21
Q

This ARB is not indicated in black patients, elderly patients or children

A

Losartan

22
Q

What are the 3 warnings for ARBs?

A
  1. Fetal death
  2. Hypotension
  3. Impaired liver and kidney function
23
Q

This ARB is associated with asthenia, allergic reaction, impotence, palpitations

A

Valsartan

Valliance has it’s price: impotence, weakness and allergies

24
Q

This beta blocker is indicated for treatment of mild to severe chronic heart failure, LV dysfunction after MI, HTN

A

Carvedilol

25
Q

This beta blocker is indicated for angina, atrial fibrillation, atrial flutter, HF, HTN

A

Bisoprolol

26
Q

This beta blocker is indicated for MI, migraines, tremor, unstable angina

A

Metoprolol

27
Q

What is the warning for carvedilol?

A

Acute CAD exacerbation after stopping therapy, don’t discontinue

28
Q

What is the warning for Bisoprolol?

A

Abrupt cessation of therapy

29
Q

What is the indication for furosemide?

A

Rapid onset edema associated with heart, liver, kidney, give IV for this effect

30
Q

What are the contraindications for Furosemide?

A

Anuria, furosemide hypersensitivity that leads to water/electrolyte depletion

Anything that indicates you’re already fluid depleted

31
Q

What are the adverse effects of furosemide?

A

Low sodium, potassium, magnesium, calcium

Hypochloremic alkalosis

32
Q

What are the drug interactions of furosemide?

A

Ototoxicity esp. if renal impairment

Don’t use with ethacrynic acid

33
Q

What is the warning against spironolactone?

A

Hyperkalemia, hypotension, electrolyte abnormalities, gynecomastia

34
Q

What drug do we not give to patients with Addison’s disease?

A

Spironolactone

35
Q

Drug used for HF, hepatic/nephritic syndrome, primary hyperaldosteronism

A

Spironolactone

36
Q

Management of pericarditis

A

NSAIDs + colchicine for 2 weeks or symptoms resolve then taper for 1 day. Check CRP weekly until normal then begin taper

37
Q

When are glucocorticoids used in pericarditis?

A

CI to NSAIDs, low doses pls

38
Q

What are the risks of prolonged NSAID use?

A
  1. PUD
  2. Age 65+
  3. Aspirin, corticosteroids, anticoagulants used at the same time

That’s why we give colchicine to help

39
Q

Active gastric ulcer or duodenal ulcer, GI bleed, liver issues, renal issues. What drug CI?

A

Ibuprofen

40
Q

When is colchicine indicated?

A

Gout treatment, pericarditis

41
Q

What are the contraindications to colchicine?

A

CYP3A4 drugs (drug interactions), liver or kidney issues

42
Q

How do we treat endocarditis?

A

Target to blood culture for endocarditis, accurate diagnosis is critical, therapy can await blood results most times. Vancomycin is appropriate empiric (staph, strep, entero), obtain infectious disease consult

Acutely ill = empiric therapy
Completing therapy = IV therapy best if hemodynamically stable first with monitoring
Counsel patients that you may need repeat labs, can last 4-6 weeks

43
Q

What are the contraindications to vancomycin?

A

Hypersensitivity

44
Q

What are the 5 common adverse reactions to vancomycin?

A

Anaphylaxis, “red man syndrome”, AKI, hearing loss, neutropenia

45
Q

What are the drug interactions with vancomycin?

A

Anesthetics -> erythema and flushing

46
Q

Infusion reactions, nephrotoxicity, ototoxicity, C. difficile diarrhea, neutropenia, phlebitis, and drug resistant bacteria are associated with this drug

A

Vancomycin

Pharm CPR (9 decks)

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