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KC Cardio Module-2 > Pharm > Flashcards

Pharm Flashcards

1
Q

Nitrates indicated for acute CP:

A
  • IV NTG

- SL NTG

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2
Q

IV NTG onset of action, duration, and initial dose

A
  • 1-2 min
  • 3-5 min
    Dose: 5-10 mcg/min
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3
Q

SL NTG onset of action, duration, and initial dose:

A
  • 1-3 min
  • 30-60 min
  • 0.4 mg PRN
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4
Q

Isosorbide dinitrate onset of action, duration, and initial dose:

A
  • 20-40 min
  • 4-6 hours
  • 10-20 mg TID
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5
Q

NTG patch onset of action, duration, and initial dose:

A
  • 40-60 min
  • > 8 hrs
  • 1 patch
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6
Q

Isosorbide mononitrate onset of action, duration, and initial dose:

A
  • 30-60 min
  • 6-8 hrs
  • 30 mg QD
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7
Q

Nitrates for chronic CP:

A

Isosorbide dinitrate
Isosorbide mononitrate
NTG patch

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8
Q

SE w/ NTG use:

A

1- tolerance (tachyphylaxis- reduction in tissue C-GMP)
2- flushing
3- orthostasis
4- HA

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9
Q

C/I w/ NTG:

A
  • PDE-5 inhibitor use (taken w/in 24h)

- HCM

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10
Q

Ranolazine dosage:

A

500 mg PO BID (max: 1000 mg QD)

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11
Q

Morphine dosage:

A

2-5 mg IV Q5-15 min until pain relief or ADR occurs

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12
Q

Naloxone (Narcan) dosage:

A

0.4 mg IVP

Morphine reversal agent

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13
Q

Clopidogrel (plavix) loading dose and QD dosing:

A

300 mg loading dose

75 mg QD doses

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14
Q

Ticagrelor (Brillinta) loading dose and QD dosing:

A

180 mg loading dose

90 mg BID dosing for the first year; 60 mg BID following stable state

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15
Q

Prasugrel (Effient) loading dose and QD dosing:

A

Loading dose: 60 mg

5-10 mg QD dosing

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16
Q

Apixaban dosage:

A
  • 5 mg BID

- 2.5 mg BID if 2/3: SCr <1.5, wt: <60 kg or age >80 y.o.

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17
Q

Rivaroxaban

A

20 mg QD

Unless GFR < 15-50 mL/min- then rq. 15 mg QD

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18
Q

Dabigatran dosage:

A

150 mg BID

19
Q

Edoxaban dosage:

A

60 mg QD

Unless GFR <50, then 30 mg QD

20
Q

Epinephrine dosage:

A

1 mg IV push repeat every 3-5 minutes

21
Q

Amiodarone dosage:

A

300 mg IV push (first dose), then 150 mg IV push (second dose)

22
Q

Atropine dosage:

A

0.5 mg IV push every 3-5 minutes; max dose 3 mg

23
Q

Adenosine dosage:

A

6 mg IV push (first dose), 12 mg (repeat dose x2)

24
Q

Magnesium dosage:

A

2 mg IV push

25
Q

Diltiazem dosage:

A

10-20 mg IV bolus w/ titrated IV drip

26
Q

BB benefits and C/I in stable angina tx:

A

Decreased mortality in post-MI patients; MC used

Shouldn’t be used in pts with vasospastic angina; unopposed alpha-receptor activity

27
Q

Use for nitrates off-label:

A

Esophageal spasm

28
Q

Nitrates should be used with caution in these pts:

A

Volume depletion

Aortic stenosis

29
Q

SL nitroglycerin dosing recommendations:

A

Take on PRN basis
Max: 3 tablets or 3 sprays (5 minutes apart over 15 minutes)
Pt should sit down; monitor HA; do not swallow!

30
Q

CCB use in stable angina:

A

When BB are C/I or stopped due to an ADR

If BB and nitrates are not alleviated stable angina sxs

31
Q

Ranolazine MOA:

A 
Prolongs ventricular AP
Does not affect HR and BP
Reduces ventricular tension
Decreases myocardial oxygen demand
*last resort after BB, nitrates and CCB
32
Q

Ranolazine SE:

A

HA
Dizziness
Constipation
Nausea

33
Q

Ranolazine DDI’s:

A

DANGS
Digoxin (increases levels)
Antifungals (azoles)- avoid
Non-DHP CCB (verapamil/diltiazem)- limit doe of ranolazine
Grape fruit juice- avoid
Simvastatin- should not exceed 20 mg, limit does of ranolazine

34
Q

Ranolazine metabolism:

A

Extensive hepatic metabolism; 75% renal excretion
Avoid in pts w/ cirrhosis
Pt. W/ CKD likely 40-50% dose increase

35
Q

Drugs that should be avoided in an acute MI: (6)

A 
DO NOT CONSIDER in AN EMERGENT SETTING
Digoxin
Nitroprusside
CCB
NSAIDs
Enalaprilat
Steroids
36
Q

NTG use should be avoided in these pts (2)

A

SBP <90 mm Hg

C/I w/ RV infarction

37
Q

NTG use beyond 48 hours should be reserved for these pts: (3)

A
  • persistent HF, CP, or HTN
38
Q

Morphine dosage and concerns:

A

2-5 mg IV over 5-15 minutes

- may interfere w/ anti-platelet Drugs and common w/ allergic rx

39
Q

Indicated immediately in ACS

A

BB
Reduce mortality
Decreases incidence of ventricular arrhythmias and cardiac death
Improve perfusion to the heart

40
Q

C/I to BB: (5)

A 
1- hypotension, cardiogenic shock
2- AV heart block (more than first degree)
3- active asthma, bronchospasm
4- signs of HF
5- bradycardia <55 BPM
41
Q

BB should be titrated w/ these goals in mind:

A

HR: 70 BPM w/ SBP > 90 mm Hg

42
Q

CCB do not decrease progression in an acute MI, but should be used w/ these pts: (2)

A
  • NSTEMI pts. W/ persistent or recurrent CP (despite BB and nitrate TX)
  • sxs ACS pts. Unable to tolerate BB
43
Q

UFH is preferred for anticoagulation w/:

44
Q

LMWH, enoxaparin, is preferred in these pts:

A

Unstable angina
NSTEMI
(Though UFH can be used as well)

KC Cardio Module-2 (6 decks)

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