Pharm Review

Question 1

What should you do in the case of heparin-induced thrombocytopenia?

Answer 1

• Turn off heparin, switch to argatroban if patient has no liver complication
• Consult pharmacology

Question 2

Treatment of choice for refractory hypertension

Answer 2

alpha-1 selective agonist

Question 3

Antipyretics safe for pediatric cases

Answer 3

• Tylenol safe if at least 12 weeks old
• Ibuprofen safe if at least 6 months old
• Naproxen not safe until over age 12, unless pediatrician condones use

Question 4

In what case do you give dobutamine to a patient with STEMI?

Answer 4

If their forward heart failure is so severe that their brain is at risk. Ex, if systolic is below 90 mmHg

Question 5

Beta blocker summary

Answer 5

Question 6

Adverse effects and contraindications of beta blockers

Answer 6

Question 7

CCBs in acute coronary syndrome

Answer 7

In ACS, you do NOT want to use a dihydropyridine CCB. This will cause arterial vasoilation, which may decrease afterload, but will cause reflex tachycardia.

Nondihydropyridines diltiazem and verapamil are used for essentially the same effects as beta blockers.

Question 8

Who benefits from dual antiplatelet therapy?

Answer 8

ALL patients with history of ACS.

If someone has had an episode of ACS, they should be on aspirin and clopidogrel (or other P2Y₁₂ inhibitor) unless contraindicated.

Question 9

Summary of ACS pharmacologic management

Answer 9

Question 10

What type of statin therapy should be initiated for ACS patients?

Answer 10

High-intensity statin therapy for ALL patients with previous ACS episode regardless of their baseline LDL