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Cardiovascular > Side Effects and Warnings > Flashcards

Side Effects and Warnings Flashcards

1
Q

Lipitor

A

Atorvastatin
CI: pregnancy, breastfeeding, liver disease

Warnings: muscle damage (increased CPK), use in elderly > 65 years), may increase A1c and FBG (but benefits outweigh the risk)

SE: myalgia/myopathy
hepatotoxicity/nephrotoxicity

Do NOT use with gemfibrozil

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2
Q

Which Statins should you take in the evening?

A

Lovastatin (Altoprev)
Simvastatin (Zocor)
FLuvastatin

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3
Q

Which statin should you take with a meal?

A

Lovastatin (Altoprev)

Take in the evening with a meal!

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4
Q

Pravacol

A

Pravastatin
CI: pregnancy, breastfeeding, liver disease

Warnings: muscle damage (increased CPK), use in elderly > 65 years), may increase A1c and FBG (but benefits outweigh the risk)

SE: myalgia/myopathy
hepatotoxicity/nephrotoxicity

Do NOT use with Gemfibrozil

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5
Q

Which statins should you AVOID with CYP3A4 inhibitors?

A

Lovastatin (Altoprev)
Simvastatin (Zocor)

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6
Q

What are the CYP3A4 inhibitors that should be avoided?

A

G PACMAN
Grapefruit
Protease Inhibitors
Amiodarone
Cyclosporine, Cobicistat
Macrolides (not Azithro)
Azoles
Non-DHP CCBs

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7
Q

Zetia

A

Ezetimibe
CI: pregnancy breastfeeding
Warning: avoid in hepatic impairment

SE: myalgias, diarrhea

Give Zetia 2 hours before bile acid sequestrant

DO NOT use with gemfibrozil (Lopid)

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8
Q

A patient is on Pravachol, Zetia, and Lopid for HLD and high TG. What is wrong with this regimen? What do you recommend?

A

Lopid (gemfibrozil) should NOT be used with statins or Zetia!!!!!!

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9
Q

Praluent

A

Alirocumab SC
SE: injection site rxns, URTI, increased LFTs

store in fridge, can be at room temp for up to 30 days

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10
Q

Repatha

A

Evolocumab
SE; injection site rxns, URTI, back pain

store in fridge, can be at room temp for up to 30 days

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11
Q

Welchol

A

Colesevelam
Bile acid sequestrant

CI: bowel obstruction, TG > 500, history of TG induced pancreatisis

SE: constipation, ab pain, cramping, bloating, gas, INCREASED TG

***not recommended when TG are >/= 300

**SAFE in pregnancy (:

DECREASED absorption of fat soluble vitamins KADE

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12
Q

Cholestyramine

A

Bile Acid Sequestrant
CI: biliary obstruction

SE: constipation, ab pain, cramping, bloating, gas, increased TG

**not recommended when TG are >/= 300

**use good oral hygeine!!! Enamel erosion or teeth discoloration!!!

DECREASED absorption of fat soluble vitamins KADE

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13
Q

Which drugs should be taken 4 hours PRIOR to colesevelam (Welchol)?

A

Levothyroxine
Cyclosporine
Glimepiride (Amaryl)
Glipizide (Glucotrol)
Glyburide (Glynase)
Olmesartan (Benicar)
Phenytoin
Oral contraceptions with Ethyl estradiol and Norethindrone

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14
Q

Antara

A

Fenofibrate
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

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15
Q

Tricor

A

Fenofibrate
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

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16
Q

Trilipix

A

Fenofibrate
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

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17
Q

Lopid

A

Gemfibrozil
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

***DO NOT USE WITH STATINS or ZETIA due to increased risk of myopathy and rhabdomyolysis

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18
Q

What lopid and warfarin are given in the same patient what can happen?

A

Wafarin efffects increase causing an INCREASED bleeding risk and INR

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19
Q

Niacin

A

CI: active liver disease, PUD, or arterial bleeding
Warning: rhabdomyolysis, hepatotoxicity

INCREASED BG and uric acid and LFTs

SE: FLUSHING, pruritis, vomiting, diarrhea, hyperglycemia, hyperuricemia (GOUT)

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20
Q

Niacor vs Niaspan vs Slo-Niacin

A

Niacor - IR formulation most flushing and itching

Niaspan - ER formulation
less hepatotoxicity AND less flushing ===== THE BEST CHOICE*****

Slow-Niacin - CR formulation
less flushing but more hepatotoxicity!!!

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21
Q

Vascepa

A

Icosapent ethyl
Warning: hypersensitivity to fish or shellfish

SE: eructation (burping), dyspepsia, arthralgias

**can increase LDL and BLEEDING RISK!

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22
Q

Lovaza

A

Omega-3 acid ethyl esters

Warning: hypersensitivity to fish or shellfish

SE: eructatin (burping), dyspepsia, taste perversions

***can increase LDL and BLEEDING RISK

23
Q

Which dyslipidemia drugs should you avoid in pregnancy?

A

STATINS + Zetia

24
Q

Which dyslipidemia drugs are SC and can be stored at room temp for up to 30 days?

A

Repatha
Praluent

25
Q

Which dyslipidemia drugs affect the absorption of fat soluble vitamins KADE?

A

Bile acid sequestrants

26
Q

Chlorthalidone

A

CI: hypersensivity to sulfonamide

SE: hypo - K, Mg, Na
hyper - Ca, UA, LDL, TG, BG, Lithium
Photosensitivity
Impotence (ED)

DO NOT USE CrCl < 30

INCREASE Lithium levels

27
Q

Hydrochlorothaizide

A

CI: sulfa allergy

SE: hypo - K, Mg, Na
hyper - Ca, UA, LDL, TG, BG, Lithium
Photosensitivity
Impotence (ED)

DO NOT USE CrCl < 30

INCREASE Lithium levels and dofetilide to increase QTc

28
Q

Norvasc

A

Amlodipine
Warning: Hypotension

SE: peripheral edema, HA, flushing, palpitations, gingical hyperplasia

*substrate CYP3A4

29
Q

Nicardipine IV

A

CI: advanced aortic stenosis

Warning: chronic HTN or BP in non-pregnant adults

DOC in pregnancy!!!!!
*CYP3A4 substrate

30
Q

Adalat CC

A

Nifedipine

Warning: hypotension
SE: peripheral edema, HA, flushing, palpitations, gingival hyperplasia, reflex tachycardia

**used to prevent peripheral vasoconstriction in Raynaud’s

*CYP3A4 substrate

31
Q

Clevidipine

A

CI: allergies to soy or eggs
SE: hypotension, reflex tachy, infections!!!!! increases TG

**contains 2 kcal/mL of lipid emulsion

**time of use good for 12 hours after puncture!

32
Q

Tiazac

A

Diltiazem
CI: hypotension (SBP <90), heart block
Warning: Heart failure!!!!!! bradycardia

SE: edema, gingival hyperplasia, constipation (less than Calan)

**CYP3A4 inhibitors and pgp substrates === lower dose of sim and lova

33
Q

Calan

A

Verapamil

CI: hypotension (SBP <90), heart block
Warning: Heart failure!!!!!! bradycardia

SE: edema, gingival hyperplasia, constipation (MORE than Tiazac)

**CYP3A4 inhibitors and pgp substrates === lower doses of sim and lova

34
Q

Lotensin

A

Benazepril
BW: Pregnancy - death in developing fetus

CI: angioedema, within 26 hours of Entresto

Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis

SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension

35
Q

Vasotec

A

Enalapril
BW: Pregnancy - death in developing fetus

CI: angioedema, within 26 hours of Entresto

Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis

SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension

36
Q

Prinivil

A

Lisinopril
BW: Pregnancy - death in developing fetus

CI: angioedema, within 26 hours of Entresto

Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis

SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension

37
Q

Accupril

A

Quinapril
BW: Pregnancy - death in developing fetus

CI: angioedema, within 26 hours of Entresto

Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis

SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension

38
Q

Altace

A

Ramipril
BW: Pregnancy - death in developing fetus

CI: angioedema, within 26 hours of Entresto

Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis

SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension

39
Q

ACE and ARB drug interactions

A

Increase Lithium concentration!!!!!

*** do not use RAAS inhibitors together

40
Q

Avapro

A

Irbesartan
like ACE inhibitors but
- less angioedema
- less cough
- NO WASHOUT PERIOD with entresto

41
Q

Cozaar

A

Losartan
like ACE inhibitors but
- less angioedema
- less cough
- NO WASHOUT PERIOD with entresto

42
Q

Benicar

A

Olmesartan
Warning: spruce like enteropathy (diarrhea with weight loss)

like ACE inhibitors but
- less angioedema
- less cough
- NO WASHOUT PERIOD with entresto

43
Q

Diovan

A

Valsartan
like ACE inhibitors but
- less angioedema
- less cough
- NO WASHOUT PERIOD with entresto

44
Q

Aldactone

A

BW: hyperkalemia (K >/= 5.5)

CI: Addisons disease and severe renal impairment

SE: hyperkameia, increased SCr, dizziness, gynecomastia, breast tenderness, impotence (blocks androgens)

Increase Lithium concentration!!!!!

45
Q

Eplerenone

A

BW: hyperkalemia (K >/= 5.5)

CI: strong CYP3A4 inhibitors (Azoles, Clarithromycin, Ritonavir)

SE: hyperkalemia, increase SCr, dizziness, hypertriglycerides

Increase Lithium concentration

46
Q

Triamterne

A

Hyperkalemia
Increased Scr
Dizziness

INCREASE Lithium concentration (all diuretics!!!!)

47
Q

Beta 1 selective blockers

A

“AMEBBA”
Atenolol (Tenormin)
Bisoprolol
Esmolol (Brevibloc)
Metoprolol tartrate (Lopressor)
Metoprolol succinate (Toprol)
Nebivolol (Bystolic

BW: do NOT dc abruptly
CI: heart block
Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud’s syndrome and other peripheral vascular diseases

**preferred in COPD and asthma due to less beta-2 blockage (:

SE: bradycardia, fatigue, hypotension, dizzines, depression, impotence, cold extremities

48
Q

Beta-1 and 2 blockers

A

Propranolol (Inderal)
Nadolol (Corgard)

BW: do NOT dc abruptly
CI: heart block
Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud’s syndrome and other peripheral vascular diseases

SE: bradycardia, fatigue, hypotension, dizzines, depression, impotence, cold extremities

49
Q

Coreg

A

Carvedilol
BW: do not abruptly discontinue
CI: severe hepatic impairment, heart block

Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud’s syndrome and other peripheral vascular diseases

***take ALL forms with FOOD!!!!!!!!! Carnivor EAT WITH FOOD

SE: Edema, weight gain bradycardia, fatigue, hypotension, dizzines, depression, impotence, cold extremities

50
Q

Labetalol

A

DOC in pregnancy

CI: heart block
Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud’s syndrome and other peripheral vascular diseases

BW: do not abruptly discontinue
SE: dizziness, fatigue, bradycardia

51
Q

Catapres

A

Clonidine
Warning: do not abruptly dc

SE: dry mouth, somnolence, fatigue, constipation, hypotension, bradycardia, impotence

patch: pruritus, erythema, rash

**weekly patch that you muse remove before MRI

52
Q

Methyldopa

A

CI: concurrent use with MAOi

Warning: hemolytic anemia (postive Coombs test)

SE: DILE, edema or weight gain

53
Q

Hydralazine

A

Direct vasodilatory
Warning: DILE

SE: peripheral edema, HA, flushing, palpitations, reflex tachycardia

Cardiovascular (6 decks)

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