SIHD & ACS exam 1 review Flashcards by Paige Tustanowsky

What is the antiplatelet indication for patients with CCD with no history of stent implantation (secondary prevention)?

low dose aspirin (SAPT)
if CI to ASA then Clopidogrel 75mg
if high risk then DAPT

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What is the maintenance dose of prasugrel (Effient)?

10 mg daily

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What is the maintenance dose of ticagrelor (Brilinta)?

90 mg BID

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What is the maintenance dose of clopidogrel (Plavix)?

75 mg daily

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Ticagrelor adverse effects?

bleeding, bradycardia, heart block, dyspnea

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What is the antiplatelet indication for patients with CCD and have had an elective PCI + Stent?

DAPT minimum for 6 months
SAPT indefinetely
if high risk of bleeding, 1-3 months of DAPT may be reasonable; SAPT as a P2Y12 inhibitor until 12 months then switch to aspirin

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What is the indication for antiplatelet therapy in SIHD CABG (non-emergent)?

DAPT for 12 months
then, SAPT

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Adverse Effects of nitrates?

headache, hypotension, dizziness, lightheadedness and facial flushing, reflex tachycardia

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What Beta Blockers are indicated for CCD?

Atenolol (Tenormin), Metoprolol (Lopressor), Propranolol (Inderal)

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What do non-DHP CCBs do to myocardial contractility?

decrease/reduce (Verapamil more)
which reduces cardiac output

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What are the adverse effects of DHPs?

peripheral edema, hypotension, flushing, headache, dizziness, maybe some reduced myocardial contractility

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What is the dosing for the NTG patch?

-once daily
-on for 12-14 hrs then off for 10-12 hrs
on at 7am off @7-9 pm

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What is the dosing for ISDN tabs?

2-3 times/day
8,12,4 pm
10 mg TID

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What is the dosing for ISMN tabs?

2 times/day 7 hrs apart
8am & 3 pm(4pm)

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What is the dosing for ISMN SR tabs?

once daily at 8 am
30 mg

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What is a negative result for the high sensitivity troponin?

less than 14ng/L

What is a negative result for the conventional troponin?

less than 0.05ng/mL

What is the dose of morphine for ACS patients?

4-8 mg IV, followed by 2-8mg IV q5-15 mins

What is the loading dose of Clopidogrel?

600 mg
-300 mg if using fibrinolytic

What is the loading dose of Ticagrelor?

180 mg

What is the loading dose of Prasugrel?

60 mg

What is the loading dose of Cangrelor?

30mcg/kg followed by 4 mcg/kg/min for 2 hrs

What antiplatelets are preferred for ischemia guided therapy?

clopidogrel and ticagrelor

What antiplatelets are preferred for early invasive strategy?

ticagrelor or prasugrel

What antiplatelets are preferred in STEMI patients on fibrinolytics?

clopidogrel

What antiplatelets are preferred in STEMI patients with PCI?

ticagrelor or prasugrel

What anticoagulants are indicated for ischemia guided strategy?

UFH, Enoxaparin, Fondaparinux

What anticoagulants are indicated for early invasive strategy?

UFH, Bivalirudin, Enoxaparin

What anticoagulants are indicated for a STEMI w/fibrinolytics?

UFH, enoxaparin, fondaparinux

What anticoagulants are indicated for a STEMI w/a PCI?

UFH, bivalirudin (preferred in high bleeding risk)

What are the renal dosing requirements for Enoxaparin?

if CrCl <30mL/min then 1mg/kg q24h

What are the renal dosing adjustments for Fondaparinux?

CI if CrCl <30 mL/min

What are the renal dosing adjustments for Bivalirudin?

if CrCl <30 mL/min then 1mg/kg/hr Dialysis 0.25 mg/kg/hr

What are the renal dosing adjustments for Unfractionated heparin?

-no renal adjustments

What are the contraindications for Prasugrel?

CI in pts with history of TIA/stroke -not recommended for pats 75+ or less than 60kg