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NAPLEX BITCH > Some Heart and Some Blood Things > Flashcards

Some Heart and Some Blood Things Flashcards

1
Q

A TG level above ______ can cause acute pancreatitis

A

500

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2
Q

Please name 6 drugs that increase LDL and TG:

A

Diuretics
Efavirenz
Steroids
Immunosuppressants
Atypical Antipsychotics
Protease Inhibitors

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3
Q

What dyslipidemia drug is known to slightly elevate LDL?

A

Fish Oils

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4
Q

Name 3 drugs that increase TG only

A

Propofol
IV lipid emulsion
Bile Acid Sequestrates

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5
Q

Friedewald Equation

A

LDL = TC - HDL - TG/ 5

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6
Q

What are intensity does a diabetic patient that is 42 and an LDL of 120 require?

A

Moderate intensity!

Diabetic patient: 40 - 75
LDL: 70 - 189
With no ASCVD risk factors

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7
Q

What are intensity does a diabetic patient that is 42 and an LDL of 120 with ASCVD risk factors require?

A

High Intensity!

Diabetic patient: 40 - 75
LDL: 70 - 189
With ASCVD risk factors

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8
Q

A patient that is between 40 - 75 with an LDL between 70 - 189 and ASCVD risk score between 7.5 - 19.9% requires a…

A

Moderate intensity

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9
Q

Name the two high intensity statins and their doses

A

Atorvastatin 40 - 80

Rosuvastatin 20 - 40

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10
Q

What is the Pitavastatin Moderate intensity dose range?

A

2- 4 mg

Low: 1 mg

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11
Q

What is Simvastatins Moderate intensity dose range?

A

20 - 40 mg
Low: 10 mg

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12
Q

What is the moderate intensity dose range for pravastatin?

A

40 - 80 mg

Low: 10 - 20 mg

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13
Q

What is the moderate intensity dose range for Lovastatin?

A

40 mg

Low: 20 mg

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14
Q

What is the moderate intensity dose range for Fluvastatin?

A

40 mg BID / 80 QD XL

Low: 20 - 40

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15
Q

How do we reduce the risk of statin based Myalgia?

A

Avoid DDI

Do not exceed simvastatin 80 mg/d

Do not use gemfibrozil with a statin

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16
Q

How to manage Myalgia from a statin?

A

Hold, Check CPK

After 2 - 4 weeks rechallenge with the same statin or decrease the dose.
If myalgia returns d/c statin. Once muscle sx’s resolve a low dose statin can be started with a gradual increase

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17
Q

What statins can be taken at any time of day? (5)

A

Crestor
Lipitor
Livalo
Lescol XL
Pravachol

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18
Q

What are the lipid effects of statins?

A

Decrease LDL by 20 - 55%

Increase HDL by 5 - 15%

Decrease TG by 10 - 30 %

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19
Q

What are the significant DDI with Statins?

A

G <3 PACMAN

G: grapefruit
P: Protease inhibitors
A: Azoles
C: Cyclosporine
M: Macrolides (except Zpak )
A: Amio
N: Non DHP CCB

Do not use Simvastatin or Lovastatin in G - M

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20
Q

Statins MOA:

A

inhibit HMG CoA reductase. Rate limiting step in cholesterol synthesis

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21
Q

Ezetimibe MOA:

A

inhibits absorption of cholesterol in the small intestine

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22
Q

MOA of PCSK 9 Inhibitors:

A

PCSK9 = enzyme that increases LDL receptor degradation
the Inhibitors at MAbs that block the ability of PCSK 9 to bind to the LDL receptor.

(dramatic decrease in LDL)

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23
Q

Alirocumab

A

Praluent - SC

  • HeFH or ASCVD
  • PCSK9 - I
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24
Q

Evolocumab

A

Repatha - SC

*HeFH or ASCVD
* HoFH

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25
Q

Bile Acide Séquestrants MOA:

A

bind bile acids in the intestine forming a complex that is excreted in the feces. Prevents BA reabsorption

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26
Q

Welchol, a BA sequestrate has three important things:

A
  • Take with a meal and liquid
  • Also approved for glycemic control in type 2 DM (~0.5%)
  • Can be used in pregnant patients
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27
Q

What are the 3 CI of Welchol?

A
  • TG > 500
  • history of HyperTg induced pancreatitis
  • bowel obstruction
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28
Q

What do BA do to the TG level?

A

Increase ~5%

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29
Q

Fibrate MOA:

A

PPAR alpha activators, up regulate the expression of apolipoprotein C2 (apoC-2) which increases lipoprotein lipase activity, leads to increased catabolism of VLDL particles

(decreases TG A LOT)

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30
Q

Contraindications for Fibrates (Gemfibrozil - Lopid, and Fenofibrate)

A

Severe liver disease (including primary biliary cirrhosis

Gall bladder disease

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31
Q

What is a side effect of gemfibrozil?

A

Dyspepsia

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32
Q

What is a SE and Warning of Fibrates?

A

Can increase LFTs

increased myopathy with administered with a statin

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33
Q

Gemfibrozil should not be given with ___ and ____

A

Ezetimibe and Statins ( increases risk of myopathy)

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34
Q

Fibrates ___ the effects of sulfonylureas and warfarin

A

increase!

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35
Q

Niacin MOA:

A

decreases rate of hepatic VLDL and LDL synthesis.
- decreases LDL and TG

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36
Q

When the TG are high fibrates can…

A

increase LDL

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37
Q

Nicotinic acid = Niacin = ____

A

Vitamin B 3

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38
Q

If a patient has just taken Welchol (BA), how long must you wait to take Niacin?

A

4 - 6 hours

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39
Q

Thiazide MOA:

A

inhibit sodium reabsorption in the DCT causing increased excretion of Na, Cl, H20, and K

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40
Q

What is the dosing of Chlorithalidone

A

12.5 - 25 mg QD

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41
Q

What is the dosing of HCTZ

A

12.5 - 50 mg QD

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42
Q

Patients with a _____ hypersensitivity are CI in thiazides.

A

Sulfonamide derived drug sensitivity

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43
Q

What electrolytes/labs do thiazides increase?

A

UA, Ca, LDL, TG, BG

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44
Q

Billie Joe has a CrCl of 28. What evidence is there with him starting a thiazide?

A

It has been shown to be ineffective in CrCl < 30

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45
Q

DHP CCB MOA

A

inhibit Ca ions from entering the vascular smooth muscle and myocardial cells. Leading to peripheral arterial vasodilation and coronary artery dilations.

The peripheral vasodilation leads to sx’s: reflex tachy, palpitations, headaches, flushing, peripheral edema

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46
Q

Nifedipine ER can be used in ___ patients (not pregnant)

A

Raynouds - to help prevent peripheral vasoconstriction

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47
Q

Bella has an allergy to Soy and Eggs. What DHP can she not use?

A

Cleviprex

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48
Q

Hypertriglyceridemia can occur with which DHP?

A

Clevidipine

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49
Q

How many calories are in the lipid emulsion of Clevidipine?

A

2kcal/ ml

STRICT aseptic technique needs to be utilized. Vial is only good for 12 hours after puncture

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50
Q

Non DHP CCB MOA:

A

inhibit Ca ions from entering the vascular smooth muscle and myocardial cells
* more selective for the myocardial than DHP CCB*
the decrease in BP is from the negative ionotropic and the decreased HR is from negative chronotropic effects

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51
Q

ACE inhibitors should not be used within ___ hours from entresto?

A

36 hours

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52
Q

ACE MOA:

A

block the conversion from Ang 1 to Ang 2 (decrease vasoconstriction and aldosterone secretion)

also believed to block the degradation of bradykinin (vasodilatory effects)

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53
Q

ARB MOA:

A

Block Ang2 from binding to AT1 receptor (prevents vasoconstriction)

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54
Q

What is a warning associated with Benicar?

A

Olmesartan is associated with Sprue - like enteropathy
(can occur at any time)

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55
Q

Direct Renin Inhibitor, Aliskiren MOA:

A

direct inhibitor of Renin, which is responsible for the conversion of Angiotensinogen to Ang 1.

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56
Q

What is a CI of Aliskiren?

A

Do not use with ACE/ARB in a Diabetic patients

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57
Q

Tekturna:

A

Aliskiren

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58
Q

difference between spironolactone and eplerenone

A

Spironolactone: non selective aldosterone receptor antagonists that also blocks androgen

Eplerenone: selective aldosterone receptor antagonist that DOES not exhibit the endocrine SE of Aldactone

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59
Q

What BB have ISA (intrinsic sympathomimetic activity)?

A

Acebutolol , Penobutolol, pindolol

  • not recommended post MI
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60
Q

Name the Beta 1 selective BB:

A

Atenolol - tenormin

Esmolol - Brevibloc - inj

Metoprolol

Acebutolol
Betaxolol
Bisoprolol

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61
Q

Metoprolol Tartate IV to PO:

A

1 : 2.5

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62
Q

Name the 1 BB that is beta 1 selective blocker with nitric oxide dependent vasodilation

A

Nebivolol - Bystolic

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63
Q

Non Selective BB 1 and 2:

A

Nadolol (corgard)

Propranolol

Pindolol, Timolol

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64
Q

What is a big point with propranolol

A

high lipid solubility!!! More CNS SE - migraine prophy

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65
Q

Non selective BB with Alpha 1 blocking

A

Labetolol and Coreg

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66
Q

Inutiv is associated with what serious SE?

A

DILE
Guanfacine

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67
Q

Minoxidil BBW:

A

potent antihypertensive can cause pericardial effusion and angina exacerbations

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68
Q

HTN Emergency:

A

Acute target organ damage

Stroke, AKI, ACS, Encephalopathy

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69
Q

HTN Urgency:

A

No evidence of acute target organ damage
- treat with PO med okay
- Decrease BP gradually over 24 - 48 Hours

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70
Q

Prinzmetals Angina:

A

can be variant or vasospastic

Chest pain caused via Vasospasm

(DHP = DOC)

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71
Q

What are the ABCDE of SIHD?

A

A: antiplatelets + antianginals
B: BB + BP meds
C: Cholesterol and Cigs
D: Diet and diabetes
E: exercise and education

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72
Q

When would Yosprala be indicated?

A

With chronic ASA use PPI can be used to help protect the gut. This is a combo product with ASA and Prilosec

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73
Q

How long will DAPT be for Bare metal Stent?

A

1 month

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74
Q

How long with DAPT be for drug- eluting stent?

A

at least 6 months

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75
Q

How long with DAPT be for post CABG?

A

at least 12 months

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76
Q

BB MOA in SIDH

A

reduce myocardial oxygen demand: decrease HR, contractility, and left ventricular wall tension

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77
Q

CCB MOA in SIDH:

A

non DHP : decrease HR and contractility
DHP: decrease after load (SVR)

All CCB’s increase myocardial O2 supply

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78
Q

Nitrates MOA in SIDH:

A

reduce myocardial O2 demand, decrease preload, produces vasodilation of the veins

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79
Q

Ranolazine (Ranexa) big points:

A

not for acute Chest pain

Qt prolonging
A LOT OF DDI

80
Q

A PCI is preferred in STEMI when…

A

Patient presents within 90 minutes or 120 minutes of first medical contact

81
Q

If a PCI is not possible, what is the timeline to induce fibrinolytic therapy?

A

30 minutes within hospital arrival (door to needle time)

82
Q

What is the MONA-GAP-BA for ACS management?

A

M- morphine
O- oxygen
N - nitrates
A- ASA
G - IIb/IIa antagonists
A: anticoagulant
P: P2Y12 inhibitors
B: BB
A: Ace inhibitors

83
Q

What are the contraindications of Effient

A

Prasugrel is CI in active serious bleeding

AND: history of stroke or TIA

84
Q

glycoprotein IIb/IIIa receptor antagonist:

A

Abciximab (reopro) only for patients undergoing PCI

Eptiflibatide (integrillin)

85
Q

Loop Diuretics MOA:

A

block reabsorption in the thick ascending limb in the LOH. increase excretion of Na, K, Cl, Mg, Ca, and H2O

DO NOT IMPROVE SURVIVAL in HF

86
Q

What labs do Loops increase:

A

HCO3 (metabolic alkalosis)

UA, BG, TG’s, TC

87
Q

Please give the dosing conversions for loops

A

Lasix 40
Torsemide 20
Bumex 1
Ethacrynic Acid: 50

88
Q

Lasix IV to PO

A

1: 2

89
Q

Ivabardine (Corlanor)

A

Funny Channel = decrease HR
indicated if BB is maxed out or unable to be tolerate and the resting HR is > 70

GOAL: 50 - 60

90
Q

Digoxin MOA:

A

inhibits Na/K/ATP-ase pump = positive ionotropic effects. (increases CO)
- which leads to a decrease in HR (negative chronotropic)

91
Q

Digoxin Therapeutic level in HF:

A

0.5 - 0.9

92
Q

Digoxin dose change when going PO to IV?

A

Decrease by 20 - 25%

93
Q

Vericiguat

A

Verquvo

Soluble guanylate cyclase stimulator which increased cyclic GMP and leads to smooth muscle relaxation.

DO NOT USE WITH Riociguat

94
Q

KCl 10% = x mEq/ 15 ml

A

20 mEq/15 ml

95
Q

Holter Monitor is a…

A

Ambulatory ECG Device

96
Q

The SA Node is _____

A

the hearts natural pacemaker

97
Q

The SA node cells have ____ which allows them to initiate their own action potential unlike other myocytes.

A

Automaticity

98
Q

When is Phase 0 of the cardiac action potential initiated?

A

When there is a rapid ventricular depolarization due to an influx of Na ions… causes contraction

99
Q

In the cardiac action potential Phase 1 is….

A

Early rapid repolariation (Na channels close)

100
Q

In the cardiac action potential In Phase 2 there is a plateau response to ________

A

an influx of Ca and efflux of K

101
Q

cardiac action potential Phase 3 is the….

A

Rapid depolarization the occurs in response to an efflux of K and this leads to ventricular relaxation. Resulting in Phase 4 which is the resting membrane state.

102
Q

What class of antiarrhytmics prolong the QTc?

A

Class 1a, 1c, and 3

103
Q

What Anti-infective agents prolong QTc? (5)

A
  1. Antimalarials (hydroxychloroquine)
  2. Azoles (except isavuconazonium)
  3. Macrolides
  4. Quinolones
  5. Lefamulin
104
Q

What 3 oncology based meds prolong QTc?

A

Androgen Deprived therapy (leuprolide)

Tyrosine Kinase Inhibitors (nilotinib)

Oxaliplatin

105
Q

Classifying drugs with Vaufhan Williams.

“Double Quarter Pounder, Lettuce Mayo, Fries Please, Because, Dieting During Stress is Always, Very Difficult”

A

1a: Disopyramide, Quinidine, Procainamide
1b: Lidocaine, Mexiletine
1c: Flecainide, Propafernone
2: BB
3: Dronedarone, Dofetilide, Sotalol, Ibutilide, Amiodarone
4: Verapamil, Diltiazem

106
Q

AF rate control Agents?

A

BB or NON DHP are used and sometimes digoxin

107
Q

AF rhythm control agents?

A

Class 1a, 1c, or 3
if AF is permanent avoid this strategy with antiarrhythmics . R>B

108
Q

Digoxin Arrhythmia Concentration:

A

0.8 - 2 ng/mL

Starting dose 0.125 - 0.25 mg QD

109
Q

Norpace

A

Disopyramide (class 1a)

110
Q

Quinidine Class 1A should be…

A

Taken with food to decrease GI upset.
Can cause DILE

111
Q

What is Quinidine Cinchonism?

A

overdose. Tinnitus, hearing loss, blurred vision, headache, delirium

112
Q

What is Procainamide, Class 1a Active metabolite?

A

N-acetyl procainamide = recalled cleared. Watch out in slow acetylators

113
Q

Class 1C Propafenone Brand + one SE

A

Rythmol

Taste Disturbance (metallic)

CI: HF and MI

114
Q

Flecainamide a Class 1c is CI in these two heart conditions…

A

HF and MI

115
Q

Class 3 Multaq has what BBW?

A

Dronedarone

BBW: increased risk of death, stroke, and HF in patients with decompensated HF or permanent AF

Has little effects on thyroids.

116
Q

Class 3 Dofetilide ( Tikosyn) BBW:

A

must be initiated in a setting with continuous ECG monitoring. Need to assess CrCl a minimum of 3 days. (QT prolongation)

DOC In HF ( so is amio)

117
Q

Adenosine Injection Is indicated for:

A

paroxysmal supraventricular tachycardia (PSVT)

SHORT 1/2 Life 10 seconds

118
Q

Alteplase MOA:

A

tissue plasminogen activator.
Binds to fibrin in the thrombus and converts plasminogen to plasmin. Resulting in fibrinolysis.

ONLY FDA approved fibrinolytic to treat acute ischemic stroke

119
Q

Due to the bleeding risk with tPA, what are three categories they are contraindicated in?

A
  1. Active bleed
  2. Labs or Conditions that increase bleeding (severe HTN, INR >1.7)
  3. Drug interactions with bleeding risks (anticoagulant)
    LMWH ~ last 24 hours
    DOAC ~ last 48 hours
120
Q

Alteplase is CI in severe uncontrolled HTN. What is that range?

A

> 185/110

Can decrease BP with labetalol, cleviprex, or Cardene to get patient below this

121
Q

When should ASA be given in stroke?

A

ASA 162 - 325 should be given within 24 - 48 hours after stroke onset

122
Q

DVT prophylaxis in stroke?

A

Usually Mannual should be used if the patient is receiving tPA

If a LMWH is started it should be started > 24 hours post injection

123
Q

What is the goal BP for a person post stroke?

A

< 130/80

124
Q

What is Na restriction post stroke?

A

< 2.4 g

or
<1.5 g for optimal BP reduction

125
Q

In pateints with a NON cardioembolic stroke, is anticoagulation warranted?

A

No, it is recommended that a patient utilize antaplatelet therapy.

ASA, Aggrenox, or Plavix

126
Q

If a patient was already on ASA 81 prior to the stroke, is there a benefit in increasing there dose to the 162-325 dose range ?

A

No, there has been no proven benefit if a patient was on statin therapy prior to the stroke.

127
Q

ASA moa:

A

irreversibly inhibits COX-1 & 2 leading to decreased prostaglandin and TXA 2

128
Q

Aggrenox MOA:

A

ASA + Dypyridamole

ASA same
Dipyridamole: inhibits the uptake of adenosine into platelets and increases cAMP levels (inhibits platelet aggregation)

129
Q

Plavix is a ____ drug that _____

A

Prodrug; that irreversibly inhibits P2Y12

130
Q

If a patient comes in with an intracerebral hemorrhage (ICH) that is on anticoagulant therapy what should be done?

A

Patients should be considered for reversal of the anticoagulant. IF there is also evidence of seizures then patients should be placed on AED treatment dosing

131
Q

What is the main complication with ICH?

A

Increased intracranial pressure

132
Q

Mannitol MOA:

A

produces osmotic diuresis by increasing osmotic pressure of the glomerular filtrate in the kidneys. Inhibiting tubular reabsorption of water and electrolytes and increases urinary output.

AKA: reduced ICP by withdrawing water from the brain parenchyma and excreting it via the urine

133
Q

What is a CI for mannitol?

A

Severe renal disease!! (pulmonary edema, hypovolemia)

134
Q

What are some warnings with Mannitol?

A
  • vesicant
  • nephrotoxic
  • can cause rebound ICP if used for prolonged time frame (intermittent blouses are preferred)
  • fluid and electrolyte imabalnces (DEHYDRATION)
135
Q

When looking at Mannitol administration what are two big counseling points to the nurse?

A
  • inspect for crystals! if they are present warm the solution
  • filter should be used for admin
136
Q

Other than Mannitol what other IV can be used for ICH?

A

HypER tonic saline can be used

137
Q

Why is Nimodipine used in Acute Subarachnoid Hemorrhage (SAH)?

A

used to prevent vasospasm (which can occur 3 - 21 days after a bleed)

138
Q

Nymalize BBW:

A

Nimodipine should NOT be admin IV!!!! (death, serious life threatening events!!!)

139
Q

Name the direct Factor Xa inhibitors.

A

Edoxaban
Apixaban
Rivaroxaban

140
Q

What factors does Warfarin inhibit?

A

2, 7, 9, 10

141
Q

Direct thrombin inhibitors names

A

IV: Argatroban, Bivalirudin
PO: Dabigatran

142
Q

Indirect Factor Xa inhibitor name:

A

Fondaparinux

143
Q

When looking at Key points, when is oral anticoagulants appropriate?

A
  • AF and DVT/PE
  • Xarelto and ELiquis r not indicated for the acute management of ACS when platelet aggregation is the main target of therapy
144
Q

When looking at Key points, what is Fibrinolytics appropriate?

A

used to break down existing clots.
Used to immediately treat an acute ischemic stroke or STEMI

145
Q

When looking at Key points, when is antiplatelet therapy appropriate?

A

in CAD and to help prevent recurrent stroke/TIA

DAPT: common in patients who have had an ACS.

146
Q

Heparin treatment dosing for VTE:

A

80 U/kg bolus

18 u/kg/hr infusion

147
Q

Heparin treatment dosing for ACS/STEMI:

A

60 U/kg bolus

12u /kg/ hr infusion

148
Q

When do you check anti-xa and aPTT levels in heparin ?

A

6 hours after starting and every 6 hours until therapeuitc.

aPTT: 1.5 - 2.5 x control
Anti-xa: 0.3 - 0.7

149
Q

Lovenox dosing for STEMI in pt < 75

A

30 mg IV bolus + 1mg/kg SC dose

followed by BID

150
Q

LMWH BBW:

A

patients receiving neuraxial anesthesia are at risk for hematomas and subsequent paralysis

151
Q

HIT is when:

A

Platelets drop > 50 % from baseline with no other underlining cause

152
Q

If a patient develops HIT while on Heparin and was also receiving warfarin what should be done?

A

patient should be stopped on both the heparin and the warfarin (increased risk of necrosis) and Vitamin K should be administered.

153
Q

When can warfarin be started/restarted after a patient develops HIT?

A

Until Platelets are at least 150,000

154
Q

Antidote for Apixaban and Xarelto?

A

Adexanet alfa (Andexxa)

155
Q

What is the dose of Xarelto that can be used for reduction in the risk of major CVD events in CAD/PAD?

A

2.5 mg PO BID with ASA 81

156
Q

Savaysa

A

Edoxaban

157
Q

Savaysa AF CrCl cutoffs

A

> 95: DO NOT USE
< 15: do not use

158
Q

When do you start savaysa therapy in DVT/PE treatment?

A

Edoxaban should be 60 mg QD started 5 - 10 days after parental anticoagulation

159
Q

Arixtra

A

Fondaparinux

160
Q

What is a CI when using Pradaxa (what type of heart thing)

A

CI in use of a mechanical prosthetic heart valve

161
Q

Angiomax

A

Bivalirudin

162
Q

What are SE to Jantoven other than bleeding?

A

Skin Necrosis and Purple toe Syndrome

163
Q

what agents decrease INR?

A

2C9 inducers: carbamazepine, phenobarbital, phenytoin, rifampin (drastic), St. Johns wart

164
Q

Agents that increase INR:

A

2C9 inhibitors: Metronidazole, amiodarone, fluconazole, TMP/SMX

165
Q

What are the five G’s of supplements tht increase INR?

A

Ginger
Ginkgo
Ginseng
Glucosamine
Garlic

166
Q

What are the warfarin tablet colors?

A

Pink - 1 mg
Lavender - 2 mg
Green - 2.5 mg
Brown/tan - 3 mg
Blue - 4 mg
Peach - 5 mg
Teal - 6 mg
Yellow - 7.5 mg
White - 10 mg

Please Let Greg Brown Bring Peaches To Your Wedding

167
Q

What agent is used for UFH/LMWH reversal?

A

Protamine!
UHF: 1 mg will reverse 100 U of heparin

LMWH: 1mg per 1 mg of protamine

168
Q

Idarucizumab aka Praxbind is the _____

A

Dabigatran reversal agent

169
Q

For a patient that is set to undergo a cardio version. If their AFib duration is unknown how long should anticoagulant therapy be utilized?

A

For 3 weeks prior and for 4 weeks after

170
Q

MCV < 80 = Microcytic. What is the likely cause?

A

Iron Deficiency

171
Q

MCV 80 - 100 = Normocytic what is the likely cause?

A

Acute blood loss
CKD
Bone Marrow Failure ( aplastic anemia)
Hemolysis

172
Q

MCV> 100 = Macrocytic. What is the likely cause?

A

Vitamin B 12 or Folate deficiency

173
Q

What laboratory findings are best associated with iron anemia?

A

Decreased: Hgb, MCV, RBC production (low reticulocyte count)

Decreased: serum from, ferritin, and TSAT

Increased:TIBC

174
Q

What is the goal with treating iron anemia?

A

increase serum Hgb ~1g/dL Q2-3 weeks and continue treatment for 3 - 6 months after anemia has resolved

175
Q

% of elemental iron in Ferrous Gluconate

A

12%

176
Q

% of elemental iron in Ferrous Sulfate

A

20%

177
Q

% of elemental iron in Ferrous Sulfate DRIED

A

30 %

178
Q

% of elemental iron in carbonyl iron, polysaccharide iron complex, ferric mall

A

100%

179
Q

BBW with Oral Iron

A

Accidental OD of iron containing products leading to overdose in children

180
Q

What can be given with oral iron and why?

A

Docusate to prevent Constipation

181
Q

What can iron be taken with to slightly enhance the absorption of it?

A

Vitamin C

182
Q

BBW with Feruxytol (feraheme) and Iron Dextran (INFEdD)

A

serious anaphylaxis concern. Present with all but noted with these two.

A patient should receive a test dose of iron dextran before actually recieving it

183
Q

What is unique about Triferic?

A

Ferric Pyrophosphate Citrate is only indicted for iron replacement in patients with hemodialysis dependent CKD

Should be added to bicarb concentrate of the hemodialysate

184
Q

Nascobal is:

A

A intranasal B12. Given in one nostril every week

185
Q

Prolonged use of Metformin, H2RA, or PPIs can lead to:

A

Vitamin B12 deficiency (2 yrs)

186
Q

When do you initiate Procrit in patients of Normocytic anemia that have cancer or CKD?

A

When Hgb is < 10

187
Q

What is the admin frequency for Epoetin Alfa (Epogen/procrit)?

A

3x/wk
IV or SC

188
Q

What is the admin frequency for Aranesp?

A

IV or SC weekly for Darbepoetin

189
Q

What is the Hgb goal in patients with Sickle Cell?

A

10!

190
Q

What is considered the only cure for sickle cell?

A

Bone Marrow Transplant

191
Q

Droxia MOA:

A

stimulated the production go HgbF.

Indicated in adults with >/= 3 moderate to severe pain crises in one year.

Considered in all children > 9 months

192
Q

What are two warnings with Hydrea/Droxia/Siklos/Hydroxyurea?

A

Fetal toxicity
Avoid Lie Vaccines (Myelosuppression BBW)

193
Q

What supplementation is recommended with hydroxyurea?

A

Folic acid to help avoid macrocytosis

194
Q

Oxbryta MOA:

A

Voxelotor: inhibiting hemoglobin S polymerization (cause of SCD)

Tablet form

195
Q

What is the antidote for Iron toxicity?

A

Deferoxamine

196
Q

What are the current oral formulation utilized to chelating iron in SCD patients.

A

Exjade, Jadenu (Desferasirox)

Ferriprox (deferiprone)

NAPLEX BITCH (9 decks)

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