Treatments

Question 1

Hypertension Treatments

Answer 1

Diuretics (first line) e.g. HCTZ 12.5-25 mg

Angiotensin Converting Enzyme Inhibitors (ACEi): (first line) e.g. Lisinopril, Enalapril.. 5-10mg

Angiotensin Receptor Blockers (ARBs): e.g. Losartan 50-100mg

CCBs: e.g. Diltiazem 180 mg titrate to 360/ Amlodipine 2.5 mg titrate to 10mg

Alpha blockers (maybe… probably not according to Dr)

Question 2

Hypertensive Urgency

Answer 2

Alpha Blocker: e.g. Clonidine .1-.2 mg PO

Beta Blockers (selective or non selective): e.g. Metoprolol 50mg, Labetalol 100mg

Question 3

Hypertensive Emergency

Answer 3

IV, 02 if < 94%, monitor with telemetry.

Reduce BP by 25% w/in 1-2 hours. 160/100 in 24 hrs.

Labetalol (non selective Beta Blocker) 20 mg IV, then Metoprolol 25-50 PO once stable.

Question 4

Atherosclerotic Coronary Artery Disease (CAD)

Answer 4

SMOKING CESSATION

Statins: e.g. Atorvastatin 10mg before bed.

Aspirin

SURGICAL: CABG, Stenting, primary percutaneous coronary intervention

Question 5

Atherosclerotic Peripheral Vascular Disease (PAD)

Answer 5

Smoking Cessation, lose weight, exercise

Phosphodiesterase inhibitor: e.g. Cilostazol 100mg PO BID

Question 6

Acute Arterial Occlusion of a Limb

Answer 6

Enoxaparin (lovenox): 1mg/kg SC q12h

Heparin Sulfate 5000-10000 units IV

Revascularization w/in 3 hours.. Limb loss at 6 hrs

Question 7

Occlusive Cerebrovascular Disease

Answer 7

Smoking Cessation, weight reduction, diet

Aspirin
Statins
Thrombolytics for those within 6 hrs of sx

Question 8

Dyslipidemia

Answer 8

Low fat diet (25% of your diet) , Med Diet, high fiber diet, lose weight

Statins: e.g. Simvastatin 5-10mg

Question 9

Paroxysmal Supraventricular Tachycardia (PSVT)

Answer 9

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Unstable? Cardioversion
Stable? Vasal Vagal Maneuvers. If failed, Adenosine 6mg IV (first line)

Beta Blockers: Metoprolol 5mg IV, Metoprolol 50mg PO

Calcium Channel Blockers: Diltiazem .25 mg/kg IV

Question 10

Wolf Parkinson White Syndrome

Answer 10

Unstable? Synchronized Cardioversion

Stable? vagal maneuvers. or adenosine or metoprolol (as in SVT)

Question 11

Atrial Fibrillation

Answer 11

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Stable? AF > 48 hrs? Enoxaparin 1mg/kg SC q12h
Metoprolol 5mg IV/50mg PO
Diltiazem .25 mg/kg IV

Unstable? Synchronized Cardioversion

Question 12

Atrial Flutter

Answer 12

Metoprolol
Diltiazem (sae as A Fib for both)

Unstable? synch cardioversion

Question 13

Ventricular Tachycardia

Answer 13

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Pulseless? ACLS protocol
Unstable? Synch Cardio

Stable? Lidocaine .5-.75 mg/kg IV
Amiodarone 150 mg IV
Magnesium 2 grams IV

Question 14

Ventricular Fibrillation

Answer 14

ACLS protocol per cardiac arrest

Question 15

Torsades de Pointes

Answer 15

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Pulseless? ACLS

Stable? Magnesium sulfate 2 g IV

Question 16

2nd degree AV block type 1

Answer 16

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Unstable? Atropine .5mg IV and prepare for transcutaneous pacing
Stable? Medadvice

Question 17

2nd Degree AV block type II

Answer 17

prepare for transcutaneous pacing

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%
Unstable? atropine .5mg IV. if ineffective move on to Dopamine IV 2-20 mcg/kg/min
Heart failure? Dobutamine 5-20 mcg/kg/min

Question 18

3rd degree AV block

Answer 18

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Unstable? Atropine .5 mg IV, prep for pacing. Ineffective? Dopamine IV 2-10 mcg/kgmin.

Heart failure? Dobutamine 5-20 mcg/kg/min or Epinephrine 2-10 mcg/min

Question 19

Acute Coronary Syndrome Treatment (STEMI, Unstable Angina…)

Answer 19

Aspirin
Nitro
Morphine

Lovenox (if STEMI) 30mg IV.
Metoprolol (if STEMI w Tachy) 5mg IV (if NSTEMI) 50mg PO BID

Question 20

Congestive Heart Failure

Answer 20

Acute?
ABC’s, IV, Vitals, Monitor, Oxygen if < 94%. Correct reversible causes

Diuretics: Furosemide 40mg IV
Bumetanide 1mg IV

Chronic?
Ace Inhibitors
Diuretics
Nitro

Question 21

Dissecting Aortic Aneurysm

Answer 21

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Metoprolol 5m IV
Labetalol 5-10mg IV

Question 22

Pericarditis

Answer 22

Aspirin 325-650 mg q6h (SCHEDULED not PRN)

NSAIDS

Question 23

Myocarditis

Answer 23

AVOID NSAIDS

Morphine for pain

Question 24

Endocarditis Cegt

Answer 24

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Empiric therapy: Ertapenem 1 g IV or Vancomycin 1 g IV, + Ceftriaxone 2g IV

Question 25

Pericardial Tamponade

Answer 25

IV bolus to help with hypotension

if needed, pericardiocentesis

Question 26

Cardiac Contusion

Answer 26

ABC’s, IV, Vitals, Monitor, Oxygen if < 94%

Analgesics for pain

Question 27

Deep Vein Thrombosis

Answer 27

Aggressive anticoagulation: Lovenox 1mg/kg/ SC q`12h
Heparin, 80 units

Tylenol, Morphine