Treatments Flashcards
Hypertension Treatments
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)
Hypertensive Urgency
Alpha Blocker: e.g. Clonidine .1-.2 mg PO
Beta Blockers (selective or non selective): e.g. Metoprolol 50mg, Labetalol 100mg
Hypertensive Emergency
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.
Atherosclerotic Coronary Artery Disease (CAD)
SMOKING CESSATION
Statins: e.g. Atorvastatin 10mg before bed.
Aspirin
SURGICAL: CABG, Stenting, primary percutaneous coronary intervention
Atherosclerotic Peripheral Vascular Disease (PAD)
Smoking Cessation, lose weight, exercise
Phosphodiesterase inhibitor: e.g. Cilostazol 100mg PO BID
Acute Arterial Occlusion of a Limb
Enoxaparin (lovenox): 1mg/kg SC q12h
Heparin Sulfate 5000-10000 units IV
Revascularization w/in 3 hours.. Limb loss at 6 hrs
Occlusive Cerebrovascular Disease
Smoking Cessation, weight reduction, diet
Aspirin
Statins
Thrombolytics for those within 6 hrs of sx
Dyslipidemia
Low fat diet (25% of your diet) , Med Diet, high fiber diet, lose weight
Statins: e.g. Simvastatin 5-10mg
Paroxysmal Supraventricular Tachycardia (PSVT)
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
Wolf Parkinson White Syndrome
Unstable? Synchronized Cardioversion
Stable? vagal maneuvers. or adenosine or metoprolol (as in SVT)
Atrial Fibrillation
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
Atrial Flutter
Metoprolol
Diltiazem (sae as A Fib for both)
Unstable? synch cardioversion
Ventricular Tachycardia
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
Ventricular Fibrillation
ACLS protocol per cardiac arrest
Torsades de Pointes
ABC’s, IV, Vitals, Monitor, Oxygen if < 94%
Pulseless? ACLS
Stable? Magnesium sulfate 2 g IV
2nd degree AV block type 1
ABC’s, IV, Vitals, Monitor, Oxygen if < 94%
Unstable? Atropine .5mg IV and prepare for transcutaneous pacing
Stable? Medadvice
2nd Degree AV block type II
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
3rd degree AV block
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
Acute Coronary Syndrome Treatment (STEMI, Unstable Angina…)
Aspirin
Nitro
Morphine
Lovenox (if STEMI) 30mg IV.
Metoprolol (if STEMI w Tachy) 5mg IV (if NSTEMI) 50mg PO BID
Congestive Heart Failure
Acute?
ABC’s, IV, Vitals, Monitor, Oxygen if < 94%. Correct reversible causes
Diuretics: Furosemide 40mg IV
Bumetanide 1mg IV
Chronic?
Ace Inhibitors
Diuretics
Nitro
Dissecting Aortic Aneurysm
ABC’s, IV, Vitals, Monitor, Oxygen if < 94%
Metoprolol 5m IV
Labetalol 5-10mg IV
Pericarditis
Aspirin 325-650 mg q6h (SCHEDULED not PRN)
NSAIDS
Myocarditis
AVOID NSAIDS
Morphine for pain
Endocarditis Cegt
ABC’s, IV, Vitals, Monitor, Oxygen if < 94%
Empiric therapy: Ertapenem 1 g IV or Vancomycin 1 g IV, + Ceftriaxone 2g IV
