Name that suffix
-olol
Beta Blocker
Metoprolol, bisoprolol
Use: lower/slow HR, reduce arrythmias
What is the first line for all ACS patients?
ASA
Antiplatelet therapy
Reduces mortality; prevents clot progression
To reduce risk of AKI.
Metformin is excreted by the kidneys. Contrast dye can temporarily reduce kidney function. If kidneys are impaired and metformin accumulates= increased risk of lactic acidosis.
This antibiotic can cause red man syndrome if infused too quickly.
Vancomycin
This medication requires a PTT to initiate treatment and 6 hours after.
IV Heparin
-pril
ACE Inhibitor
Lisinopril, enalapril
Use: lower BP, reduce afterload
What is the class of medications used to lower LDL levels?
HMG-CoA reductase inhibitors
ie: atorvastatin, rosuvastatin
What medication has the side effect of ototoxicity if given too quickly?
Furosemide
A patient on antibiotics develops oral thrush. This is likely due to what complication?
Fungal overgrowth/disruption of normal flora.
When giving furosemide, what lab values should be monitored?
Lytes (specifically Na and K), Crea, GFR
- sartan
ARBs- Angiotensin II receptor blockers
Losartan, valsartan
Use: lower BP, manage HF, alternative when pt does not tolerate ACE (cough)
Name a P2Y12 inhibitor and why it is used
Ticagrelor, Clopidogrel
Often given with aspirin
Used to prevent further platelet activation and stent thrombosis.
These drugs decrease heart rate, reduce myocardial oxygen demand, and require monitoring of HR and BP.
Beta Blockers
In a patient with sepsis, it is ok to give antibiotics before blood cultures are drawn. True or false?
False. Antibiotics can break through cell walls of bacteria within 20 minutes and will skew the blood culture results.
This electrolyte sometimes increases with pip-taz use, especially in renally impaired patients.
Each gram of pip taz contains a significant amount of sodium.
Kidneys normally excrete excess sodium; in renal impairment, this does not happen as effectively leading to Na accumulating in the blood= hypernatremia.
-dipine
Calcium channel blocker
Amlodipine, Nifedipine
Use: lower BP, vasodilation, good for HTN and angina
Name 5 classes of medication all NSTEMI patients will be on
Beta Blocker
Antiplatelet
Statin
Anticoagulation
Pain/Ischemic relief ie nitro or morphine
What clinical implications would help decide if a patient is on oral anticoagulation, subcutaneous or IV?
Oral: use when patient is stable and long term prevention is needed. ie: afib, long term DVT/PE tx/prevention
**stable=oral**
SC: use when predictable anticoagulation is needed quickly, but pt is stable. **predictable, practical=SC** ie: tx DVT/PE, bridging to warfarin, prophylaxis when admitted to hospital. Enoxaparin
IV: used when fast, high control anticoagulation is needed or pt is unstable. Indications: ACS, massive PE, when rapid on/off control is needed (ie surgery), Afib with RVR and high clot risk.
A patient on broad spectrum antibiotics isn't improving after 48hrs. What are the next steps?
Review culture and sensitivity results and narrow down therapy.
Before giving vancomycin, check this lab value to prevent nephrotoxicity.
Creatinine/BUN
-arone
Antiarrhythmics
Amiodarone
Use: Afib, VT/VF managemement
Name a reperfusion related medication used in STEMIs
tpa, alteplase
Name 5 medications given to treat liver failure.
1. Lactulose: treats hepatic encephalopathy
2. Rifaximin: reduces gut bacteria and used to prevent hepatic encephalopathy.
3. Diuretics: treat ascites and edema associated with liver failure.
4. Beta blockers: prevents variceal bleeding by reducing portal hypertension.
5. PPI: prevent stress ulcers/GI bleeding in advanced liver disease.
This is a broad spectrum antibiotic combination of a penicillin + a _______
Beta-lactamase inhibitor.
A patient on corticosteroids should be monitored for these two metabolic changes.
Hyperglycemia- increase gluconeogensis in the liver so more glucose is prduced. They also decrease peripheral glucose uptake by muscle and fact= insulin resistance.
Hypokalemia- have mineralocorticoid activity (increase NA retention and K+ excretion) and increase renal potassium excretion= low serum K+