Heart Failure
What are 2 risk factors for developing HF?
MI, HTN, DM, obesity, cigarette smoking
What blood pressure ranges are classified as stage 1 HTN?
SBP 130-139 mmHg
OR
DBP 80-89 mmHg
What is the preferred anticoagulant for dialysis patients?
UFH
What category is a BMI of 36.3? (with class)
Obesity (class 2)
What is the MOA of statins?
competitive inhibition of HMG-CoA reductase
If someone has a LVEF ≤ 40%, what type of HF are they in?
HFrEF
Where do potassium sparing diuretics work in the Loop of Henle? Give an example of one.
ENaC channels in the cortical collecting tubule
Spironolactone
What is the mechanism of action/drug class of bivalirudin (Angiomax)?
Direct Thrombin Inhibitor (DTI)
Binds directly to thrombin (IIa)
State 3 side effects of decongestants in cough and cold treatment.
CV stimulation: increased BP, tachycardia, palpitations, arrhythmias
CNS stimulation: restlessness, insomnia, anxiety, tremors, fear, hallucinations
Name 2 statin benefit groups according to the 2018 ACC/AHA Multisociety guidelines.
ASCVD, diabetes, LDL 190+, 10 year risk 7.5%+
What is the IV to PO conversion for furosemide?
40 mg IV = 80 mg PO
What are the 2 compelling indications to start a patient on a Beta Blocker who also has hypertension?
Heart failure
Post-MI (cardioselective beta blocker)
What proteins are Vitamin-K dependent (warfarin)?
what are:
Factors II,VII, IX, X and proteins C and S
Up to how many days can you use Diclofenac gel for musculoskeletal injuries?
21 days
Name 3 of the main drug interactions with statins.
G PACMAN
Grapefruit
Protease Inhibitors
Azole Antifungals
Cyclosporine
Macrolides
Amiodarone
Non-DHP CCBs
What are the five medications that every patient with HFrEF should receive?
loop diuretics
ACEi/ARB/ARNi
beta blockers
SGLT2i
spironolactone or eplerenone
Where do potassium sparing diuretics work in the Loop of Henle? Give an example of one.
ENaC channels in the cortical collecting tubule
Spironolactone
What are the requirements needed to consider dose decrease in Eliquis? (2/3)
-age greater than/equal to 80
-body weight less than/equal to 60kg
-SCr greater than/equal to 1.5 mg/dL
What is the dosing for a nicotine patch if a patient smokes less than or equal to 10 cigarettes per day?(full dosing with # of weeks)
14 mg x 6 weeks
then
7 mg x 2 weeks
Which statins are lipophilic?
Atorvastatin & Simvastatin
What are the 3 beta blockers used in HF and their target dosing?
metoprolol succinate: 200 mg daily
carvedilol: 25 mg BID (< 85 kg), 50 mg BID (> 85 kg)
bisoprolol: 10 mg once daily
What are the agents of choice for treating an acute aortic dissection? (hint, three different options)
labetalol
combination of nicardipine and esmolol
combination of nitroprusside and esmolol
What populations should be considered for Anti-Xa monitoring when on Lovenox? (3/5 needed)
-renal dysfunction
-major obesity
-pregnancy
-trauma pts
-orthopedic pts
Which complementary therapy should pregnant patients not use for vaginal/vulvovaginial disorders?
boric acid
What class of medications lowers serum LDL-C the most?
PCSK9 Inhibitors