Cardiac Flashcards
(35 cards)
Best drug to lower LDL?
Side fx?
STATIN —| HMG CoA Reductase
Fx: hepatotoxicity,myositis
Drug to lower LDL & Raise HDL but causes flushing…
How do you prevent this side fx?
Niacin –| HSL in fat, decreasing FFA transport
Fx: flushing!, hepatotoxicity
Prevent flushing with asprin!
Best drug to lower total cholesterol? Side fx?
Fibrates –> PPAR-a agonist = increases lipolysis, raising HDL & lowering TC
Fx: gallstones, myositis
Lipid drug that causes diarrhea, constipation, gallstones & bloating? Mechanism of action?
Resins –> increases secretion of bile acids in GI resutling in decreased LDL
Drug that blocks the absorption of cholesterol in the intestines? Fx?
Ezetimibe = decreases LDL
Fx: myositis, contipation, bloating, diarrhea
Who gets a statin?
- Vascular disease
- LDL >/= 190
- LDL 70-189 + 40-75yoa +DM or 10yr risk
- LDL 70-189 + 40-76 w/calculated risk
How often do you check lipids in a person on a statin or w/hypercholesteremia?
ANNUALLY!
*dont need to check liver shit unless symptoms
SIRs Criteria requires 2+ of….
- Temp >38 or <34
- HR >90
- RR>20 or PaCO2 <32
- WBC >12000 or <4000 or >10% bands
How often do you screen for cholesterol levels?
35q5
Screening for osteoporosis?
> 65
Breast cancer screening?
50q2 till 75
Cervical cancer screening?
21q3 till 75
HTN screening?
18q2
Tx of SIRs?
- Give 30cc/kg bolus IVF
- Remove sources of infection
- O2 as needed
- Pressers of bolus fails
- Empiric abx
Treatment fo HF for EVERYBODY?
<2g of salt per day, <2L H2O per day, ACE/ARB, BB
Tx for reducing preload in HF pt…which type needs a reduced preload?
Diuretics(furosemide), Nitrates, Dietary modifications.
*usually diastolic needs this
Diastolic heart failure etiology
FILLING FAILURE due to Pericardium(tamponade, constrivie pericarditis) or Cardiomyopathy(restritive or hypertrophic)
Systolic HF etiology
FORWARD failure due to Leaky valves(regurge), Dead heart(ischemia/infarct), floppy muscles(HTN, EtOH, Drugs)
NYHA classifications of HF…
1: no limitations, no sx
2: slight limitation, comfortable at rest and walking
3: Moderate, comfortable at rest only
4: bed bound, sxs at rest
Tx for reducing afterload in HF pt….who needs this?
usually needed by systolic failure
- ACE/ARB, Hydralazine, Spironolactone
When do you use inotropes like dobutamine in HF?
once they reach class 4 = bed bound w/sxs at rest
Who gets anticoagulated?
Ppl with a score of 2 on CHAD2(CHF, HTN, age>/=75, DM or previous stroke or TIA(2pts)). A fib with out these RF = no anticoagulant
CHAD = 1 use ASA only
40 yo male w/2 wks fever, malaise, wknes, weight loss, L sided chest pain + ab pain. decrease lung sounds + dullness in L lower. 2/6 systolic murmer. L sided pleural effusions, splenomegaly w/splenic fluid. dx?
Infectivie endocarditis causing splenic abscess
Prob due to staph or strep
Drug user who now has Fever, cough + some endocarditis. MC endocardiits? what murmer would you hear?
Tricupid due to Staph Aureus = triscupid regurge = holosytolic murmer that increases with inspiration
