Cardiac HF/anticoag

Question 1

Classifications HF

Answer 1

a- risk of HF
b-strucutral disease no symptoms
c- disease past or current symptoms
d- refractory, all the time

Question 2

Treatment HF 
A 
B
C
D

Answer 2

a- acei 
b-ace+beta
c- ace+beta+loop 
end of c add digoxin 
d- all of the above, dobutamine

Question 3

HF
do not use

use ACE in all except

use beta if

Answer 3

CCB

pregnancy, bilateral renal artery stenosis, high potassium, angioedema

history MI

Question 4

Digoxin

metabolism
excretion
need?
interactions

Answer 4

not extensively metabolized

excreted unchanged in kidneys

loading dose (half life long)- IV first then switch to oral

quinidine, amiodarone, CCB (verapimil, diltiazem)

Question 5

Antiarrythmic categories

Answer 5

Sodium channel blockers- lengthen duration action potential, shorten duration action potential, minimally increase action potential- (quinidine, lidocaine, phenytoin, flecainide)

Beta blocker (sotalol is II and III)

Potassium channel blocker- prolong duration action potential, reduce speed of conduction (amiodarone)

Calcium channel blocker (verapamil, diltiazem)

Question 6

Amiodarone

prolong..

Metabolism

Elimination

ADRs

Interactions

Answer 6

effective refractory period, reduce sped of conduction
Class III antiarrythmic

long half life- need loading dose

excreted in feces

thyroid, pulmonary fibrosis*

MANY, grapefruit juice

Question 7

Beta blocker ISA

MI patients?
Patients experiencing bradycardia?

Answer 7

MI patients- without ISA post MI

Bradycardia- with ISA

Question 8

Nitrates
ADRS

dont give to

hypotension…

interactions

pregnancy?

Answer 8

headache, orthostatic hypotension, tachycardia

patients with ICP

myocardial ischemia, arrythmia, rebound hypertension

use with vasodilators like viagra
additive hypotension beta blockers etc. alcohol

cat c

Question 9

Acute angina use

stable angina use

Answer 9

sublingual nitroglyceride sl every 5 minutes up to 3 doses

isosorbide dinitrate

Question 10

Peripheral vasodilators

adrs

interactions

Answer 10

minoxidil hydralazine

adrs: tachycardia, increase contractility, sodium and water retention, headache

nsaids