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Clin Med Comprehensive > Cardio therapeutics > Flashcards

Cardio therapeutics Flashcards

(47 cards)

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1
Q

What are high intensity statins?

A

Atrovastatin 40-80mg

Rosuvastatin 20-40mg

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2
Q

What are moderate intensity statins?

A

Atrovastatin 10-20mg
Rosuvastatin 5-10mg
Simvastatin 20-40mg
Pravastatin 40-80mg

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3
Q

What are low intensity statins?

A

Simvastatin10mg
Pravastatin 10-20mg
Lovastatin 20mg

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4
Q

What monitoring needs to be done for statins?

A

fasting lipid panel 4-12 wks after initiation and reassess every 3-12 mo

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5
Q

How do PCSK9 inhibitors work?

A

bind to PCSK9 to block from downregulating LDL-R (will increase LDL-R)

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6
Q

What is evolucumab?

A

PCSK9 inhibitor

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7
Q

How do you treat CAD?

A

PCI (balloon tip catheterization), GABG (vein graft), stabilization

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8
Q

Treatment for stable angina

A

Nitroglycerine (NTG) a vasodilator that brings more blood to the heart
or CABG or PCI if not working

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9
Q

How long does NTG take to work?

A

5 min if angina not gone then repeat (if 3 x and no relief call 911)

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10
Q

Risks and complications of PCI

A

inflammatory response, thrombosis, MI, restenosis

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11
Q

What are the long acting nitrates?

A

Isosorbide dinitrate/mononitrate
Nitropaste
Transdermal nitro patch

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12
Q

What are follow up assessments for stable angina?

A
  1. changes in phys activity
  2. changes in freq of angina
  3. possible adverse effects of therapy
  4. adherance
  5. knowledge about CAD
  6. changes in comorbid conditions
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13
Q

How often do you see a patient with stable angina?

A

4-6 mo in first year then yearly
ECG if change in pattern
annual stress test for high risk pateints

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14
Q

Treatment of coronary vasospasm or variant angina

A

Cath lab to make sure variant not STEMI

Nitro if pain returns (can use IV drip)

Aspirin Plavix
Statins
Heparin and Integrillin

Chronic tx: Ca channel blockers, long acting nitrates

AVOID non selective βblockers

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15
Q

What is the effect of ivabradine?

A

used for CHFdec HR, acts on SA node

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16
Q

What is the best anti-arrhythmic option for patient with stable sustained ventricular tachycardia?

A

Amiodarone

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17
Q

You diagnose an 80 yo patient with new onset of complete heart block. What is your next recommendation?

A

pacemaker

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18
Q

You diagnose a 76 year old female with paroxysmal atrial fibrillation. She has DM and hypertension. She is on a beta blocker and her heart rate is 80 bpm during episodes. What should you do to protect her against strokes?

A

Apixaban

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19
Q

You diagnose a patient with WPW. He has recurrent AVRT. What is your recommendation?

Study These Flashcards
A

Catheter Ablation

20
Q

What is the difference between a vasopressor and an inotrope?

Study These Flashcards
A

vasopressor works primarily on the vascular system and inotrope has effect on contractility of myocardium

21
Q

What is treatment for anaphylactic shock?

22
Q

What is initial vasopressor of choice for shock?

Study These Flashcards
A

NE (levophed) helps with BP

23
Q

What is treatment for pulm HTN and shock?

24
Q

What is treatment plan for hypovolemic shock?

Study These Flashcards
A

fluid resuscitation and control fluid loss

25
What is treatment for hemorrhagic shock
fluid resuscitation and find bleeding source, control and correct coagulopathy
26
What is treatment for septic shock
ID and drain infection , supportive care, fluid resucitation and vasopressors (phenylephrine, NE< vasopressin)
27
What is treatment for cardiogenic shock?
obstructive: cath lab | heart failure: diuresis, afterload reduction and inotropic support
28
What is the treatment for bradycardia?
correct underlying prob, pacemaker
29
What is the treatment for tachycardia?
correct underlying problem, vagal maneuvers, drugs, cardioversion/defib, catheter ablation, surgery
30
What is electrical cardioversion?
electrical current discharged across chest to allow sinus node to regain pacemaker control
31
Why do you need a pacemaker?
symptomatic brady
32
What pacemaker do you use for normal AV conduction sinus brady?
AAI(R)
33
What pacemaker do you use for abnormal AV conduction sinus brady with abnormal atrial fn?
VVI(R)
34
What pacemaker do you use for abnormal AV conduction sinus brady with normal atrial fn?
DDD(R)
35
Treatment for atrial septal defect
Prevent pulmonary vascular disease Direct suture closure, pericardial septal patch, septal occluded device monitor for return of normal RA/RV morphology
36
Treatment for ventricular septal defect
Half close spontaneously by age 2 Closure indicated if sx of CHF Surgical or percutaneous
37
Treatment for aortic stenosis
Balloon valvuloplasty | Surgical revision or replacement
38
Treatment for pulmonic stenosis
Transcatheter ballon valvuoplasty | Usually followed by regression of rap hypertrophy
39
Treatment of Coarctation of Aorta
Prostaglandin to keep ductus arteriosus open (good pre pre-ductal) Excision and reanastamosis or balloon and stent
40
Treatment of Tetralogy of Fallot
Temporary: connect aorta and pulm artery to encourage mvt of blood to pulm artery Surgical closure of VSD
41
Treatment of Transposition of the Great Vessels
``` Prostaglandin infusion Transcatheter infusion (puncture hole in intraventricular septum) Arterial switch ```
42
When do we use pphx for bacterial endocarditis?
Unrepaired cyanotic heart disease (TF, TGV) Post-repair w/ prosthetic or device for 6 mo Post-repair w/ residual defects at site of prosthetic patch or device (indefinitely) Surgery, catheterization, dental procedures
43
What is abx pphx for bacterial endocarditis?
Amoxicillin single dose po the evening before Ampicillin single dose IM/IV Clindamycin po Cephalexin po
44
Treatment of Stable Angina
Nitroglycerin (vasodilator) Sublingual tablet 0.3 or 0.4 up to 0.6 LT nitro, β blockers CABG or PCI if nothing is working F/u 4-6 mo then yearly
45
Treatment of variant angina
Cath lab to make sure variant not STEMI Nitro if pain returns (can use IV drip) Aspirin Plavix Statins Heparin and Integrillin Chronic tx: Ca channel blockers, long acting nitrates AVOID non selective βblockers
46
Treatment of Unstable Angina & NSTEMI
High Risk: coronary angiography→PCI or CABG Med management: Morphine, O2, Nitro, Aspirin, UFH, LMWH, Heparanoids, direct thrombin inhibitor Integrelin as soon as diagnosed W/in 1st 24 hrs β-blocker or CCB, ACE-I, Statin, D/C NSAIDS (except Aspirin)
47
Treatment of Acute Myocardial Infarction
``` Aspirin 325 mg daily 12 lead EKG O2 2-4 L/min NC NTG Fibrinolytics (clot buster) β blocker Morphine Cardio consult/cath lab PCI Monitor 24 hrs Smoking cessation, cardiac rehab ``` Aspirin, β blocker and statin continued

Clin Med Comprehensive (9 decks)

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