Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

pharm week 1 > Cardio Week 1 > Flashcards

Cardio Week 1 Flashcards

(79 cards)

Start Studying
1
Q

Examples of acute coronary syndrome?

A

Unstable angina

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Usual cause of coronary heart disease?

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Two other terms for coronary heart disease?

A

Coronary artery disease

Ischemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of cardiovascular disease (7)?

A

Coronary heart disease

Cerebrovascular disease

Peripheral artery disease

Rheumatic heart disease

Congenital heart disease

DVT

PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

All-cause Mortality refers to?

A

Whether statin therapy Increases the risk of death from non-coronary causes more than it reduces coronary heart disease (CHD) death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major coronary events include?

A

Non-fatal MI

CHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Secondary prevention using Statin therapy is most applicable to which patient population?

A

Those with acute coronary syndrome. History of unstable angina or MI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thiazide diuretics work here?

A

Distal convoluted tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thiazide diuretics do this?

A

Inhibit tubular reabsorption of Na, Cl, K ions

Dilate the arterioles via direct relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

First line tx for hypertension? Dose?

A

HCTZ 12.5 mg OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dose that HCTZ reaches 80% of it’s effectiveness?

A

25mg OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HCTZ treats this? (6)

A

Heart failure

Edema related to:
Heart failure
Renal dysfunction
Cirrhosis
Steroid therapy
Estrogen therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Don’t use HCTZ for? (4)

A

Drug allergy
Anuria
Severe renal failure
Breastfeeding mothers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ADE of HCTZ?

A 
dehydration
electrolyte imbalances
hyperuricemia
insulin dose may need adjusting
photosensitivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pts on HCTZ may need?

A

K supplementation
Serum electrolyte assessments
Insulin adjustments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is Chlorthalidone a pain in the butt?

A

Only comes in 5omg tabs
starting dose= 12.5mg (most effective SBP lowering)
25mg = most effective DBP lowering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Spironolactone is… (4)

A

Aldactone
a aldosterone receptor antagonist
a steroid
analogue (comparable to) aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spironolactone works by:

A

inhibits aldosterone in collecting ducts
= loss of bicarbonate and calcium, conserves potassium and hydrogen (K sparing!)
Decreases Na reabsorption (water flows out of blood into tubules - follows Na)
Decreases K excretion (K sparing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Spironolactone is…

A

A weak diurectic
A weak antihypertensive (compared to other diurectics)

Increases survival in HF
Potassium sparing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Drugs that can reach toxic levels if taken with diuretics ?

A

Digoxin

Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This can lead to additive hypokalemia in pts taking thiazides diuretics?

A

Black licorice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Compound found in licorices root that causes increased Na and decreased K?

A

Glycyrrhetic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do the adrenal glands secrete?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where does aldosterone exert its effect ?

A

Kidneys
Heart
Arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What does aldosterone do?
Increases BP by: Increasing systemic vascular resistance (artery constriction) Retains Na in the kidneys Increased heart contractility, HR, BP
26
Ace inhibitors are the …?
“prils ” Ramipril Captopril Lisinopril Enalapril
27
ACEi lower BP by:
Reducing systemic vascular resistance
28
First line agents for BP tx?
Thiazide diurectics | ACE inhibitors
29
Captopril starting dose?
25mg daily | Capoten
30
Enalapril starting dose?
5mg daily | vasotec
31
Lisinopril starting dose?
10mg daily | Prinvil, Zestril
32
Ramipril starting dose?
2.5 mg daily | altace
33
Ace inhibitors such as ramipril reduce BP by what amount?
``` SBP = 8 DBP= 5 ```
34
ACE inhibitors treat? (6)
First line for HTN First line for heart failure (stopping aldosterone = decreased systemic resistance, decreased HR, decreased BP = lets the heart rest) Cardio protection post MI Renal protective in DM Reduce GFR pressure Reduce proteinuria = reduced diabetic nephropathy
35
BP meds not advised as 1st line in patients of African decent?
ACEi | ARBs
36
Who should not be given Vitamin K?
< 9 INR with no risk of bleeding
37
INR goal range and target for non-valvular atrial fib?
2.0- 3.0 | Target= 2.5
38
Drugs associated with increased risk of bleeding for patients taking warfarin?
NSAIDS antiplatelet agents some antimicrobials Some foods, herbal products
39
Recommended way of preventing drug/herbal interactions with warfarin?
check 2 drug resources
40
Antimicrobials that may interact with anticoagulants?
- amoxi-clav - fluoroquinolones - trimethoprim-sulfamethoxazale - macrolides - metronidazole - azole antifungals - tetracyclines - rifampin
41
Cardiovascular medications that may react with anticoagulants?
``` amiodarone fenofibrate propafenone propranolol simvastatin ```
41
Cardiovascular medications that may react with anticoagulants?
``` amiodarone fenofibrate propafenone propranolol simvastatin ```
42
What CNS meds potentially react with anticoagulants?
Carbamazepine SSRI Tramadol
43
Risk factors for anticoagulant associated bleeding? (9)
Hx of GI bleed, thrombocytopenia, platelet dysfunction, active peptic ulcers Uncontrolled hypertension Renal or hepatic dysfunction CV disease Increased age Labile or supratherapeutic INRs Concomitant meds (NSAIDS, antiplatelets) Excessive alcohol consumption Malignancy
44
3 fold risk of bleeding when you take these 2 meds with warfarin?
ASA | Clopidogrel
45
Special circumstances where anticoagulants and antiplatelets are warrented?
1- intracoronary stent placement | 2- acute coronary syndrome
46
What is a prescribing cascade?
A prescribing cascade occurs when a drug-related adverse event leads to the addition of a subsequent medication to treat the adverse event
47
dihydropyridine Calcium channel blocker that studies show causes a 3-11% of peripheral edema?
Amlodipine
48
What is important to monitor for new oral anticoagulants?
Renal function hepatic function compliance
49
When to consider Warfarin? (9)
* Prosthetic heart valves or hemodynamically-significant valvular disease * currently well managed on warfarin * Stable coronary heart disease, placement of an intracoronary stent or acute coronary syndrome * CYP- P450 3A4 and P‐glycoprotein drug interactions * History of GI bleed * Reversal needed * Cost concerns * Poor compliance * Consider travel insurance
50
Transient Lifestyle changes that can affect INR levels?
Gastrointestinal illness Missed or extra dose Antibiotics Recent increase of alcohol
51
Permanent changes that can cause fluctuations in INR?
Lifestyle change Change in chronic medication
52
When should you not adjust warfarin doses?
previously stable INR for the last three months with a single INR that is within + or Minus 0.5 of therapeutic range Recheck INR within 1 to 2 weeks
53
INR > 9.0
Urgently assess Temporarily stop warfarin Consider a vitamin K 2.5 mg orally, repeat in 24 hours if INR remains > 9 Once I know it is in therapeutic range of 2 to 3 Decrease weekly dose by 20%
54
INR < 1.5
Give one extra dose (equivalent to 20% of weekly dose). Increase weekly dose by 10 to 20%
55
INR 1.5-1.9
Increase weekly dogs by 5 to 10%
56
INR 3.1- 3.5
Consider decreasing weekly dose by 5 to 10%
57
INR 3.6 to 4.9 (without bleeding)
Hold one dose Decrease weekly dose by 10-20%
58
INR 5.0 - 9.0
Hold 2 doses Decrease weekly dose by 10 to 20%
59
Which meds are dual action alpha and beta blockers?
Labetalol | Carvedilol
60
What does the alpha 1 receptor blockade cause?
Vasodilation
61
What does the beta 1 receptor blockade cause?
Decreased HR
62
2 drugs used for epilepsy, pain and anxiety that are calcium antagonists?
Pregabalin | Gabapentin
63
Cardiac drugs that are Ca antagonist?
Diltiazem Verapamil Nifedipine (dihydropyridines)
64
What does ASA do?
Tx suspected: MI TIA Embolic stroke Prevention of MI and STROKE in prosthetic heart valve
65
ASA is a 1st line :
Anti platelet option for secondary prevention in ischemic stroke
66
Clopidogrel dosing?
300 mg initial dose Then 75mg daily
67
What drug may decrease effectiveness of clopidogrel?
Omeprazole
68
What class of enzyme might increase clopidogrel metabolites and increase bleeding risk?
CYP2C19 inducers
69
Normal aPTT?
Normal: 25-35 seconds Therapeutic: 55-80 seconds
70
How long to stop plavix ahead of surgery?
5-7 days
71
How long to stop heparin prior to surgery?
24-48 hrs (pt dependent) 90 min half life.
72
Advantage of heparin over warfarin ?
Can be used in pregnancy. Warfarin cannot. Used as bridging therapy for oral anticoagulants
73
What to monitor on patient on heparin?
Platelet count aPTT signs of bleeding drug interactions
74
Tx and dose for PE, DVT, ACS?
Enoxaparin 1mg/kg BID
75
LMWH is sometimes preferred over heparin because: (6)
* Greater affinity for factor Xa than heparin * Longer ½ life than heparin * Higher bioavailability * Predictable dose response * Less risk of thrombocytopenia * Preferred in pregnancy r/t less HIT and osteoporosis risk
76
Whats the antidote for heparin and LMWH?
Protamine Sulphate
77
Negative inotropic effect?
Weaken the force of the heartbeat treat high blood pressure, chronic heart failure, arrhythmias, and angina
78
Positive inotropic effect?
Strengthen the force of the heart beat Tx: congestive heart failure or cardiomyopathy

pharm week 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions