misc cardio Flashcards
Name the drug class and possible adverse effect of Ticlopidine
ADP Receptor Inhibitor (1st)
Neutropenia, thrombocytopenia
Is Clopidogrel expensive?
No there is a generic
What should you advise patients when taking clopidogrel with other meds?
Potential PPI interaction that causes reduces efficacy (increased clot risk!)
Prasugrel is a ____ generation ADP receptor inhibitor. Name an advantage and a con.
No PPI reactions, but $$$$$.
Ticagrelor is what sort of drug? Why is good for emergency surgery? What is another advantage?
ADP receptor inhibitors
Works faster and lasts shorter
No PPI reaction
Compared to clopidogrel, is ticagrelor have quicker or slower reversibilty?
quicker reversibility
Unfractioned heparin is _______ derived and a strong organic ______.
porcine derived
acid
Heparin inhibits Factors __a, __a and __a, and activates _____ III. How can it be administered?
9, 10, 12
antithrombin
IV and SQ (NOT PO)
Is unfractioned heparin safe to use during pregnancy?
yes, it does not cross the placenta.
What is the antidote for unfractioned heparin? Dose?
IV protamine, 1mg for 100units of H
What is the standard dosing regimen for unfractioned heparin?
80u/kg bolus + 18u/kg/kr for maintenance and titrate upon a PPT
How do you monitor unfractioned heparin? why do you have to monitor it? how often do you monitor it?
PPT
unpredictable pharmokinetics
Test 6 hours after initiation or rate change.
What do you have to monitor while on unfractioned heparin?
platelets
Heparin Induced Thrombocytopenia
What is Lovenox?
Low molecular weight heparin
How do you monitor LMWH?
Obtain anti-factor Xa levels 3-5 hours post SQ injection
What is therapeutic for LMWH?
0.6-1u/mL
What is the antidote for LMWH?
IV protamine (only blocks 60% of anti Xa activity).
Why is LMWH easier to manage?
Standard dose!
Is HIT still a concern with LMWH?
It is less of a concern. But if a patient has a hx of HIT, do not try LMWH.
What are the heprinoids?
Fondaparinux, Danaparoid, Hirufins, Argatroban
How does Nesiritide work?
It is the peptide (human B-type natruretic) that senses stretch of the heart and makes you pee.
Why would you use Nesiritide?
For acute decompensated CHF with dyspnea at rest
What is dopamine? Which receptors does it work on?
Acts as a adrenergic agonist
Renal dopaminergic receptors, beta 1 and alpha 1 receptors
If stimulated, what will the renal dopaminergic receptors cause?
increased renal blood flow secondary to VASODILATION
… increased urinary output as a result
