Misc CV Agents

Question 1

Atorvastatin brand name

Answer 1

Lipitor

Question 2

Atorvastatin indication/dosage

Answer 2

adjunct to diet to reduce elevated cholesterol levels: 10-80mg daily, given at any time of the day. Begin with 10mg daily with or without meals

Question 3

Atorvastatin mechanism

Answer 3

selective, competitive inhibitor of HMG-CoA reductase. Decreases # of LDL receptors on cell surface
Reduces LDL, VLDL, and trigs, and increases HDL

Question 4

Atorvastatin metabolism and elimination

Answer 4

metabolized by 3A4
excretion primarily in bile
>98% protein bound

Question 5

Atorvastatin drug interactions

Answer 5

May increase digoxin level
coadmin with the following may increase plasma levels of atorvastatin: gemfibrozil, grapefruit, nicotinic acid, itraconazole, erythromycin, clarithromycin, azole antifungals, protease inhibitor combinations, and cyclosporine

Question 6

Atorvastatin CI/precautions

Answer 6

CI: pregnancy and lactation, active liver disease, unplanned persistent elevations of LFT’s
caution: liver dysfunction, and who consume large amounts of alcohol

Question 7

Atorvastatin monitoring

Answer 7

LFT q6w for first 3 months, then periodically

Question 8

Atorvastatin discontinuation

Answer 8

LFT elevation >3x ULN

if do not decrease with discontinuation, biopsy should be considered

Question 9

Atorvastatin pregnancy category

Answer 9

X

Question 10

Atorvastatin ADRs

Answer 10

constipation, diarrhea, dyspepsia, flatulence

contact physician if myopathy or rhabdo occurs (muscle pain or tenderness)

Question 11

Atorvastatin patient education

Answer 11

closely follow prescribed diet! cholesterol-lowering diet continued through therapy
avoid overexposure to sunlight
do not become pregnant during therapy
limit alcohol intake

Question 12

Bumetanide brand name

Answer 12

Bumex

Question 13

Bumetanide indication/dosage

Answer 13

treatment of edema associated with HF, cirrhosis of liver, and renal diseases
Oral: 0.5-2mg daily in 1-2 doses.
Parenteral: 0.5-1mg IM or IV over 1-2 minutes. second and third doses at intervals of 2-3h until desired diuresis occurs

Question 14

Bumetanide max dose

Answer 14

10mg daily

Question 15

Bumetanide mechanism

Answer 15

inhibits reabsorption of Na and Cl in ascending limb of LOOP OF HENLE
also has some action in proximal tubule, but NOT in distal tubule

Question 16

Bumetanide onset of diuresis

Answer 16

30-60 minutes, lasts about 4 hours

IV speeds up onset to just minutes

Question 17

Bumetanide drug interactions

Answer 17

cisplatin or aminoglycosides: increased auditory toxicity

electrolyte disturbances may predispose patient to digitalis-induced arrhythmias

Question 18

Bumetanide CI/precautions

Answer 18

CI: patients with anuria and uncorrected hepatic coma or severe electrolyte depletion
caution: hypersensitivity to sulfonamides
excessive dosing may cause volume and electrolyte depletion
prevention of hypokalemia is important in patients with cirrhosis or ascites, diarrhea, K-losing nephropathy, and receiving digitalis therapy

Question 19

Bumetanide pregnancy category

Answer 19

C

Question 20

Bumetanide ADRs

Answer 20

DIZZINESS, MUSCLE CRAMPS, WEAKNESS, IMPAIRED HEARING, HYPOKALEMIA, hypotension, hyperuricemia, hypochloremia, hyponatremia, azotemia, and hyperglycemia

Question 21

Bumetanide patient education

Answer 21

may take with food
should be given in AM or early in the day, due to diuresis
ortho hypo!! use care when standing

Question 22

Chlorthalidone brand name

Answer 22

Hygroton

Question 23

Chlorthalidone indication/dosage

Answer 23

adjunctive therapy in edema associated with HF, cirrhosis, CS and estrogen therapy, or renal dysfunction: 50mg daily, or 100mg QOD. Up to 200mg/day

HTN: 25mg daily initially, then 50-100mg/day

Question 24

Chlorthalidone mechanism

Answer 24

inhibits Na and Cl reabsorption at cortical diluting segment of ascending limb of loop of Henle

Question 25

Chlorthalidone drug interactions

Answer 25

may decrease SU hypoglycemia
electrolyte disturbances may cause DIGITALIS-induced arrhythmias
use with diazoxide may cause hyperglycemia
May increase lithium serum levels

Question 26

Chlorthalidone CI/precautions

Answer 26

CI: anuria or hypersensitivity to sulfonamide-derrived drugs
Caution: dirrhosis, gout, impaired renal/hepatic function, diabetes, or taking CS or ACTH

Question 27

Chlorthalidone pregnancy category

Answer 27

B

Question 28

Chlorthalidone ADRs

Answer 28

MUSCLE CRAMPS, WEAKNESS, dry mouth, nausea, vomiting, anemia, dizziness, ortho hypo, anorexia, GI distress (diarrhea, constipation) hyperglycemia, photosensitivity, rash, transient blurred vision

Question 29

Chlorthalidone patient education

Answer 29

take with food
Usually taken in early AM due to diuresis
avoid excessive sun exposure