Weeks 6-10 Flashcards
(159 cards)
1
Q
Vitamin B3 AKA
A
Niacin
1
Q
What angina med can’t you take with your penis pills?
A
No nitrates with sildenafil
2
Q
look at this picture
A
look at it
2
Q
optic neuropathy, polyneuritis, malaise, weight loss, irritability, confusion, potentially fatal
A
vitamin B1 deficiency, korsokoff’s syndrome
3
Q
hydrochlorothiazide side effects
A
dehydration, hyponatremia, hypokalemia, renal dysfunction, increase in serum uric acid
4
Q
nifedipine and amlodipine, which is short acting?
A
nifedipine
4
Q
Vitamin that is highly effective in raising HDL
A
Niacin (nicotinic acid)
5
Q
med recommended for classes II - IV heart failure
A
Aldosterone blockers
6
Q
prototype thiazide diuretics (2)
A
chlorthalidone, hydrochlorothiazide
6
Q
look at this picture
A
look at it.
7
Q
ezetimibe action
A
cholesterol absorption inhibitor, modest LDL lowering
8
Q
2 aldosterone blockers
A
spironolactone, eplerenone
8
Q
problems with furosemide toxicity
A
(OHHHHH DANG) Ototoxic, Hypokalemia (hypokalemic metabolic acidosis), Hypocalcemia, Hypomagnesemia, Hyperglycemia, Hyperlipidemia, Dehydration, Allergy (sulfonamide, but ethacrynic acid is ok), Nephritis (interstitial), Gout
8
Q
Look at this picture
A
Look at it.
9
Q
NYHA class I
A
no symptoms
9
Q
acetazolamide X urine pH and Y body pH
A
increases urine, drops body
9
Q
2 main manifestations of heart failure
A
SOB
Congestion
10
Q
Vitamin B1 is used in the synthesis of
A
acetylcholine and GABA
10
Q
clinical uses of thiazides
A
hypertension, CHF, nephrolithiasis (calcium), osteoporosis, diabetes insipidus
11
Q
Med recommended for classes I and II heart failure
A
beta blockers
12
Q
This drug decreases coronary tone, helping in angina
A
CCB’s
12
Q
Stage B heart failure
A
structural heart disease, no s/sx
14
Q
Clinical presentation of Vitamin B2 deficiency
A
Painful red tongue with sore throat, chapped and fissured lips (cheilosis), and inflammation of the corners of the mouth (angular cheilitis)
14
Q
Stage C heart failure
A
structural heart disease with s/sx
15
Effect of calcitonin on serum calcium
lower
16
Meds for systolic heart failure not proven to decrease mortality
digoxin, diuretics
16
In management of ischemic heart disease, nitrates work best when prescribed with
CCB's or Beta Blockers
17
diseases that elevate triglycerides
DM
17
clinical indications for furosemide
edema, acute pulmonary edema, increase urine flow in acute renal failure, hypertensive emergency, hypercalcemia and hyperkalemia (combined with fluid replacement)
18
crackles
wheezing
decreased breath sounds
left sided S3
mitral regurg murmur
increased P2 component of S2
pulmonary congestion of heart failure
19
Major side effects of bile acid sequestrants like cholestyramine
GI side effects (constipation, diarrhea, bloating, farts, and such)
20
If on isosorbide dinitrate, take it in the X because
morning, because body downregulates the effect of nitrates, need a nitrate free afternoon/evening
20
major side effect of amlodipine
peripheral edema
21
dihydropiridine CCB action
smooth muscle in peripheral vasculature
21
clinical uses of mannitol
decreases intraocular and intracranial pressure, prevention of acute renal failure in hypotension and acute tubular necrosis
22
2 cardioselective beta blockers
metoprolol and atenolol
23
Clinical presentation of B6 deficiency
seborrheic dermatitis-like eruption, atrophic glossitis with ulceration
23
Don't give statins with
fibrates
24
2 statins for high intensity therapy
atorvastatin, rosuvastatin
24
2 types of congestion
pulmonary and systemic (guess which side of the heart is related to each)
25
NYHA class III
symptoms with less than ordinary activity
25
cholestyramine action
bile acid sequestrant, lowers LDL, also used in butt paste
25
Here's another picture
picture time!
26
B12 AKA
Cobalamin
27
What do beta's do goodly in heart failure?
prevent remodeling
28
seborrheic dermatitis-like eruption, atrophic glossitis with ulceration
Clinical presentation of B6 deficiency
29
prototype potassium sparing diuretics
spironolactone, amiloride
29
Stage B heart failure treatment
control BP
Statins if CV history
maybe an implantable defib? (if needed? it's on the slide?)
Ace and Beta
maybe some ARB's if Ace is contraindicated
30
Stage D heart failure
you gonna die (news flash: we all gonna die)
Refractory heart failure requiring specialized interventions
31
Recommended daily dose of calcium (calcium carbonate)
400-1200 mg (1-3 g)
32
2 dihydropiridine CCB's
amlodipine and nifedipine
32
prototype carbonic anhydrase inhibitor
acetazolamide
33
prototype osmotic diuretic
mannitol
34
drugs that elevate triglycerides
estrogen, retinoic acid, beta blockers (not carvedilol), thiazides
36
The other nitrate, what makes it different?
Isosorbide dinitrate, longer acting
38
IM or IV iron
iron dextran
39
HFrEF first line
Ace and Beta
(The ambiguously Bi duo?)
40
most efficacious diuretics currently available
loop diuretics (furosemide)
40
JVD
Pleural effusion
Right sided S3
tricuspid regurg murmur
ascites
big fuckin liver
edema
systemic congestion of heart failure
42
Animals get Vitamin B1 from
diet (fungi, bacteria, plants)
42
Standard therapy in HFrEF
beta blocker + ACEi or ARB
43
furosemide drug interactions
antiarrhythmics (esp QT prolongers), Glucocorticoids, NSAIDS, aminoglycoside abx and cisplatin (increased risk of ototoxicity), other antihypertensives (additive effect)
44
4 statin benefit groups
people with ASCVD LDL \>190 all healthy diabetics \>40 age \>40 ASCVD risk \>7.5%
45
Where do we store B12
Liver (3000-5000 micrograms)
45
Statin side effects
myalgias and maybe some rhabdo with the high intensity
46
Calcitriol effects on serum calcium
increases by increasing gut uptake and potentially increasing uptake from bone
47
MOA of nitroglycerin
relax vascular smooth muscle
48
atorvastatin side effects
rhabdomyolysis with acute renal failure, liver function abnormalities
49
The only indication for iron supplementation
Treatment or prevention of iron deficiency anemia
50
side effects of amiloride and spironolactone
hyperkalemic metabolic acidosis
51
Calcium carbonate is X% calcium
40%
52
Stage C heart failure treatment
Ace and Beta
Diruetics
ARB if they can't Ace
Aldosterone receptor antagonists
Nitrate-Hydralazine maybe
Digoxin (or not, whatever)
Omega fatty acids
53
prototype loop diuretic
furosemide
55
beta blocker contraindications
prinzmetal angina, severe bradycardia, asthma
56
drugs that elevate LDL
diuretics, glucocorticoids
57
Which thiazide shows better CV risk data?
chlorthalidone
58
NYHA class II
symptoms with ordinary activity
60
X% of body calcium is stored in bone
98%
61
Using this supplement in women of childbearing age decreases the risk of neural tube defects
folic acid
62
The most common cause of elevated right sided filling pressures is
elevated left sided filling pressures
63
chronic action of thiazides
decrease peripheral resistance
64
Duration of action for furosemide
2-4 hours
65
Vitamin B3 Deficiency, AKA and clinical presentation
Pellagra: 3 D's, diarrhea, dermatitis, dementia common in alcoholics and impoverished
66
acute action of thiazides
decrease intravascular volume and cardiac output
67
metoprolol side effects
hypotension, bradycardia, heart block
68
another name for statins
HMG CoA reductase inhibitors
69
Potassium sparing diuretics location of action and mechanism
collecting tubule, inhibits Na resorption which inhibits K secretion
70
diseases that elevate LDL
biliary obstruction, nephrotic syndrome, hypothyroidism, obesity, pregnancy
71
2 non dihydropiridine CCB's
diltiazem and verapamil
73
side effect of diltiazem
peripheral edema
74
Stage A heart failure
High risk, that's all
76
Why are Tums no longer labeled as a calcium supplement?
They don't contain vitamin D
77
Common 2nd generation CCB
amlodipine
78
X% of body phosphorus is stored in bone
85%
79
conivaptan toxicity problems
nephrogenic diabetes insipidus, dry mouth, thirst, polyuria (you don't say?!)
80
classic go-to for cirrhosis
spironolactone
82
Vitamin B6 is involved in the synthesis of
neurotransmitter, histamine, hemoglobin, (gene expression)
84
Niacin side effects, method to prevent one
flushing, pretreat with aspirin and slowly titrate dose up, also inhibits tubular secretion of uric acid, which may worsen gout
85
Vitamin B6 serves as a cofactor in metabolism of
amino acid, glucose, lipids
87
Consequences of B12 deficiency
Megaloblastic, macrocytic anemia with CNS dysfunction, paresthesias, weakness, ataxia
88
X are not directly helpful for angina
ACE inhibitors
89
ACC and AHA prefer X over Y for survival rate post MI
Beta blockers over calcium channel blockers
91
Lisinopril side effects
cough, renal dysfunction, angioedema, hyperkalemia
92
action of fibrates
lower triglycerides, raise HDL
93
Define surrogate endpoint
Something along the lines of "Who gives a fuck if we change some measurement or lab value? What matters is if the patient id dead."
95
Cause of pernicious anemia
defective secretion of intrinsic factor by gastric mucosal cells, necessary for absorption of vitamin B12
96
NYHA class IV
symptoms at rest or with minimal activity
97
initial antianginal therapy in all patients without contraindications
beta blockers
98
conivaptan location of action
collecting duct
99
2 fibrates
gemfibrozil and fenofibrate
100
this should be used in all patients with a reduced EF to prevent heart failure
Ace and Beta
the ambiguously bi duo
102
This supplement can correct B12 deficiency anemia, but does not prevent the permanent neuro damage
folic acid
103
2 meds for management of fluid overload
furosemide and spironolactone
104
diarrhea, dermatitis, dementia common in alcoholics and impoverished
B3 deficiency, pellagra
106
nifedipine can worsen
angina
107
Treatment for stage A heart failure
fix the things that make them at risk (smoking, lipids, etc)
107
Painful red tongue with sore throat, chapped and fissured lips (cheilosis), and inflammation of the corners of the mouth (angular cheilitis)
Clinical presentation of Vitamin B2 deficiency
109
prototype ADH antagonists
conivaptan
111
action of diltiazem
peripheral smooth muscle and myocardium
113
Hydralazine and nitrates decrease mortality in which patients with heart failure
African Americans
114
What kind of MI should you not use nitrates with?
Right sided
116
risk of fibrates
increased risk of myopathy when given with statins
117
furosemide MOA
loop diuretic, inhibits Na/K/2Cl cotransport, decreasing reabsorption
119
Arrange ferrous sulfate, gluconate, and fumarate in order from most to least elemental iron
fumarate sulfate gluconate
121
Vitamin B6 AKA
Pyridoxine
122
clinical indications of conivaptan
syndrome of inappropriate ADH secretion, CHF, autosomal dominant polycystic kidney disease
124
B12 deficiency is almost always from
malabsorption (pernicious anemia)
125
avoid non dihydropiridine CCB's in patients with
heart failure
126
This drug is no good for uncompensated heart failure
Betas
127
Vitamin B1 AKA
Thiamine
128
Nitrates mostly relax \_\_\_\_\_
Veins
130
Vitamin B2 AKA
Riboflavin
132
thiazide MOA
inhibits NaCl resorption in distal convoluted tubule
133
verapamil mainly affects the
myocardium
134
Thiazide interactions
QT prolongers, corticosteroids, NSAIDS, lithium, other antihypertensives
135
Another name for Niacin / B3
Nicotinic acid
136
Treatment for B12 malabsorption
1,000 micrograms IM daily for a week then monthly for life
137
Thiazide toxicity problems
HAIG Hypo (Na, K, Mg), Hyperglycemia, Hyperlipidemia, Allergy, Impotence, Gout
138
Megaloblastic, macrocytic anemia with CNS dysfunction, paresthesias, weakness, ataxia
Consequences of B12 deficiency
139
Vitamin B1 deficiency, AKA and clinical presentation
Korsakoff's syndrome: optic neuropathy, polyneuritis, malaise, weight loss, irritability, confusion, potentially fatal
140
noncardioselective beta blocker
propanolol
141
MOA for spironolactone
aldosterone antagonist, aldosterone promotes sodium retention. Spironolactone use results in retention of K and excretion of Na
142
1,25-dihydroxyvitamin D3 AKA
Calcitriol
144
Effect of calcitonin on bone
inhibits osteoclastic calcium resorption
145
First line therapy in the treatment of chronic stable angina?
Beta Blockers, motherfuckers
146
definition of clinical ASCVD
ACS, MI, angina, revascularization, stroke, TIA, atherosclerotic PAD
147
diet influence to elevate triglycerides
EtOH
148
Big no-no for ACEi
teratogenic
149
Commonly used oral form of calcium
Calcium carbonate
150
avoid ezetimibe in
patients with moderate to severe hepatic dysfunction
151
\_\_\_\_\_\_\_\_ has a shirt that looks like an ugly old couch
KeiKei
152
Patients taking simvastatin along with inhibitors of X are at an increased risk for rhabdomyolysis
CyP450
153
acetazolamide blocks X in the Y
NaHCO3 resorption in the proximal convoluted tubule
154
clopidogrel side effects
bleeding
155
Diuretic for open angle glaucoma
acetazolamide
156
How long does it take to use up B12 left in the liver
5 years, we only use about 2 micrograms per day
157
MOA for CCB's
arteriolar vasodilators
158
mannitol action
mobilizes intracellular fluid to extracellular space, initially expands intravascular volume, which is then eliminated via osmotic effect in kidneys
159
Common drug and dose for high-intensity statin therapy
Atorvastatin 80
