Term
Which of the following medications increases the risk for CDiff?
Amoxicillin
Azythromycin
Cephalexin |
|
Definition
|
|
Term
Which of the following are beta blockers?
Lisinopril
Metoprolol
Valsartan
Amlodipine
Benazepril
Carvedilol
Atenolol |
|
Definition
Metoprolol
Carvedilol (beta and alpha blocker)
Atenolol |
|
|
Term
Which of the following treats convulsions?
Quetiapine
Alprozolam
Clonazepam
Gabapentin
Methylphenidate |
|
Definition
|
|
Term
| Benazepril (Lotensin) treats HTN how? |
|
Definition
| It is an ACEI, angiotensin converting EZ inhibitor, so it decreases angiotensin II production, causing vasoconstriction and decreasing aldosterone, therefore decreasing blood volume and peripheral resistance |
|
|
Term
| Which of the following is contraindicated in pregnancy? Valsartan Omeprazole Atenolol Azithromycin Hydrochlorothiazide |
|
Definition
| Valsartan (ARB) Atenolol (BB) |
|
|
Term
Which of the following are antipsychotics?
Duloxetine
Quetiapine
Zolpidem
Aripiprazole
Sertraline |
|
Definition
Quetiapine (seroquel)
Aripiprazole (Abilify) |
|
|
Term
Which of the following treats nausea?
Memantine
Promethazine
Alprozolam
Gabapentin
Methylprednisolone |
|
Definition
Promethazine (phenergan)
Alprozolam (Xanax) - usually more anti-anxiety
Methylprednisolone (medrol) - usually more anti-inflammatory |
|
|
Term
| What does Amlodipine (Norvasc) treat? How? |
|
Definition
| HTN, Its a CCB so it blocks calcium channels |
|
|
Term
| What are some safety concerns for Warfarin? |
|
Definition
Narrow therapeutic index - Monitor INR
Subdural hematoma
PUD
Toxicity |
|
|
Term
Which of the following is a gastric acid inhibitor?
Rosuvastatin
Esomeprazole
Hydrochlorothiazide
Omeprazole
Amlodipine
Alprazolam |
|
Definition
Esomeprazole (Nexium)
Omeprazole (Prilosec) |
|
|
Term
Which of the following are antihistamines?
Fexofenadine
Methylprednisolone
Tiotropium
Promethazine
Albuterol |
|
Definition
Fexofenadine (Allegra)
Medrol is NOT! (It's an anti-inflammatory)
Tiotropium is NOT! (It treats COPD & asthma)
Promethazine (phenergan - as well as nausea!) |
|
|
Term
| How do thiazide-type diuretics like hydrochlorothiazide work? |
|
Definition
| They inc urine flow by inc Na and Cl excretion |
|
|
Term
| What are some safety concerns for HCTZ? |
|
Definition
Contraindicated in pregnancy and elderly!
Inc risk of hypokalemia and orthostatic hypotension |
|
|
Term
Which of the following treat DM?
Levothyroxine
Metformin
Clopidigrel
Duloxetine
Meloxicam |
|
Definition
|
|
Term
Which of the following is an anticoagulant?
Warfarin
Digitoxin
Clopidigrel
Benazepril
Fexofenadine |
|
Definition
Warfarin (Coumadin)
Clopidigrel (Plavix) |
|
|
Term
Which of the following will treat ADHD?
Methylprednisolone
Methylphenidate
Trazodone
Zolpidem |
|
Definition
| Methylphenidate (Concerta) - CNS stimulant |
|
|
Term
| Lisinopril (prinivil) treats HTN how? |
|
Definition
| It is an ACEI, angiotensin converting EZ inhibitor, so it decreases angiotensin II production, causing vasoconstriction and decreasing aldosterone, therefore decreasing blood volume and peripheral resistance |
|
|
Term
What is Quetiapine (Seroquel) prescribed for?
Nausea
HTN
Psychosis
Depression |
|
Definition
|
|
Term
| How does Atenolol (Tenormin) dec HTN? |
|
Definition
| It's a beta blocker, so it blocks the Beta1 receptors on the heart, preventing NE/Epi from dec AV node delay |
|
|
Term
What is Carisoprodol (Soma) prescribed for?
HTN
Gastric acid reduction
Depression
Muscle relaxation
Asthma |
|
Definition
|
|
Term
|
Definition
| Abilify - it's an antipsychotic |
|
|
Term
| Name 3 lipid lowering drugs. |
|
Definition
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Rosuvastatin (Crestor) |
|
|
Term
What is escitalopram prescribed for?
Nausea
Anxiety
Depression
Asthma |
|
Definition
|
|
Term
Which of the following is a sedative?
Quetiapine
Alprozolam
Clonazepam
Citalopram
Aripiprazole |
|
Definition
NOT Quetiapine = antipsychotic
Alprozolam!
Clonazepam!
NOT Citalopram = antidepressant
NOT aripiprazole = antipsychotic |
|
|
Term
| What class do Tramadol, alprazolam, clonazepam, and carisoprodol fall under? |
|
Definition
|
|
Term
Which of the following would be contraindicated for a pt w/ uncompensated CHF or bradycardia?
Metoprolol
Metformin
Omeprazole |
|
Definition
| Metoprolol (Lopressor) a beta blocker |
|
|
Term
Which of the following would be contraindicated for a pt w/ kidney disease?
Metoprolol
Metformin
Omeprazole |
|
Definition
| Metformin (glucophage) for DM T2 |
|
|
Term
Which of the following would be contraindicated for a pt w/ a history of b12 deficiency or osteoporosis?
Metoprolol
Metformin
Omeprazole |
|
Definition
| Omeprazole (Prilosec), a PPI |
|
|
Term
Which of the following medications decreases the effectiveness of clopidigrel?
Omeprazole
Oxycodone
Esomeprazole
Sertraline |
|
Definition
| Omeprazole (Prilosec), a PPI |
|
|
Term
| How does Warfarin (coumadin) treat coagulopathy? |
|
Definition
| It is an antagonist for vitamin K, so ir prevents the production of many important clotting factors |
|
|
Term
| Your pt is c/o of depression, what 5 antidepressents are most commonly prescribed? |
|
Definition
"Depressed Zebras Can't Love Cats"
Trazodone (Desyrel)
Sertraline (Zoloft)
Duloxetine (Cymbalta)
Escitalopram (Lexapro)
Citalopram (Celexa) |
|
|
Term
| Your pt is c/o of nasal allegies? What is the most common nasal spray? |
|
Definition
| Fluticasone (flonase) an anti-inflammatory for allergies |
|
|
Term
| Your pt is c/o of severe back pain, what are the 3 most commonly prescribed analgesics? |
|
Definition
Tramadol (Ultram)
Hydrocodone & APAP (Vicodin)
Oxycodone (Percocet) |
|
|
Term
| Your pt has a strep infection, what are the 3 most commonly prescribed abx to treat this? |
|
Definition
Amoxicillin (Amoxil) - treats staph and strep
Cephalexin (Keflex) - treats G+ and G-
Azithromycin (Zithromax) - treats G+ and G- and atypical |
|
|
Term
| You want to start your pt on anticoagulant therapy, what are the 2 most commonly prescribed medications fot this? |
|
Definition
Warfarin (coumadin)
Clopidigrel (plavix) |
|
|
Term
| Your pt has recently starting having convulsions and you want to start anticonvulsive treatment, what are the 2 most commonly prescribed meds for this? |
|
Definition
Gabapentin (Neurontin)
Clonazepam (Klonopin) |
|
|
Term
| Your pt present w/ a mild rash and you want to prescribe an antihistamine, what are the 2 most commonly prescribed meds for this? |
|
Definition
Fexofenadine (Allegra)
Promethazine (phergan) |
|
|
Term
| Your pt needs an antihypertensive, what are the 7 most commonly prescribed meds for this and what are their classes? |
|
Definition
Lisinopril (prinivil) - ACEI
Benazepril (lotensin) - ACEI
Valsartan (Diovan) - ARB
Metoprolol (Lopressor) -BetaBlocker
Atenolol (Tenormin) - BetaBlocker
Carvediol (Coreg) - BetaBlocker
Amlodipine (Norvasc) - CCB |
|
|
Term
| Your pt is psychotic, what are the 2 most commonly prescribed meds you could prescribe? |
|
Definition
Quetiapine (Seroquel)
Aripiprazole (Abilify) |
|
|
Term
| Your pt has asthma, what are the 3 most commonly prescribed meds you could prescribe? |
|
Definition
Montelukast (Singulair)
Albuterol (ProAir HFA)
Tiotropium (Spiriva) - also treats COPD |
|
|
Term
| Your 7yo pt has ADHD, what is the most common med prescribed for this? |
|
Definition
| Methylphenidate (Concerta) - CNS stimulant |
|
|
Term
| Your pt is newly dx w/ COPD, what is the top med prescribed for this? |
|
Definition
| Tiotropium (Spiriva) - also treats asthma |
|
|
Term
| Your pt presents w/ contact dermatitis from poison sumac and you want to prescribe a corticosteroid, what is the most commonly prescribed corticosteroid? |
|
Definition
| Methylprednisolone (Medrol) - also an anti-inflammatory |
|
|
Term
| Your 82yo pt is showing signs of dementia, what is the most commonly prescribed med for this? |
|
Definition
|
|
Term
| You just dx your 32yo pt with Type II DM, what is the most common med prescribed to treat this? |
|
Definition
|
|
Term
| Your pt is c/o of edema of the lower extremities, what are the 2 most commonly prescribed meds you might use to treat this? What are their classes? |
|
Definition
Furosemide (Lasix) - loop type diuretic
Hydrochlorothiazide (HCTZ) - thiazide type diuretic |
|
|
Term
| Your pt is presenting with PUD and you want to prescribe a gastric acid inhibitor, what are the 2 most commonly prescribed meds and their classes? |
|
Definition
Esomeprazole (Nexium) - PPI
Omeprazole (Prilosec) - PPI |
|
|
Term
| Your pt is having trouble sleeping, what is the most commonly prescribed sleep aid? |
|
Definition
| Zolpidem (Ambien) - hypnotic |
|
|
Term
| Your pt was just dx w/ CHF, what is the most commonly prescribed med for this? |
|
Definition
| Digoxin (Lanoxin) - Inotropic agent |
|
|
Term
| Your pt has high cholesterol, what are the top 3 lipid-lowering agents to choose from? |
|
Definition
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Rosuvastatin (Crestor) |
|
|
Term
| Your pt needs a muscle relaxant, what are the top 2 meds for this? |
|
Definition
Cyclobenzaprine (Flexeril)
Carisoprodol (Soma) |
|
|
Term
| Your pt needs an NSAID, what are the 2 top meds for this? |
|
Definition
Ibuprofen (Advil)
Meloxicam (Mobic) |
|
|
Term
| Your pt has anxiety and you want to prescribe a medicine, what is the most commonly prescribed med for this? |
|
Definition
| Alprozolam (Xanax) - also a sedative |
|
|
Term
| Your pt needs thyroid hormone replacement, what is the most commonly prescribed medication for this? |
|
Definition
| Levothyroxine (Synthroid) |
|
|
Term
Which of the following is an anticonvulsant?
A. Fluticasone
B. Warfarin
C. Carvedilol
D. Tiotropium
E. Gabapentin |
|
Definition
|
|
Term
Where are proton pumps located?
Parietal cells of the antrum and fundus
Chief cells of antrum and fundus
Parietal cells of body
Chief cells of body |
|
Definition
| Parietal cells of the antrum and fundus |
|
|
Term
Gastrin, histamine (H2), and acetylcholine are ___ for gatric acid secretion?
Suppressors
Stimulators |
|
Definition
|
|
Term
Prostaglandin E2 and I2 are ___ for gatric acid secretion?
Suppressors
Stimulators |
|
Definition
|
|
Term
| What 4 things do prostaglandins cause? |
|
Definition
Supress acid production
Stimulate mucin production
Increase bicarbonate secretion
Increase mucosal blood flow |
|
|
Term
What class of bacteria is H pylori?
Gram + cocci
Gram - bacillus
Gram - spirochete
Gram + streptococci |
|
Definition
|
|
Term
| What does the quadruple regimen for H pylori tx consist of? |
|
Definition
Tetracycline (abx)
Metronidazole (abx)
PPI (dec acid)
Bismuth (reduce inflammation)
for 14 days! |
|
|
Term
| What does the triple regimen for H pylori tx consist of? |
|
Definition
Clarithromycin (abx)
Amoxicillin or metronidazole (abx)
PPI
for 14 days! |
|
|
Term
How long does it take for a H2 to take effect?
15min
45min
60min
24hrs
1 week |
|
Definition
|
|
Term
Which H2 blocker has an anti-androgen effect?
Ranitidine
Famotidine
Cimetidine
Nizatidine |
|
Definition
| Cimetidine (tends to bind and inhibit androgen receptors - has been used for hirsutism!) |
|
|
Term
Which is the most powerful gastric acid reducer?
H2 blockers
Antocholinergics
Prostaglandins
PPIs |
|
Definition
| PPIs (>60% reduction of acid) |
|
|
Term
How long does it take for a PPI to take effect?
15min
45min
60min
24hrs
1 week |
|
Definition
|
|
Term
Which can inhibit B12 absorption?
H2 blockers
Antocholinergics
Prostaglandins
PPIs |
|
Definition
|
|
Term
Clopidogrel's effectiveness can be decreased by?
H2 blockers
Antocholinergics
Prostaglandins
PPIs |
|
Definition
| PPIs (inhibits CYP 2C19, which is activated by clopidogrel) |
|
|
Term
Which can inc risk of osteoporosis?
H2 blockers
Antocholinergics
Prostaglandins
PPIs |
|
Definition
|
|
Term
Which can inc risk of an MI?
H2 blockers
Antocholinergics
Prostaglandins
PPIs |
|
Definition
|
|
Term
How long does it take for a prostaglandin agonist to take effect?
15min
45min
60min
24hrs
1 week |
|
Definition
|
|
Term
Which can inc risk of first trimester abortion?
Esomeprazole
Misoprostol
Cimetidine |
|
Definition
| Misoprostol (a prostaglandin agonist) |
|
|
Term
How do aluminum hydroxide, Mg hydroxide, and Ca carbonate help reduce acid?
Eradicating H pylori
Reducing acid secretion
Neutralizing acid
enhancing mucosal defense |
|
Definition
|
|
Term
What is a common side effect of calcium carbonate?
Nausea
Gas
Diarrhea
Headache |
|
Definition
|
|
Term
Which causes diarrhea?
Magnesium
Aluminum
Calcium |
|
Definition
|
|
Term
Which causes constipation?
Magnesium
Aluminum
Calcium |
|
Definition
|
|
Term
| What are the 4 groups of laxatives? |
|
Definition
"But I Can't Shit"
bulking agents
irritants/stimulants
chloride channel activators
stool softeners |
|
|
Term
Castor oil, emodin, basically, and phenolphthalein are examples of...
irritants/stimulants
bulking agents
stool softeners
chloride channel activators |
|
Definition
| irritants/stimulants - laxatives |
|
|
Term
Which puts you at risk for atonic colon w/ prolonged use?
irritants/stimulants
bulking agents
stool softeners
chloride channel activators |
|
Definition
|
|
Term
Colloids (bran) and Saline cathartics (golytely) are examples of...
irritants/stimulants
bulking agents
stool softeners
chloride channel activators |
|
Definition
|
|
Term
| What is the difference between polyethylene glycol and ethylene glycol? |
|
Definition
polyethylene glycol is antifreeze
ethylene glycol is a bulking agent |
|
|
Term
Mineral oil and solace are examples of...
irritants/stimulants
bulking agents
stool softeners
chloride channel activators |
|
Definition
|
|
Term
Lubiprostone (amitiza) is an example of...
irritants/stimulants
bulking agents
stool softeners
chloride channel activators |
|
Definition
| chloride channel activators - laxative |
|
|
Term
| What are the 2 anti-diarrheal drug classes? |
|
Definition
antimotility agents
adsorbents |
|
|
Term
Lomotil and imodium are examples of...
antimotility agents
adsorbents |
|
Definition
| antimotility agents - anti-diarrheal |
|
|
Term
| Lomotil and imodium can cause ____ in children and ____ is a contraindication for use in adults? |
|
Definition
To x i c m e g a c o l o n i n c h i l d r e n
Avoid use in adults with severe colitis |
|
|
Term
Kaolin, pectin, (Kaopectolin), methylcellulose are examples of...
antimotility agents
adsorbents |
|
Definition
|
|
Term
What drug class can cause hyperprolactinemia?
Anti-sterotonins
Anti-Dopamines |
|
Definition
|
|
Term
What drug class ends w/ "-tron"?
Anti-serotonins
Anti-Dopamines |
|
Definition
|
|
Term
What drug class can cause a prolonged QT interval?
Anti-serotonins
Anti-Dopamines |
|
Definition
|
|
Term
| What 4 classes fall under prokinetic agents? |
|
Definition
"Some Dopes Can't Move"
Serotonin receptor modulation agents (cisapride, reglan, zofran)
Dopamine receptor antagonists (reglan)
Cholinergic agents (carbachol, neostigmine)
Motilin-like agents (macrolide abx) |
|
|
Term
| T/F HTN is highly treatable |
|
Definition
|
|
Term
| How can we ↓ BP? How can we ↓ CO? |
|
Definition
↓ BP: By ↓ CO or peripheral resistance (BP = CO x PVR)
↓CO: ↓HR, ↓contractility, ↓venous return |
|
|
Term
| What are the 3 ways to ↓PVR? |
|
Definition
| vasodilation = direction action on smooth muscle, central action on CNS, ganglionic action on SNS trunk |
|
|
Term
| What are the 2 most common ways to control BP? |
|
Definition
SNS input w/ alpha and beta blockers
Renal blood flow w/ RAAS meds |
|
|
Term
| What 3 things does angiotensin II cause? What does aldosterone cause? |
|
Definition
Angiotensin II: direct vasocontristion, aldosterone release, inc SNS tone
Aldosterone: inc Na loop absorption (fluid retention and inc volume) |
|
|
Term
| What are the 4 RAAS targets for HTN tx? |
|
Definition
Inhibit renin production
Block angiotensin converting enzyme (ACE)
Block angiotensin II receptors (ARBs)
Block the action of aldosterone |
|
|
Term
| Do beta or alpha receptor activation inc CO? |
|
Definition
|
|
Term
| Do beta or alpha receptor activation inc PVR? |
|
Definition
|
|
Term
| Do alpha or beta blockers dec CO? |
|
Definition
|
|
Term
| Do alpha or beta blockers dec PVR? |
|
Definition
|
|
Term
| Name a K+ sparring diuretic |
|
Definition
|
|
Term
| Name 2 sympathoplegic drugs |
|
Definition
| methyldopa, clonidine, reserpine, guanadrel, atenolol, propanolol, prazosin, terazosin, labetalol |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Selective dihydropyridine CCB |
|
|
Term
| What are the biggest potential side effects from loop diuretics? |
|
Definition
| hypokalemia and ototoxicity |
|
|
Term
| Is loop diuretic related ototoxicity usually reversible? |
|
Definition
|
|
Term
| When would you choose a non-selective beta blocker like propranolol or nadolol? |
|
Definition
| when you want to block both B1 (heart) and B2 (bronchioles/uterus) - more useful in hyperthyroidism |
|
|
Term
| When would you choose a selective beta blocker like metoprolol or atenolol? |
|
Definition
| when you just want to dec CO (more useful in HTN) |
|
|
Term
| When would you choose a combined beta/alpha blocker like labetalol or carvedilol? |
|
Definition
| when you want to dec CO (B1), constrict bronchioles (B2), and dec PVR (alpha) |
|
|
Term
| What do blocker/partial agonists have that makes them less metabolic that other non-selective beta blockers? What does this mean? |
|
Definition
ISA - intrinsic sympahomimetic activity
Less issues w/ bradycardia and metabolic effects |
|
|
Term
| When would you use a beta blocker w/ ISA like acebutolol or pindolol? |
|
Definition
| Hypertension treatment in diabetics or patients with slow heart rate |
|
|
Term
| What's cool about Nebivolol (Bystolic)? |
|
Definition
| It's a strongly selective B1 blocker and achieves vasodilation by increasing nitric oxide |
|
|
Term
| What are 4/5 adverse effects from beta blockers? |
|
Definition
Arrhythmias (esp w/ abrupt cessation)
CNS effects (Fatigue, Insomnia, Hallucinations)
Sexual dysfunction
Bronchospasm (Esp. non-selective blockers)
Metabolic effects (inc HDL and hypoglycemia) |
|
|
Term
| Why do you always want to taper pts off beta blockers? |
|
Definition
|
|
Term
| T/F Pts w/ CHF or recent MI should be on beta blockers? |
|
Definition
|
|
Term
| T/F Alpha Adrenergic Blocking Agents (alpha blockers) like doxaszosin, prazosin, terazosin can relax the bladder sphincter |
|
Definition
|
|
Term
| Which drug do you worry about the first dose phenomenon? |
|
Definition
| Alpha Adrenergic Blocking Agents (alpha blockers) |
|
|
Term
| What are the 3 classes of calcium channel blockers? |
|
Definition
Non-selective: Diphenylalkylamines (verapamil)
Somewhat selective: Benzothiazepines (diltiazem)-
less negative ionotropism
Selective: Dihydropyridines (nifedipine, nicardipine et al) |
|
|
Term
| T/F CCBs work more on cardiac than vascular |
|
Definition
| False, they work more on vascular muscle |
|
|
Term
| T/F CCBs are especially useful in patients with diabetes, asthma or angina |
|
Definition
|
|
Term
| What is the main side effect from CCBs? |
|
Definition
|
|
Term
| T/F CCBs cause angioedema |
|
Definition
| False! ACEIs do (ARBs less so) |
|
|
Term
| What are the primary choices for preHTN, stage I, single drug tx? |
|
Definition
Diuretic (hydrochlorthiazide)
ACE inhibitor (benazepril, lisinopril) |
|
|
Term
| What are the secondary choices for preHTN, stage I, single drug tx? |
|
Definition
Alpha blocker (prazosin)
Angiotensin receptor blocker (losartin)
Beta blocker (atenolol)
Calcium channel blocker (diltiazem)
Central sympathoplegic (clonidine) |
|
|
Term
| What are the primary choices for HTN stage II, multidrug tx? |
|
Definition
ACE inhibitor + thiazide
ACE inhibitor + calcium channel blocker
ARB + diuretic
ARB + calcium channel blocker
Beta blocker + thiazide |
|
|
Term
Which lipoprotein transports endogenous cholesterol?
LDL
HDL
Lipoprotein(a) |
|
Definition
|
|
Term
Which lipoprotein removes LDL-cholesterol and triglycerides?
LDL
HDL
Lipoprotein(a) |
|
Definition
|
|
Term
| T/F Lowering LDL reduces risk of atherosclerosis |
|
Definition
|
|
Term
| T/F low HDL is associated w/ reduced risk of atherosclerosis |
|
Definition
| False, HIGH HDL reduces your risk |
|
|
Term
| T/F it is easy to raise HDL cholesterol |
|
Definition
|
|
Term
|
Definition
High HDL levels = lower risk of heart disease
BUT: Drugs which increase HDL levels do not lower
risk of heart disease!! |
|
|
Term
| How many lipid lowering drug classes are there? |
|
Definition
"I Feel Healthier, Not Because of Penises"
Inhibitors of sterol absorption
Fibric acid derivatives
HMG-CoA reductase inhibitors
Niacin (nicotinic acid)
Bile acid-binding agents
Omega-3 fatty acids
PCSK-9 inhibitors |
|
|
Term
| What are the two main adverse effects from Niacin? |
|
Definition
| cutaneous flush and hepatotoxicity |
|
|
Term
| Your pt just started a new medication for high cholesterol and is now c/o of an itchy rash and RUQ pain, what is the most likely drug? |
|
Definition
|
|
Term
| How do bile acid exchange agents lower cholesterol? What is the main adverse effect from them? |
|
Definition
They block the re-absorption of bile acids
Impaired Absorption of Fat soluble vitamins (D, E & K), folate, vitamin C |
|
|
Term
Cholestyramine (Questran), Colestipol (Colestid), Colesevalam (Welchol) are examples of?
Bile acid-binding agents
HMG-CoA reductase inhibitors
Fibric acid derivatives
Inhibitors of sterol absorption
Omega-3 fatty acids
PCSK-9 inhibitors |
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Definition
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Term
| How do statins lower cholesterol? What are the 3 main adverse effect from them? |
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Definition
Block Sterol (and hence Cholesterol) Synthesis so lowers LDL
Liver damage, myopathy/rhabdomyolysis, contraindicated in pregnancy, lactation, children/teens cause intereferes w/ sex hormones |
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Term
Atorvastin (Lipitor) • Fluvastatin (Lescol) • Lovastatin (Mevacor) • Pravastatin (Pravachol) • Rosuvastatin (Crestor) • Simvastatin (Zocor) are examples of?
Bile acid-binding agents
HMG-CoA reductase inhibitors
Fibric acid derivatives
Inhibitors of sterol absorption
Omega-3 fatty acids
PCSK-9 inhibitors |
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Definition
| HMG-CoA reductase inhibitors (aka statins) |
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Term
| Your 78yo pt has been on Lovastatin (mevacor) for 5 years, but is now complaining of weakness. What do you recommend? |
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Definition
| His weakness is likely dt the statin and the dose should be decreased |
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Term
| What labs should be monitored in pts taking statins? |
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Definition
| liver EZ (AST/ALT) and muscle EZ (Creatine kinase) |
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Term
| How do fibrates lower cholesterol? What is the main adverse effect from them? |
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Definition
lower fibrinogen (an important clotting factor) levels
Contraindicated in pregnancy! |
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Term
Gemfibrozil (Lopid) and Fenofibrate (Tricor) are examples of?
HMG-CoA reductase inhibitors
Fibric acid derivatives
Inhibitors of sterol absorption
Omega-3 fatty acids
PCSK-9 inhibitors |
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Definition
| Fibric acid derivatives (fibrates) |
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Term
| How do sterol absorption inhibitors lower cholesterol? What is the main adverse effect? |
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Definition
Works synergistically w/ statins to affect abrosption of cholesterol
-Hepatotoxicity |
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Term
Fish oil is an example of?
HMG-CoA reductase inhibitors
Fibric acid derivatives
Inhibitors of sterol absorption
Omega-3 fatty acids
PCSK-9 inhibitors |
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Definition
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Term
| How does fish oil lower cholesterol? What are the 2 main adverse effects? |
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Definition
Acts as an anti-inflammatory
-Mild anticoagulant and makes glycemic control more difficult |
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Term
Alirocumab (Praluent) and Evolcumab (Repatha) are examples of?
HMG-CoA reductase inhibitors
Fibric acid derivatives
Inhibitors of sterol absorption
Omega-3 fatty acids
PCSK-9 inhibitors |
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Definition
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Term
| How do PCSK-9 inhibitors lower cholesterol? When should you prescribe them? |
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Definition
Blocks normal mechanism for removing LDL-C from blood
Use only if other therapy ineffective or not tolerated |
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Term
What is the first line lipid lowering therapy?
HMG-CoA reductase inhibitors
Fibric acid derivatives
Inhibitors of sterol absorption
Omega-3 fatty acids
PCSK-9 inhibitors |
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Definition
| HMG-CoA reductase inhibitors (aka statins) |
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Term
| What are the 2 main clinical implications for recommending lipid lowering tx? |
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Definition
Preventative: Patients with hyperlipidemia
Treatment: Patients with known heart disease
• Even if LDL not clearly elevated |
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Term
What is the usual target for LDL?
<50
<70
<100
<150
<200 |
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Definition
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Term
What is the target LDL for diabetics w/ heart dz?
<50
<70
<100
<150
<200 |
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Definition
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Term
| Your pts HDL is 48, what do you recommend? |
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Definition
| Nothing, anything over 40 is great! |
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Term
Which is characterized by Extreme fatigue with minimal exertion?
Stable angina
Variant (Prinzmetal's)
Unstable angina |
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Definition
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Term
What is the best tx for Variant (Prinzmetal's)?
CCBs
BBs
ACEI
Statins |
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Definition
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Term
| T/F sublingual and buccal NTG provide immediate pain relief for stable angina |
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Definition
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Term
| Your pt has been taking NTG w/ no problems for his stable angina, but is now c/o of ED and is requesting a prescription of Viagra. What do you recommend? |
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Definition
| Sorry dude, you can't take ED drugs w/ NTG cause both are potent vasodilators and will cause severe orthostatic hypotension |
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Term
Which is more effective in preventing stable angina attacks?
Nonselective BB (propanolol)
Selective BB (Atenolol) |
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Definition
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Term
| T/F BBs are indicated for both stable and unstable angina |
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Definition
| False! BBs are contraindicated for treatment of variant angina |
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Term
| T/F CCBs reduce myocardial O2 demand and prevent vasospasm |
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Definition
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Term
| T/F Randomized trials show better outcomes & symptomatic improvement with beta blockers in pts w/ stable angina |
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Definition
| True! when compared to CCBs |
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Term
| What is the main adverse effect of Na channel blockers like Ranolazine (Ranexa)? |
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Definition
| Increases the QT interval |
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Term
Reduce cardiac workload, restricting Na, diuretics, and ACE/ARB is the 1st strategy for what dz?
Heart failure
MI
CAD
PVD |
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Definition
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Term
| Spironolactone has been shown to inc deaths in heart failure pts dt what? |
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Definition
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Term
| What do you have to remember about cardiac glycosides like digoxin? What are the 4 main adverse effects? |
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Definition
| low therapeutic index, arrhythmias (heart block), heart irritability (PVC, VT, VFib), anorexia, headache |
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Term
| Which 3 drugs can prevent or reverse remodeling in HF pts? |
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Definition
Spironolactone or eplerenone
ACE inhibitor (lisinopril)
Beta and Alpha blocker (carvedilol) |
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Term
| What are the 5 classes of antiarrhythmic drugs? |
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Definition
Class I Na+ Channel Blockers
Class II Beta Blockers
Class III K+ Channel Blockers
Class IV Ca++ Channel Blockers
Others |
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Term
Which antiarrhythmic class is most useful against atrial arrhythmias?
Class I Na+ Channel Blockers
Class II Beta Blockers
Class III K+ Channel Blockers
Class IV Ca++ Channel Blockers
Others |
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Definition
| Class IV Ca++ Channel Blockers |
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Term
Which antiarrhythmic class(es) is/are most useful against atrial tachyarrhythmias?
Class I Na+ Channel Blockers
Class II Beta Blockers
Class III K+ Channel Blockers
Class IV Ca++ Channel Blockers
Others |
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Definition
Class II Beta Blockers
Class III K+ Channel Blockers |
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Term
| What are the best 3 drugs to treat AFib? |
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Definition
| Beta blockers, amioderone, propafenone (Class I Na+ channel blocker) |
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Term
| What is the most commonly affected artery from a mural thrombi? |
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Definition
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Term
| What are the 2 main adverse effects from amiodarone - useful for the tx of ventricular tachy and Vfib, and Afib? |
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Definition
pulmonary fibrosis (1% incidence)
blocks T4 to T3 conversion (causes fxnl hypothyroidism) |
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Term
| T/F Amiodarone should not be prescribed w/ macrolides like arythromycin and clarithromycin |
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Definition
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Term
| What is the double edge sword w/ antiarrhythmic drugs? |
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Definition
Anti-arrhythmic drugs can stop arrhythmias
They can also CAUSE arrhythmias
Clearly Beneficial in Acute Ischemic Episodes
Risky when used to PREVENT arrhythmias |
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