CV Meds.txt

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CV Meds.txt
2012-01-05 09:56:15
CVD medications

Medications info from RxFiles - Rx for HTN/CVD
Show Answers:

  1. What to monitor when starting ACEI?
    SCr, BUN, fluid balance and lytes x 1-2 wks of starting. If K> 5.6 or SCr > 30% rise over baseline consider stopping (unless related to volume loss)
  2. Contraindications to ACEI/ARB?
    Bilateral renal artery stenosis (uni if 1 kidney), history of angioedema, pregnancy (teratogenic)
  3. ACEI are 1st line in which conditions?
    HF, DM, Post MI, Uncomplicated HTN, LVH, Prior CVA/TIA, renal disease & ALL coronary artery disease patients
  4. Which group of patients do ACEI/ARB not work as well?
    Black people - but still use for compelling indications (MI, HF, CKD)
  5. Some Side effects of ACEI?
    K+ sparing, cough (10% - more with Asians), angioedema (0.5%), increased LFTs, low bp/fatigue/dizzy/headache
  6. Beta-blockers are 1st line for which conditions?
    Stable angina, Post-MI, LVH ≤60yrs.
  7. Which groups are B-blockers not as good with?
    Elderly - not unless post-MI/CHF/angina, Blacks - less effective
  8. Which B-blockers are cardio-selective? (4)
    Acebutolol, Atenolol, Bisoprolol, Metoprolol
  9. Metoprolol's trade name?
  10. Bisoprolol's trade name?
  11. Atenolol's trade name?
  12. Acebutolol's trade name?
  13. Non-cardio-selective B-blockers? (5)
    Nadolol, Pindolol, Propranolol, Sotalol, Timolol
  14. Special use of Propranolol (non-cardiac)
    Tremor, and reduces bleeding from esophageal varices
  15. Non-selective Beta and alpha B-blockers? (2)
    Carvedilol (COREG) and Labetalol (Trandate)
  16. Contraindications for beta-blockers?
    Asthma, 2nd or 3rd degree heart block, PR > 0.24s, uncompensated HF, severe PAD, pheochromocytoma without alpha-blockade
  17. What is NORVASC?
    Amlodipine - a Dihydropyridine (DHP) CCB
  18. What is ADALAT?
    Nifedipine - a Dihydropyridine (DHP) CCB
  19. What is CARDIZEM?
    Diltiazem - a non-DHP CCB - used for stable angina, HTN, coronary artery spasm
  20. What is DHP CCB action vs. Non-DHP?
    DHP CCB - more peripheral vasodilation (deem), less effect on heart
  21. What is Non-DHP CCB action?
    More negative chronotropic effect on heart, less vasodilation
  22. Which CCB's are bad for Wolff-Parkinson-White Syndrome?
    Non-DHP CCB's (diatiazem and verapamil) b/c slow AV node conduction and allow current to reenter faster
  23. 1st line Rx for uncomplicated HTN (no other compelling indications)
    Thiazide diuretic (HCT or chlorthalidone) then B-blocker (≤60 yr), ACEI, Long acting CCB
  24. 1st line Rx for isolated systolic HTN
    Thiazide diuretic (HCT or chlorthalidone) or CCB (Long acting DHP)
  25. 1st line Rx for DM WITH nephropathy (alb:Cr >2 in M, >2.8 in F or CKD)
    ACEI or ARB (monitor SCr and K+) - but may need 3-4 drugs
  26. 2nd line Rx for DM WITH Nephropathy if 1st drug can't control
    Add 1+ of: Thiazide, Long acting-CCB
  27. 1st line Rx in CAD
    ACEI or ARB (except not in low risk pts)
  28. 1st line Rx in stable angina
    B-blocker, but strongly consider adding ACEI
  29. 1st line Rx in prior MI
    B-blocker + ACEI together