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Asa dose for STEMI/NSTEMI
162-325 mg
Platelet receptor Asa acts on
Thromboxane A2 receptor
Time frame for Asa for STEMI/NSTEMI
< 24 hrs
Beta blocker for STEMI/NSTEMI
Lopressor
Contraindications for beta blocker
Bradycardia
1st degree AV block
Hypotensive
Benefit for beta blocker in ACS
Decreased morfality/anti-ischemic
Myocardial benefits of IV nitro with ACS
Anti-ischemic
Why minimize morphine for ACS
Masks symptoms
IV nitro dose if inadequate pain relief
Increase 10-20mg q3-5min
Eptifibitide/Abciximab platelet receptor site
GP IIb/IIIa receptor
Plavix platelet site
Adenosine diphosphate
Plavix functioning with a stent
Decrases restenosis rate
Beta blocker with EF > 40%
Metoprolol
Beta blocker with EF < 40%
Coreg
ACS pharmacotherapy without cath
Thrombolytics
Desirable total cholesterol
< 200
Borderline total cholesterol
200-239
High Total Cholesterol
>= 240
Optimal LDL
< 100
Near Optimal LDL
100-129
Borderline LDL
130-159
High LDL
160-189
High risk of CHD
Multiple risk factors
Severe/poorly controlled risk factors
ACS
Metabolic syndrome
Tri > 200, Non HDL > 130, HDL < 40
LDL goal for high risk factor CHD
< 70 mg/dL
Major side effect of statins
Myopathy
Increased liver enzymes
Time when statin-induced myopathy occurs
1st 12 months
FDA simvastatin dose
80mg
Greatest decrease in LDL
Crestor
Lipitor
Zocor
Statin pearls
increase in transaminases - watch
SE are agent specific
myalgias - change statin
MOA of Bile Acid Sequestrants
Bind dietary cholesterol - prevent absorption
SE of Bile Acid Sequestrants
GI distress/constipation
Decreased absorption of other drugs
SE of niacin
Flushing
Hyperglycemia
hyperuricemia
Upper GI distress
Hepatotoxicity
Flushing reduction (Niacin SE)
ASA/NSAID 30-60 min prior
AIM-HIGH trial ended
Increased stroke in patients
Niacin pt population
Statin-intolerant patients
SE of Fibric Acid
Dyspepsia
Gallstones
Myopathy
Zetia MOA
decreased intestinal absorption of cholesterol
1st line Anti-HTN
ACE Inhibitors
1st antihypertensives for Stage 1 HT w/o compelling indiciations
Thiazide diuretic
Diuretic HTN scheduling
AM & Afternoon - decreases nocturnal diuresis
3 common loop diuretics
Lasix
Bumex
Demadex
Loop diuretics population
1st line in patients with edema
Potassium sparing diuretics
Weak anti-HTN
Additive with loop diuretics/thiazide
Complications of Potassium Sparing diuretics in DM/CKD
Hyperkalemia
Serious SE in males on Aldactone
gynecomastia
Cardioselective Beta Blockers
B1 - one heart
B2 - two lungs
Lopressor
Immediate Release
Toprol XL
Extended Release
Noncardioselective Beta Blocker
Propranolol
Labetalol
Carvedilol
Contraindications of Beta-blockers
Wheezing
AV Block
Hypotension
Bradycardia
Intrinsic Sympathomimetic Activity (ISA)
Adrenergic agonist activity with Beta Blocking
If Beta Blocking causes bradycardia
Thiazide HTN stage
All
Uncomplicated HTN - Monotherapy
Complicated - Additive therapy
SE of Beta blockers
Sexual dysfunction
Lethargy
Suddenly stop - reflex tachycardia, ischemia & angina
Why Beta Blocker used with hydralazine or minoxidil
Counter reflex tachycardia
Antihypertensive in pregnancy
Methyldopa
Low dose Dopamine use
Renal & DA
Intermediate dose Dopamine
Beta effects and DA
High dose Dopamine
Alpha effects
Author
scherk87
ID
147319
Card Set
Pharm final.txt
Description
Pharm
Updated
4/13/2012, 12:50:05 AM
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