Pharm final.txt

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scherk87
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147319
Filename:
Pharm final.txt
Updated:
2012-04-12 20:50:05
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Pharm
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  1. Asa dose for STEMI/NSTEMI
    162-325 mg
  2. Platelet receptor Asa acts on
    Thromboxane A2 receptor
  3. Time frame for Asa for STEMI/NSTEMI
    < 24 hrs
  4. Beta blocker for STEMI/NSTEMI
    Lopressor
  5. Contraindications for beta blocker
    • Bradycardia
    • 1st degree AV block
    • Hypotensive
  6. Benefit for beta blocker in ACS
    Decreased morfality/anti-ischemic
  7. Myocardial benefits of IV nitro with ACS
    Anti-ischemic
  8. Why minimize morphine for ACS
    Masks symptoms
  9. IV nitro dose if inadequate pain relief
    Increase 10-20mg q3-5min
  10. Eptifibitide/Abciximab platelet receptor site
    GP IIb/IIIa receptor
  11. Plavix platelet site
    Adenosine diphosphate
  12. Plavix functioning with a stent
    Decrases restenosis rate
  13. Beta blocker with EF > 40%
    Metoprolol
  14. Beta blocker with EF < 40%
    Coreg
  15. ACS pharmacotherapy without cath
    Thrombolytics
  16. Desirable total cholesterol
    < 200
  17. Borderline total cholesterol
    200-239
  18. High Total Cholesterol
    >= 240
  19. Optimal LDL
    < 100
  20. Near Optimal LDL
    100-129
  21. Borderline LDL
    130-159
  22. High LDL
    160-189
  23. High risk of CHD
    • Multiple risk factors
    • Severe/poorly controlled risk factors
    • ACS
    • Metabolic syndrome
    • Tri > 200, Non HDL > 130, HDL < 40
  24. LDL goal for high risk factor CHD
    < 70 mg/dL
  25. Major side effect of statins
    • Myopathy
    • Increased liver enzymes
  26. Time when statin-induced myopathy occurs
    1st 12 months
  27. FDA simvastatin dose
    80mg
  28. Greatest decrease in LDL
    • Crestor
    • Lipitor
    • Zocor
  29. Statin pearls
    • increase in transaminases - watch
    • SE are agent specific
    • myalgias - change statin
  30. MOA of Bile Acid Sequestrants
    Bind dietary cholesterol - prevent absorption
  31. SE of Bile Acid Sequestrants
    • GI distress/constipation
    • Decreased absorption of other drugs
  32. SE of niacin
    • Flushing
    • Hyperglycemia
    • hyperuricemia
    • Upper GI distress
    • Hepatotoxicity
  33. Flushing reduction (Niacin SE)
    ASA/NSAID 30-60 min prior
  34. AIM-HIGH trial ended
    Increased stroke in patients
  35. Niacin pt population
    Statin-intolerant patients
  36. SE of Fibric Acid
    • Dyspepsia
    • Gallstones
    • Myopathy
  37. Zetia MOA
    decreased intestinal absorption of cholesterol
  38. 1st line Anti-HTN
    ACE Inhibitors
  39. 1st antihypertensives for Stage 1 HT w/o compelling indiciations
    Thiazide diuretic
  40. Diuretic HTN scheduling
    AM & Afternoon - decreases nocturnal diuresis
  41. 3 common loop diuretics
    • Lasix
    • Bumex
    • Demadex
  42. Loop diuretics population
    1st line in patients with edema
  43. Potassium sparing diuretics
    • Weak anti-HTN
    • Additive with loop diuretics/thiazide
  44. Complications of Potassium Sparing diuretics in DM/CKD
    Hyperkalemia
  45. Serious SE in males on Aldactone
    gynecomastia
  46. Cardioselective Beta Blockers
    • B1 - one heart
    • B2 - two lungs
  47. Lopressor
    Immediate Release
  48. Toprol XL
    Extended Release
  49. Noncardioselective Beta Blocker
    • Propranolol
    • Labetalol
    • Carvedilol
  50. Contraindications of Beta-blockers
    • Wheezing
    • AV Block
    • Hypotension
    • Bradycardia
  51. Intrinsic Sympathomimetic Activity (ISA)
    • Adrenergic agonist activity with Beta Blocking
    • If Beta Blocking causes bradycardia
  52. Thiazide HTN stage
    • All
    • Uncomplicated HTN - Monotherapy
    • Complicated - Additive therapy
  53. SE of Beta blockers
    • Sexual dysfunction
    • Lethargy
    • Suddenly stop - reflex tachycardia, ischemia & angina
  54. Why Beta Blocker used with hydralazine or minoxidil
    Counter reflex tachycardia
  55. Antihypertensive in pregnancy
    Methyldopa
  56. Low dose Dopamine use
    Renal & DA
  57. Intermediate dose Dopamine
    Beta effects and DA
  58. High dose Dopamine
    Alpha effects

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