Therapeutics: VHD

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Author:
kyleannkelsey
ID:
267537
Filename:
Therapeutics: VHD
Updated:
2014-03-23 03:08:55
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Therapeutics VHD
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Therapeutics: VHD
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Therapeutics: VHD
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  1. Is mild to moderate aortic stenosis what is the main treatment?
    Aggressive HTN treatments
  2. In Severe aortic stenosis, what drugs should be used with great caution?
    • Diuretics (could decrease preload)
    • BBs (don’t want to reduce efficacy of heart’s pumping)
    • Vasodilators, specifically direct: hydralazine, minoxidil or nifedipine (reduce blood return rate to heart)
  3. What would be your number one vasodilator to use in Aortic regurgitation?
    • ACEIs
    • Can also use Nifedipine
  4. What drugs should be avoided in aortic regurgitation?
    • BB’s and non DHP CCBs – They slow the HR and prolong diastole allowing for greater filling time
    • Thus, more blood has time to flow backwards
  5. What are the treatment options for Mitral stenosis?
    • Gentle dieresis: HCTZ or low dose furosemide
    • Slow the HR: BB or Non-DHP CCB
  6. What is the treatment for Mitral regurgitation due to prolapsed?
    No pharmacological treatment
  7. What is the treatment for Mitral regurgitation with ischemic or functional MR?
    • Reduce preload
    • If LV dysfunction: Standard HF treatment
  8. What antithrombotic treatment is required for a patient with a Bioprostheic valve in the aortic position?
    ASA 81 mg QD, lifelong
  9. What antithrombotic treatment is required for a patient with a Bioprostheic valve in the mitral position?
    • Warfarin to INR 2-3 for 3 months
    • ASA 81 mg for life
  10. What antithrombotic treatment is required for a patient with a Bileaflet tilting disc or Medtronic-Hall monoleaflet valve in the mitral position?
    Warfarin 2.5-3.5 lifelong
  11. What antithrombotic treatment is required for a patient with a Bileaflet tilting disc or Medtronic-Hall monoleaflet valve in the aortic position?
    Warfarin 2-3 lifelong
  12. What antithrombotic treatment is required for a patient with a Ball and Cage in the aortic position?
    Warfarin 2.5-3.5 lifelong
  13. What antithrombotic treatment is required for a patient with a Ball and Cage in the mitral position?
    Warfarin 2.5-3.5 lifelong
  14. How should you prophylactically treat Valve replacement patients undergoing dental procedures?
    • 1st line: Amoxicillin 2gm - 1 hr prior to treatment
    • 2nd line: Clindamycin 600mg - 1 hr prior to treatment

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