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48 Multiple choice questions

  1. losartan (cozaar), valsartan (diovan), candesartan (atacand), irbesartan (avapro), telmisartan (micardis)
  2. mainly hypotension (bc it's a dilator). Extreme caution if systolic BP < 90 and w/RV infarction, limit drop to 10% if pt normotensive, limit drop to 30% if pt hypertensive. Watch for HA, syncope, tachycardia.
  3. bleeding!
  4. give "low & slow." 2 to 4 mg every 5-10 min titrated to effect. no cap on the dose. given IV push over 5 min.
  5. used for DVT, PE, MI (STEMI & NSTEMI), DIC, A-Fib, post PTCA or CABG with some lytics if < 48 hrs. For STEMI with/without reperfusion up to 8 days.
  6. door to drug time - 30 minutes!
  7. death from brain (intracerebral) hemorhage esp. if over age 75, reprofusion arrhythmias (PVB, PAB, Afib/Aflutter) - has plenty of O2 all of a sudden, go away on their own (means the drug is working!)
  8. electrolyte imbalances (especially hypokalemia - which makes a person more likely to have digoxin toxicity if on that as well)
  9. bleeding from ALL sites - urine, stool, sputum, puncture sites, nosebleeds. Monitor labs - Hb, Hct, platelets
  10. slows ventricular rate. decreases afterload. more of an antiarrhythmic. Used for HTN, Afib, Aflutter.
  11. depression of ventilation (consult MD), N/V common (can premed w/zofran), bradycardia, drop in BP (increase fluids, elevate feet, lower head)
  12. ACS w/NO ST segment elevation (NSTEMI), non-Q wave MI, UA, CA reocclusion post PCI or with fibrinolytics given 24 hrs before balloon/stent.
  13. hypotension (orthostatic hypotension early on) - Monitor BP!, hyperkalemia, persistent cough (have to get off drug)
  14. overall mortality from AMI, nonfatal reinfarction, nonfatal stroke. will not do anything to clot already there!
  15. angina, MI, HTN, CHF, shock. consider early admin. in select pts: suspected ischemic chest pain, UA (change in angina pattern), acute pulm. edema (if BP > 90 systolic).
  16. hyperkalemia
  17. Watch for bleeding especially when given with NSAIDs, ASA, heparin, or coumadin
  18. Increased BP
  19. diuretics used for HTN, CHF, renal failure
  20. used for STEMI, consider in NSTEMI, evidence of acute pulmonary edema. also if systolic BP > 90 and no hypovolemia.
  21. vasodilation
  22. hypotension (don't give if SBP < 100), bradycardia, AV block, extreme fatigue/lethargy, impotence
  23. decreased BP bc it vasodilates, but can also increase BP by increasing CO
  24. used for HTN, MI. side effect - hypotension, so monitor BP!
  25. antiplatelet - inhibits platelet aggregation by selectively preventing binding of ADP to its receptor. Prolongs bleeding time.
  26. antiplatelet (PREVENTS clot formation & from getting bigger)
  27. intropin (dopamine), dobutamine (dobutrex), milrinone (primacor), digitalis (lanoxin) - used for CHF & shock to increase contractility - to increase CO
  28. CHEW the tablet. standard therapy for new pain suggestive of AMI. better to use baby aspirin bc it's flavored. if allergic give plavix.
  29. used for angina, MI (standard of care for all post MI pts indefinitely), CHF (only stable, chronic - not early mgmt), tachyarrhythmias.
  30. with or without lytics for 14 days, with or without reperfusion, NSTEMI - give for 6-9 mos, STEMI - gie for 1 year. ALL STEMIs and NSTEMIs get Plavix.
  31. ALL NSAIDs except ASA (aspirin) must be DC'd for good.
  32. decreases pain of ischemia, venous blood return to heart, preload & cardiac O2 consumption. Increases venous dilation and cardiac collateral flow. Dilates coronary arteries.
  33. hypotension - monitor BP, HR, rhythm closely. may need to reduce dosage.
  34. goal is to ELIMINATE pain (ZERO on the pain scale)
  35. they inhibit/block the SNS response - decrease HR, contractility, stroke volume, CO, BP, AV node conduction
  36. PREVENTS clot formation & from getting bigger.
  37. used for HTN, for all post MI pts indefinitely, CHF. reduces mortality & CHF from AMI. Prevents scarring of LV that leads to HF (LV remodeling).
  38. diuretics used to decrease preload (volume)
  39. monitor BP & HR. contraindicated if HR < 60 bpm, insulin dependent DM (monitor sugar more often), asthma, PVD
  40. increases force of contraction (squeeze). particularly used for acute exacerbations of CHF where BP has fallen.
  41. brings BP down really quickly - monitor BP every minute! drug of choice for hypertensive crisis (malignant HTN)
  42. causes diuresis - opposes renin so it causes excretion of sodium & water to treat fluid overload. used for ACUTE episodes of CHF.
  43. STEMI and NSTEMI, in combination with fibrinolytics. PREVENTS clot formation.
  44. potassium sparing diuretic used in MI and CHF
  45. decreases afterload by preventing vasoconstriction, decreases preload by preventing sodium & water retention (inhibits aldosterone), vasodilator.
  46. drug of choice for acute pain d/t MI. decreases pain of ischemia, decreases anxiety (gives feeling of euphoria), decreases extension of ischemia by decreasing O2 demands.
  47. antiplatelet that PREVENTS clot formation, prevents platelet aggregation and vasoconstriction. used for CAD, post MI (STEMI and NSTEMI).
  48. BREAK UP clots already formed. Used in MI (STEMI ONLY: w/chest pain > 20 min & < 12 hrs), CVA, PE. Max age for use - 75.