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46 Cards in this Set
- Front
- Back
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Determine lipoprotein levels–obtain complete lipoprotein profile after?
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after a 9- to 12-hour fast.
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LDL Cholesterol
Optimal Primary Target of Therapy |
<100 |
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LDL Cholesterol Near optimal/above optimal Primary Target of Therapy |
100-129
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LDL Cholesterol BODERLINE HIGH Primary Target of Therapy |
130-159
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LDL Cholesterol Primary Target of Therapy |
160-189
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LDL Cholesterol
VERY HIGH Primary Target of Therapy |
>190
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DESIRABLE
Total Cholesterol |
<200
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Total Cholesterol BODERLINE HIGH |
200-239
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Total Cholesterol HIGH |
>240
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LOW HDL Cholesterol
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<40
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HIGH HDL Cholesterol |
>60
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Major Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals
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DM
Cigarette smoking Hypertension (BP >140/90 mmHg or on antihypertensive medication) Low HDL cholesterol (<40 mg/dL) *Family history of premature CHD (CHD in male first degree relative <55 years;CHD in female first degree relative <65 years) Age (men >45 years; women >55 years) * HDL cholesterol >60 mg/dL counts as a “negative” risk factor; its presence removes onerisk factor from the total count. |
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TRIGLYCERIDES normal |
<150 |
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TRIGLYCERIDES
Borderline high |
150-199 |
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TRIGLYCERIDES
High |
200-499
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TRIGLYCERIDES
Very High |
> or= 500 |
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Which pts do you treat aggressively for hyperlipidemia? |
Pts with 1 DM 2 CAD 3 Stroke |
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Other name for Gemfibrozil |
Lopid Alcohol Avoid- Very serious interactions can Drug class: Fibric acid Shouldn't be used if Serum creatinine >2 mg/dl |
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M3 for Vit D if? |
If kidney dysfunction, call nephrologist can't be activated Consult Nephrologist |
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Metformin Class? Other name(s)? Containdicated if creatinine is? |
Class: Biguanide Other names: Glumetza, Riomet, Glucophage, and Fortamet Creatinie should be >1.5 mg/dl (male); 1.4 mg/dl (women) |
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Lovenox should be dose adjusted if eGFR? |
eGFR<30 or they can be changed to Heparin |
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NYHA Class 1
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No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath).
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NYHA Class 2
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Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).
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NYHA Class 3 |
Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.
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NYHA Class 4 |
Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.
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ACC/AHA Stage A |
Predisposing factors but no structural heart dx Equiv NYHA Class: None |
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ACC/AHA Stage B
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Structural heart dx but no symptoms Equiv NYHA Class: 1 |
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ACC/AHA Stage C
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Structural heart dx with HF symptoms that are not present at rest Equiv NYHA Class: 2 or 3 |
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ACC/AHA Stage D
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Symptoms at rest that are refractory to medical tx Equiv NYHA Class: 4 |
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Identify presence of clinical atherosclerotic disease that confers high riskfor coronary heart disease (CHD) events (CHD risk equivalent)?
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CHD risk equivalents
■ Clinical CHD ■ Symptomatic CAD ■ PAD ■ AAA |
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Nitrofurantoin Other name? Don't use if? |
Macrobid Don't use if serum creatinine's elevated or eGFR<60 risk of neurotoxicity |
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Biphosphonates should be avoided if |
eGFR<35 Select M5 alt med Can be contraindicated if pt has CKD |
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If pt has hypertriglyceridemia pt should not take Lovastatin |
Lovastatin is not active on triglycerides M5 alt med Lovastatin does not reduce triglycerides Brands: Mevacor and Altoprev |
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Normal eGFR |
Because the calculation works best for estimating reduced kidney function, the National Kidney Foundation (NKF) suggests only reporting actual results once values are < 60 mL/min (they state normal values as 90-120 mL/min).
An eGFR below 60 mL/min suggests that some kidney damage has occurred. |
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Other name for atorvastatin
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Brands: Lipitor
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Other name for (ezetimibe/simvastatin) |
vytorin |
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Other name for simvastatin |
Zocor |
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Ezetimibe
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Zetia or Ezetrol
is a drug that lowers plasma cholesterol levels. It acts by decreasing cholesterol absorption in the smallintestine. It may be used alone when other cholesterol-lowering medications are not tolerated, or together with statins - Vytorin |
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With liver dx, avoid these meds? |
1 Acetaminophen 2 Alfusozin (Uroxatral) 3 Statins 4 Niacin (Niaspan) 5 Fibrates (active liver dx) 6 Oral Contraceptives 7 Oxycontin 8 BRILINTA® (ticagrelor) Select M5 Alt med recommended (list med) contraindicated for members with liver dx |
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Other name for (ticagrelor)
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BRILINTA® |
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Avoid which meds with PUD, GERD |
1 NSAIDS 2 Celebrex 3 Potassium oral ER 4 ASA 5 Antiplatelets 6 Warfarin 7 Niacin (Niaspan) |
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Geodan other name don't use w/ pt's who've had an MI |
Ziprasidone can prolong the QTI increased risk for torsades |
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Avoid which meds with MI |
1 Oral Contraceptives 2 5 HT1 agonists 3 TCAs Amitriptyline |
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Triptans 5HT1 Receptor Agonist
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Triptans 5HT1 Receptor Agonist
Sumatriptan (Imitrex) Rizatriptan (Maxalt) Zolmitriptan (Zomig) Eletriptan (Relpax) Naratriptan (Amerge) don't cause vasospasms of the coronary arteries Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches |
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TCAs Amitriptyline contraindicated with CAD
AND MI b/c? |
can increase risk of arrythmias |
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PDE-5 Inhibitor |
Phosphodiesterase inhibitor Tadalafil (Cialis) Vardenafil (Levitra) Avanafil The phosphodiesterase type 5 (PDE5) inhibitors cause vasodilation in the penis and lung by blocking the breakdown of cyclic guanosine monophosphate (cGMP) which results in prolongation of the action of mediators of vasodilation including nitric oxide (NO) |
