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39 Cards in this Set

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  • Back
what labs should you do if you suspect DVT or PE?
PTT
PT
Platelets
CBC
D-Dimer
what is the first line Tx of Type II DM?
Oral meds:

Glyburide 2.5mg BID or
Metformin 500 mg PO BID
what is the best drug for high TGs?
Niacin
what is the best drug to lower LDL?
Statins:

Crestor 5mg daily
Lipitor 10mg daily
how do you dose adjust heparin?
PTT; also used to monitor heparin
name the 3 Bile Acid sequestrants
Questran
Colestid
Welchol
which drug causes flushing, hyperuricemia, and GI side effects?
Niacin
Do statins raise LDL?
NO; they lower LDL and TGs
which drug would you NOT want to give to a pt on warfarin(monitor INR), Beta blockers, or thiazides?
Bile Acid Sequestrans - they reduce absorption of these drugs
Name the 2 Fibric Acids
GF

Gemfibrozil
Fenifibrate
which drug can give you gall stones?
Fibric acids
which drug may increase TGs?
Bile Acid Sequestrans
T/F High TGs increase the risk of pancreatitis
True; treat with Fibrates or Niacin to lower TGs
what are the risk factors for hyperlipidemia?
FLASH C

Family history
Low HDL
Age: men>45; women>55
Smoking
HTN or HTN meds
CHD
what's the first line Tx for Type II?
Glyburide 2.5mg BID

Do A1c p 3 months and adjust if needed
why are first gen. sulfanylureas not used more?
because they have active metabolites which cause side effects such as hypoglycemia
what should your glucose be post prandial
<126
what is the risk of having high blood sugar in an ICU setting?
> risk of acquiring an opportunistic infection
what is an alternative Tx for 70/30 insulin?
Lantus 10 U/day, add Lispro(Rapid)
What is the insulin dose for ketosis?
Start Insulin Drip (regular) mixed in a 1:1 ratio (100 U in 100cc saline)

After insulin drip:
1.0 IU/Kg/day
start a 90kg pt on insulin
dose is 0.5 IU/kg/day:

45 U/day
Split into 70/30
Use 70% NPH; 30% Regular
a patient comes in with a stroke, what do you do?
Do CT first
Start heparin if ischemic
what is the first line Tx of an Ischemic stroke?
Thrombolytic:

TPA- use within 3 hrs of Sx
Monitor PTT, INR, CBC because a bleed can occur
If you have a Hemorrhagic stroke, what do you do?
Contact neurosurgeon
Give TPA to a 60Kg Ischemic stroke patient
Dose is 0.9mg/kg/IV

.9x60= 54mg
Give 10% bolus= 5.4mg
48.6mg IV over 1 hr
who should not get TPA?
Any pt at risk of bleed, h/o recent seizure or brain neoplasm
what antiplatelet therapy can you give for ischemic stroke?
ASA
Aggrenox
Ticlodipine
Plavix
Warfarin
your pt has TGs of 225, which cholesterol drug would you give and which ones would you avoid?
Avoid:
Bile Acids - they may > TGs

Give Niacin 2gm
what is your LDL goal for a pt with no CHD and has more than 2 risk factors?
LDL <130
your patient has liver disease and you want to reduce his LDL, what drug do you choose?
Bile Acid sequestrants:

Questran 5gm daily
Which cholesterol drugs are CI in liver disease?
Statins-absolute
Niacin
Fibric Acids
what do you monitor with statins?
CPK
LFT
Lipid levels
what is the best drug to raise HDL?
Niacin >15-35%

2gm daily
Your pt is hypoglycemic and on AGIs, what do you do?
Give glucose, NOT sucrose, because the AGIs slow breakdown and absorption of sucrose in the intestines
when should your pt take their AGIs?
Before every meal so the drug is present to inhibit enzyme activity
Your pt has CHF and has Type II, what drug should you avoid?
TZD, becase it causes edema and as a result a dilution anemia.

Also avoid Metformin
this drug enhances insulin sensitivity in hepatic and peripheral muscle tissues
Metformin
What are the two diabetic drugs that should be given with meals?
AGIs
Meglitinides
In which type of diabetes does DKA most often occur?
Type I