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16 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Digoxin
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Postive inotrophe
+ neg chronotrophe + neg dromotrophe (conductivity) No vasoldilator No antianginal Prolong post MI survival No Prolong HF survival No Used in Systolic HF, arrthmias |
inotrope, chronotorpe, dromotrope, vasodilator, antianginal, prolong survival MI and CHF,
Usual uses |
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Digoxin
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Postive inotrophe
+ neg chronotrophe + neg dromotrophe (conductivity) No vasoldilator No antianginal Prolong post MI survival No Prolong HF survival No Used in Systolic HF, arrthmias |
inotrope, chronotorpe, dromotrope, vasodilator, antianginal, prolong survival MI and CHF,
Usual uses |
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Beta-Blockers
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3+ inotrophe
3+ chronotrope 3+ dromotrophe No vasodilate Yes antianginal Yes prolong post MI survival Yes prolong CHF survival HTN, angina, CHF, arrthymia |
I,C,D,dilate,angina,MI/CHF survival, usual uses
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What does nitro do? When is it used?
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dilates veins, arteries, and arterioles, reducing LV preload > afterload. Dilate coronaries. Tolerance attenuated by 6 hour window.less likely with mononitrates than dinitrates
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What do beta blockers do?
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Decrease HR, BP, contractility
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Describe the evaluation of chronic stable angina
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1. Determine probability of CAD
2. Determine risk of death 3. Determine if the patient needs further w/u |
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When should a beta blocker not be used in ACS?
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Beta blockers should be administered as adjunct therapy in acute MI as they reduce heart rate, lower blood pressure, reduce cardiac contractility, and reduce myocardial oxygen demand. Beta blockers reduce myocardial infarct size, alleviate the pain of acute MI, and reduce the likelihood of developing complications of acute MI. Beta blockers also reduce mortality from acute MI. Beta blockers remain underused in clinical practice despite the data demonstrating effi cacy from their use in acute MI. Beta blockers should be given to all patients with acute MI unless there is a strong contraindication to treatment. Contraindications to treatment with a beta blocker include asthma, known allergy, the presence of high-grade AV block at the time of presentation, cardiogenic shock, hypotension or severe pulmonary edema, and heart rate less than 50 beats/min at the time of evaluation. The presence of mild to moderate heart failure, known obstructive airway disease (in the absence of asthma), known peripheral vascular disease, diabetes mellitus, and a history of cardiomyopathy are not contraindications to treatment with beta blockers.
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Dipyridamole
trade name Uses dosage action contraindications |
Persantine
inhibits thrombus formation casues vasodiltion at higher doses secidary prevention in stroke non-exercise stress testing adjunct to coumarin anticoagulants in the prevention of postoperative thromboembolic complications of cardiac valve replacement. Extended release 200mg BID |
http://www.medpagetoday.com/Cardiology/Strokes/3342
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What is a major limitation of ticlodipine?
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severe neutropenia in 1%
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Clopidogrel
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Plavix
ADP receptor blocker inhibits plateltet aggregation prophylatic against CVA, MI, PVD used in lieu of ASA+persantine in pts with TIA or amurosis fugax |
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Quinidine
(class, SE, uses) |
Prolongs QRS, QT
causes diarrhea rare Automimmune thrombocytopenia purpura cinchonism (hearing loss, tinitis, psychosis) |
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Disopyramide
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Prolongs QT, QRS
anticholinergic negative inotrope |
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Procanimide
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Prolongs QT, QRS
blood dycrasis drug induced lupus mild depressive myocardial effect |
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Amiodarone
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Class III
corneal deposits 98% affects thyroid pulmonary fibrosis gray sking sun sensitivity hepatic toxicity extremely long life (40-55 days) |
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True or False:
Heparin is not needed to maintain vessel patency when streptokinase is used but is required if t-PA is used. |
True
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What is the most common arrhythmia associated with dig toxicity?
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PAT with second degree AV block
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