RLP Flashcards

Question

What is a unique ADR for hydralazine?

Answer 1

Lupus-like reaction (fever, muscle pain, arthritis)

Answer 2

Yes, need ACE/ARB

Answer 3

More likely to have UTI, genital infections so watch out.

Answer 4

No, but mechanism takes place in the kidney. So, if poor function, isn't going to work well.

Answer 5

No, you don’t need an ACE or ARB

Answer 6

SGLT2 inhibitor. Inhibits reabsorption of glucose and sodium (water goes with it) in the kidney. Works better with higher glucose levels.

Answer 7

Confusion, fall risk, dry eyes, dry mouth, urinary retention, constipation. Peds – can get paradoxical effect of activation

Answer 8

fatigue, dizziness, psychiatric changes (agitation, anxiety), hypersensitivity – skin reactions, BP elevation (peds)

Answer 9

Monoclonal antibody for preventing RSV infections in pediatric patients. AAP Guidelines for administration: less than 32 weeks gestation, especially those less than 29 weeks, significant risk factors, lung disease

Answer 10

Use proteinuria to direct your therapy

Answer 11

NSAID – ACE/ARB – Loop diuretic

Answer 12

monoclonal antibody injection; skin reactions, low chance for anaphylaxis, fever, antibody development to the medication

Answer 13

oral furosemide 40mg = torsemide 20mg = bumetanide 1mg

Answer 14

pregabalin, gabapentin, amlodipine, pioglitazone

Answer 15

Prevents reabsorption of Na, Cl in the ascending loop of Henle. Water goes with it.

Answer 16

Urinary frequency, depletion of electrolytes (K, Na, Mg), electrolyte imbalances, dehydration, can cause ototoxicity, BP

Answer 17

weight based dosing; IM injection once monthly – max of 5 doses per season. RSV is seasonal in the fall and winter

Answer 18

Yes, it can be used in pregnancy

Answer 19

Usually prandial and basal | Usually 50% prandial and 50% basal; Usually 0.4 to 1 unit per kg per day

Answer 20

stent thrombosis – lumen is fine, but thrombosis forms in stent. Catastrophic. 1-2% In-stent restenosis – scar tissue? Proliferation of cells caused by the injury in placement of the stent. Drug eluting stents are designed to stop this. Return of stable angina after stent procedure “DAPT has no role in re-stenosis”"

Answer 21

Testing variability of 0.5% – A1c of 7 might be either 6.5 or 7.5 (but standarization process is underway): Can be falsely elevated or lowered by health conditions where the longer Hgb sits around, will have more sugar build up, Iron deficiency, Sickle cell, recent bleeding could be low African Americans have tendency to run about 0.5% higher A1c when compared to CGM readings"

Answer 22

Estimate about 0.1 units per kg, start around 10

Answer 23

ACS - unstable angina or MI. Dual antiplatelet needed for anyone with an MI, regardless of going to cath lab, or getting a stent New stent, whether ACS or not can have stent thrombosis – lumen is fine, but thrombosis forms in stent. Catastrophic. 1-2% Third group on DAPT – PAD, TIA, CVD, etc – huge burden on atheroschlerosis especially PAD - Used to prevent other events

Answer 24

Microvascular disease – prevented by glucose control Macrovascular disease – prevented by controlling HTN, HLD PAD, strokes, CAD Glucose is a minor player

Answer 25

It's BID – is this too hard for you to take? 10% have adenosine mediated dyspnea. What’s the co-pay, can they afford it? $400 a month

Answer 26

History of Medullary thyroid cancer (people usually have papullary)

Answer 27

Starting dose 0.25mg x 4 weeks (not therapeutic) then 0.5mg weekly

Answer 28

Obesity – once you’ve put on fat in the SQ space then body puts fat on liver, pancreas. Fat on the liver is not normal. Causes inflammation in the liver; NAFL. Fats in the pancreas causes toxicity. When fasting is over 126, or over 200, person has lost more than 50% of beta cell mass. TZD – move visceral fat to SQ compartment

Answer 29

``` In order: " Semaglutide Liraglutide Dulaglutide Exenatide Lixasenatide" ```

Answer 30

Those with symptoms of hyperglycemia, catabolism, Hgba1c >10%

Answer 31

Atherosclerotic involvement of peripheral arteries that causes flow limiting blockages in peripheral arteries Lower extremities, but also includes carotid and renal arteries Illiac, femoral popliteal, (outside of coronary circulation)

Answer 32

``` "Exercise regimen for all; very important. Medical based therapy: All PAD should be on low dose aspirin 81mg, reduce risk of MI and Stroke Atorva80 or rosuva40mg Irrespective of LDL level; even if 70 add high potency statin PAD specific – cilastozol; FDA approved to increase walking distance; Contraindicated in CHF, if class III or class IV, HFpEF and HFrEF; ADR palpitations, headache, diarrhea" ```

Answer 33

In US if 20/10 over goal then start fixed dose combination

Answer 34

No, Lifestyle modifications first. BP control is 70% lifestyle and 30% medications. If don't change lifestyle then won’t be successful and have side effects

Answer 35

Sodium plays big role in HTN. Most high yield counseling point in a clinical appointment General thresholds: AHA – 1500mg. Others less than 2300mg If cooking everything fresh, 1 teaspoon of salt (2300mg) Ham, sausage, Salad dressing, cheese, bread, Also BP meds might not work as well on high salt diet"

Answer 36

"Lower GFR, lower efficacy of HCTZ. Under GFR of 45 don’t use HCTZ so much Chlorthalidone use all the way down to GFR of 30 Add loop in CKD 4"

Answer 37

"Albuterol kicks in earlier, doesn’t last long vs ipratropium – longer to start 20m lasts longer As SABA wears off, SAMA sticks around Time of bronchodilation is extended by using both products"

Answer 38

ARBs - fewer SE, seem to be better at lowering BP

Answer 39

CCB/ARB. ARB will help eliminate edema from CCB

Answer 40

Consider eplerinone is generic now and fewer ADRs

Answer 41

"Cut off of 20 weeks – if you develop before that’s chronic HTN After 20 weeks – then that’s gestational HTN"

Answer 42

"Hx of gestational HTN, need to screen annually. Higher risk of HTN Everyone – screen every 3 to 5 years

Answer 43

"Levalbuterol – active isomer of albuterol Racemic agents – one is more active than another, or only one is active No evidence that there is a difference between the two products Claims that levalbuterol nebs last longer 3x the cost; Dose is ½ of the racemic mixture"

Answer 44

Depends on institution K Above 5.5 Or above 5.1 When it gets to 6 or 7 can get symptoms. Above 7 is a medical emergency Some dialysis patients might be able to tolerate higher levels than others

Answer 45

if have asthma exacerbation and taking LABA LABA is on the beta2 receptors Can’t give albuterol because receptor is taking What are you doing to do to bronchodialate?

Answer 46

Inhaler + spacer and nebulizer are equally efficacious Nebulizer exposes to more drug Including in the eyes which can increase interocular pressure Can cause pupil dilation – blurred vision

Answer 47

"IV Calcium – stabilize the myocardium so that arrhythmias are less likely. Doesn’t do anything about level of K Calcium gluconate – not as damaging to veins (1/3 potency) Calcium chloride – more potent, use on code cart. Lasts 30-60 minutes"

Answer 48

"IV regular insulin, IV push dextrose (50%)(D50).Redistributes potassium back into the cells Give 5 units to renal impairment IV (not SQ). Give 10 units to others Sodium potassium ATP ase pump in skeletal muscles Intervention lasts 4-6 hours, but dextrose won’t last that long. Might go low"

Answer 49

Positive response is increase of 200mL or 12% in FEV1 compared to baseline (asthma); (COPD might be 50mL, not big response)

Answer 50

"Smooth muscle surrounds the passages inside the lungs; Needs Ca in cytosol for actin and myosin to interact and contract. Albuterol - Increases cAMP in smooth muscle Decreases calcium concentrations Decreases muscle contraction thus increased relaxation"

Answer 51

"Smooth muscle surrounds the passages inside the lungs; Needs Ca in cytosol for actin and myosin to interact and contract. Muscarinic agonists - Increases guaylate cyclase and cGMP in smooth muscle Decreases calcium concentrations Decreases muscle contraction thus increased relaxation"

Answer 52

take at night, add diuretic

Answer 53

A1 – spot urine albumin/creatinine ratio less than 30 mg/g A2 – 30 to 299 – make sure it’s persistent A3 – above 300 - severe, persistent

Answer 54

Albumin/creatinine ratio. Albumin is 60 – 70% of protein in urine

Answer 55

Anxiety, stomach upset, electrical zaps

Answer 56

Blocks parathyroid hormone, then blocks osteoclast activity

Answer 57

Codeine and tamoxifen

Answer 58

Depression, anxiety, PTSD, OCD, hot flashes

Answer 59

GLP1 agonist. Slows gastric emptying; helps release insulin after eating

Answer 60

Half-life is shorter than others, about 20 hours. Stopping paroxetine abruptly might lead precipitate withdrawal

Answer 61

Higher albuminuria, higher risk for AKI, progression of CKD, ESRD, higher risk of CVD

Answer 62

Hypercalcemia, gout exacerbation, low Na, K, Mg; frequent urination;

Answer 63

Hypercalcemia, pain with fracture, in the past for osteoporosis

Answer 64

Injections once a week. Has a 5d half life; takes about a month to get to steady state. 0.75mg; 1.5mg; 3mg; 4.5mg. Higher doses have little HgbA1c lowering but more ADRs

Answer 65

Investigate the allergy history. If there is a history of serious reaction to a sulfa drug, then use caution

Answer 66

"Less than 142 mg/g then probably are A1 Between 142 mg/g to 660 – A2 Above 660 – A3"

Answer 67

low GFR, but little albuminuria – elderly, really need to intervene? Normal aging

Answer 68

Lowers Ca levels; rhinitis; nose bleeds; irritation

Answer 69

Sedation, Weight Gain

Answer 70

GFR 45 to 60, high albuminuria. this person is at high risk for poor outcomes

Answer 71

Yes, risk of mild anticholinergic ADRs, low BP

RLP Flashcards

(96 cards)