CMN 574- Unit 1 Cardiac Exam With Accurate
Solutions Latest Update
OTC analgesics - ANSWER - Ibuprofen (Pericarditis)
- Naproxen
- Acetaminophen
- ASA (Pericarditis, Acute MI)
*contraindications*
avoid NSAIDS with HFrEF (Heart Failure Reduced Ejection Fraction)
Mineralcorticoid Receptor (MR) agonist - ANSWER - Sprinolcatone (K+ sparing)
- Eplerenone
*indications*
Inhibits aldosterone, symtomatic HFrEF, used as add on to diuretic, ACE, ARB, or ARNI
and BB.
*contraindications*
hyperkalemia. monitor K levels 2-3 days, 1wk, and 4wk.
SE: hyperkalemia, gynecomastia
Normal K+ = 3.5-5.0meq
Loop Diuretic - ANSWER - Lasix (severe HF)
,*contraindications*
caution w/ dig can cause hypokalemia
SE: intravascular volume depletion (IVVD), prerenal azotemia, hypotension,
hypokalemia, skin rash, GI, ototoxicity
L=L
ACEI - ANSWER - Lisinopril
- Captopril
*indications*
1st line CHF, reduce systemic vascular resistance (SVR), antagonize RAAS, reduce LV
remodeling.
HTN, CAD, DM, CKD, HFpEF, MI, HFrEF
*contraindications*
acute renal failure, hyperkalemia, hx angioedema
SE: angioedema, dry cough, renal failure, cough, hyperkalemia
ARB - ANSWER - Valsartan
- Candesartan
*indications*
Same as ACEI, but do not use together.
1st line CHF, reduce systemic vascular resistance (SVR), antagonize RAAS, reduce LV
, remodeling.
HTN, CAD, DM, CKD, HFpEF, MI, HFrEF
*contraindications*
renal insufficiency, elevated K
SE: angioedema (less freq), hyperkalemia
ARB-neprilysin inhibitor (ARNI)- ANSWER -Sacubitril-Valsartan
*indications*
HFrEF, decrease CV death & hospitalization for HF by 20%, for symptomatic HF on BB,
ACE, & mineralocorticoid, SBP> 100, gfr >30
BB - ANSWER *indications*
Decrease HR, Cardiac force, BP, systemic vascular resistance, prevention only,
increase EF by 10%, decrease LV size and mass in HF, HFpEF, MI, angina
*contraindications*
do not use in acute CHF, unstable HF. Start low and increase. can worsen symptoms
SE: decrease Left Ventricular Failure (LVF), bradycardia, AV block
Inotrope/Pressor, antiarrhythmia - ANSWER - digoxin
*indications*
blocks Na/K ATPase, increases intracellular NA, less excretion of calcium through the
Ca/Na cotransporter, increases strength of contractions, reduce HR, reduces sx in HF
and hospitalization, does of prolong life, use indicated w/ symptomatic HFrEF class II-IV
not responsive to first line tx, SVT.
CCB (NDHP) - ANSWER - verapamil
- diltiazem
Solutions Latest Update
OTC analgesics - ANSWER - Ibuprofen (Pericarditis)
- Naproxen
- Acetaminophen
- ASA (Pericarditis, Acute MI)
*contraindications*
avoid NSAIDS with HFrEF (Heart Failure Reduced Ejection Fraction)
Mineralcorticoid Receptor (MR) agonist - ANSWER - Sprinolcatone (K+ sparing)
- Eplerenone
*indications*
Inhibits aldosterone, symtomatic HFrEF, used as add on to diuretic, ACE, ARB, or ARNI
and BB.
*contraindications*
hyperkalemia. monitor K levels 2-3 days, 1wk, and 4wk.
SE: hyperkalemia, gynecomastia
Normal K+ = 3.5-5.0meq
Loop Diuretic - ANSWER - Lasix (severe HF)
,*contraindications*
caution w/ dig can cause hypokalemia
SE: intravascular volume depletion (IVVD), prerenal azotemia, hypotension,
hypokalemia, skin rash, GI, ototoxicity
L=L
ACEI - ANSWER - Lisinopril
- Captopril
*indications*
1st line CHF, reduce systemic vascular resistance (SVR), antagonize RAAS, reduce LV
remodeling.
HTN, CAD, DM, CKD, HFpEF, MI, HFrEF
*contraindications*
acute renal failure, hyperkalemia, hx angioedema
SE: angioedema, dry cough, renal failure, cough, hyperkalemia
ARB - ANSWER - Valsartan
- Candesartan
*indications*
Same as ACEI, but do not use together.
1st line CHF, reduce systemic vascular resistance (SVR), antagonize RAAS, reduce LV
, remodeling.
HTN, CAD, DM, CKD, HFpEF, MI, HFrEF
*contraindications*
renal insufficiency, elevated K
SE: angioedema (less freq), hyperkalemia
ARB-neprilysin inhibitor (ARNI)- ANSWER -Sacubitril-Valsartan
*indications*
HFrEF, decrease CV death & hospitalization for HF by 20%, for symptomatic HF on BB,
ACE, & mineralocorticoid, SBP> 100, gfr >30
BB - ANSWER *indications*
Decrease HR, Cardiac force, BP, systemic vascular resistance, prevention only,
increase EF by 10%, decrease LV size and mass in HF, HFpEF, MI, angina
*contraindications*
do not use in acute CHF, unstable HF. Start low and increase. can worsen symptoms
SE: decrease Left Ventricular Failure (LVF), bradycardia, AV block
Inotrope/Pressor, antiarrhythmia - ANSWER - digoxin
*indications*
blocks Na/K ATPase, increases intracellular NA, less excretion of calcium through the
Ca/Na cotransporter, increases strength of contractions, reduce HR, reduces sx in HF
and hospitalization, does of prolong life, use indicated w/ symptomatic HFrEF class II-IV
not responsive to first line tx, SVT.
CCB (NDHP) - ANSWER - verapamil
- diltiazem
