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Cardiology Boards

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Question
Answer
QT prolonging drugs   Class Ia, Class III, erythromycin, haldol, cisapride, anti-histamines  
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Class Ia drugs   quinadine, procainamide, disopyramide  
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Class III drugs   sotalal, NAPA, ibutalide, dofetalide, amiodarone  
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Potentiate warfarin effect   amiodarone, propafenone, quinadine, erythromycine  
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antagonize warfarin effect   rifampin, vitamin k, barbiturates  
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increase digoxin levels   amiodarone, quinadine, flecainide, propafenone, verapamil  
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lower digoxin levels   antacides, phenytoin, reglan,  
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drugs affected by grapefruit (increased levels)   statins, terfenidine, felodipine/nifedipine, verapamil,versed, cyclosporine  
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calcineurin inhibitor side effects   HTN, renal insufficiency, hemolytic uremic syndrome (HUS), bone marrow suppression, cushing syndrome  
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cyclosporine side effects   gingival hyperplasia, hirsutism, tremor  
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tacrolimus side effects   glucose intolerance  
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azathiprine   hepatic dysfunction, increased levels with allopurinol (more bone marrow suppression)  
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MMF   GI intolerance, viral infections  
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rapamycin   poor wound healing, oral lesions, hyperlipidemia  
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lipophilic b-blockers metabolized in liver   propranolol, metoprolol, labetolol  
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hydrophilic b-blockers metabolized by kidney   atenolol, nadolol, sotalol  
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Sotalol and dofetilide - mode of elimination   renal elimination antiarrythmics  
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hepatic elimination antiarrythmic meds   quinidine, lidocaine, mexilitine, phenytoin, propafenone, amiodarone, diltiazem  
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drugs that require 50% dose reduction in pts with moderate cirrhosis   warfarin, statin, verapamil/nifedipine, propafenone  
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hepatic metabolism inhibitors   cimetidine, diltiazem, verapamil, erythromycin, anti-fungals  
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hepatic metabolism inducers   barbiturates, carbamezapine, phenytoin, rifampin  
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drugs that increase risk of statin related myopathy   gemfibrozil, niacin, verapamil, amiodarone, CSA, anti-fungals, HIV drugs, grapefruit juice -- decrease dose of statin 50%  
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incidence of rupture with lytics   no increase if lytics given early, but it can occur early if lytics given late (>14 h)  
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absolute contraindications to lytics   any ICH, known AVM, known IC neoplasm, ischemic CVA within 3 months, active bleeding, CHI or facial trauma within 3 months, suspected dissection  
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diabetic retinopathy and menses - contraindication to lytics?   no  
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risk of ICH with different lytics   SK < tPA and TNK < rPA < TNK+LMWH age>75  
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which heparin do you use with lytics?   ONLY UFH (IIb age <75) (III age >75)  
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blood thinners to give with lytic therapy   UFH or LMWH (but lower dosing), ASA, Plavix (excluded pts >75 in COMMITT and CLARITY)  
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LMWH in Primary PCI   no role, always use UFH  
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blood thinners to give with primary PCI   UFH, ASA, GPIIb/IIIa (Abciximab), Plavix  
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Class I Recs Primary PCI   MI < 12h, door to balloon < 90 mins  
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Class I Primary PCI for Shock or new LBBB   < 18 hours of shock or <36h h of MI < 75 years old  
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Supravalvular aortic stenosis   associated with hyperlipidemia and Williams Syndrome  
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