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Cardiology Boards

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