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CPJE Preperation 2
| Question | Answer |
|---|---|
| How often do you change Scopolamine patch? | Q3 days |
| How do you use Scopolamine patch? | Place behind the ear, 4H prior to travel |
| . What are the routes of admin for Epinephrine? | IM, IV, SC |
| What is the DoC for cocaine overdose/hypertensive crisis? | Phentolamine (Regitine) |
| BP goal for patients with CAD | <130/80 |
| BP goal for patients with CHF | <120/80 |
| What forms does Diuril come in? | Chlorothiazide; tabs, susp, and IV (only thiazide in injectable) |
| What are the SE of Thiazides? | Decreases Mg, K, Na, Cl. Increases Ca, Uric Acid, Glucose, and Lipids. Rash, Sulfa allergy, Preg Cat. D |
| Can you use Thiazides in patients with renal failure (CrCl<30mL/min)? | No. |
| Can you use Thiazide-like diuretics for renal patients? | Yes. Metolazone (Zaroxolyn, Mykrox) and Indapamide (Lozol). |
| What forms does Lasix come in? | IV, IM, PO (tabs, oral solution) |
| SE for LOOP diuretics? | Decrease in Mg, K, Ca, Na, Cl. Increase in Uric Acid, Lipids, Glucose. Rash, Lupus, Ototoxicity. |
| Can you use a LOOP diuretic for patients with Sulfa allergy? | Yes, Ethacrynic acid (Edecrin). |
| What diuretics are used in Renal patients? | LOOPS |
| List the Potassium-Sparing diuretics | ATSE Amiloride (Midamor) Triamterene (Dyrenium) Spironolactone (Aldactone) Eplerenone (Inspra) |
| Aldactone Side Effects? | Gynecomastia & Hirsutism (similar to ketoconazole & cimetidine) |
| What are the 2 diuretics used for end-stage HF? | Spironolactone & Eplerenone |
| What is the dosing for Inspra? Contraindicated in what? | HTN: up to 50mg BID. CHF: 50mg QD CI: K > 5.5mEq/L CrCl <30mL/min Strong inhibitors |
| SE for K-Sparing diuretics? | Increase in K Decrease in Na Rash and Headache |
| What is the DoC (diuretic) for Hypercalcemia? | Loops |
| What are the Beta Blockers used for CHF? | Carvedilol (Coreg) Metoprolol succinate (Toprol) Bisoprolol (Zebeta) |
| What is the only Beta blocker used for HTN emergency and/or SVT? | Esmolol (Breviblock) |
| What beta blockers are taken with food? | Carvedilol (Coreg) Metoprolol (Lopressor) Propranolol (Inderal) |
| What is the only Beta blocker used for arrythmias? | Sotalol (Betapace) |
| Can you use Bystolic for renal patients? | Dose adjust if CrCl <30mL/min |
| What Beta Blockers can you use for patients with Asthma/COPD? | Atenolol, Metoprolol, Esmolol, Bisoprolol, Betaxolol, Bystolic, Acebutolol |
| What Beta Blockers come in IV? | Metoprolol, Atenolol, Labetalol, Esmolol, Propranolol |
| SE for Calcium Channel Blockers (CCB)? | Flushing, Constipation, Bilateral Edema, Gingival Hyperplasia |
| Are CCB's substrates, inhibitors or inducers? | Subtrate and Inhibitor |
| What is Nimodipine used for? Contraindicated in what allergy? | Subarachonoid hemorrhage; soy & egg allergy |
| How long can you use Cleviprex after puncturing the stopper? | 4 hours then discard |
| What are the indications for Nicardipine? | Nicardipine SR = only for HTN. Cardene = angina, CHF |
| What CCB can be used for CHF? | Nicardipine (Cardene) since it does not decrease myocardial contractility |
| What is the DoC for Prinzmetal angina and Reynaud's Phenomenon? | Calcium Channel Blockers |
| Can you crush Plendil? | No, because it is an extended release tablet |
| Can you cut Toprol XL? | Yes, even if it's an extended release tab. |
| What is the indication for Nifedipine IR? | Angina and Reynaud's |
| How do you give Captopril? | BID/TID bec of its short half-life and on EMPTY stomach |
| What ACE Inh can you give to patients with renal failure? | Moexipril (Univasc) Fosinopril (Monopril) |
| What are the contraindications for using ACE Inh? | Renal failure (SCr >3mg/dL) Renal artery stenosis = Hyperkalemia Pregnancy Cat. D |
| What is the DoC for African-Americans? | CCB and diuretics |
| ACE Inh is the DoC for what? | DM, CHF, MI |
| What happens when a patient is taking both ACE Inh and Lithium? | Lithium levels increase by 300% bec ACE Inh decreases levels of Na. |
| What is Tekturna? SE? | Aliskiren, a direct renin inhibitor; diarrhea. |
| What is the dosing for Tekturna? | 150mg or 300mg QD |
| Can you use Uroxatral for renal patients | Alfuzosin has to be used with caution in patients with CrCl <30mL/min |
| Can you use Silodosin for renal patients? | Silodosin (Rapaflo) 4mg daily with meals if CrCl = 30-50mL/min; don't use for CrCl <30mL/min |
| What is the other name for Cialis? | Tadalafil (generic) Adcirca, 40mg for pulmonary HTN |
| What is Vardenafil? | Levitra |
| What are the other names for Sildenafil? | Viagra Revatio, 20mg TID for pulmonary HTN |
| What is Caverject? Dosing? | Alprostadil for erectile dysfunction given as a 2.5mcg injection. Max: 60mcg no more than 3x QW. |
| What is Muse? | Alprostadil pellet, no more than BID |
| Which alpha adrenergic blockers are also 3A4 substrates? | Alfuzosin (Uroxatral) and Silodosin (Rapaflo) |
| What are the indications for Guanfacine? | Tenex, for HTN Intuniv, for ADHD. |
| What is Aldomet? SE? | Methyldopa SE: ***CALL Colitis Anemia Liver, Lupus |
| Major SE for Reserpine? | Depression |
| What is Apresoline? | Hydralazine |
| What is Loniten? | Minoxidil; Rogaine, OTC for hair growth |
| What is Lotrel? | Benazepril and Amlodipine |
| What is Exforge? | Valsartan and Amlodipine |
| What is Lexxel? | Enalapril and felodipine |
| What is Tarka? | Trandolapril and Verapamil |
| What is Ziac? | Bisoprolol and HCTZ |
| What is Azor? | Amlodipine and Olmesartan |
| What is Twynsta? | Telmisartan and Amlodipine |
| HTN medications used for pregnant patients? | Hydralazine Labetalol Methyldopa Nifedipine |
| What are signs and sympoms of end organ damage present in HTN emergencies? | Brain: severe HA/neuro S/S Heart: angina/shortness of breath/EKG changes Eyes: Papilledema/blurry vision Kidneys: major acute renal dysfunction |
| What's the goal BP reading when dealing with HTN emergency? | Decrease BP by 10-15% or DPB 110 |
| What are the drugs used for HTN urgencies? | Captopril Labetalol Amlodipine Clonidine |
| What are the meds used for HTN emergency (IV drugs)? | Sodium nitroprusside (Nipride, Nitropress) Cleviprex Labetalol Esmolol (Brevibloc), Enalapril Nitroglycerin,Nicardipine Fenoldopam(Corlopam) Phentolamine |
| What is the antidote for cyanide poisoning? | Sodium nitrate + sodium thiosulfate |
| What forms does Hydralazine come in? | Tabs, IV, IM |
| What are the therapuetic levels for Digoxin in CHF? | 0.5 - 0.8 mg/mL |
| What are the therapeutic levels of Digoxin when treating arrythmias? | 0.8 - 2.0 mg/mL |
| What drugs displace Digoxin? | Verapamil Amiodarone Quinidine |