a
Which is recommended for ALL patients?
a) Beta-Blocker
b) CCB
c) ACEi/ARB
d) Aldosterone Antagonist
e) statins
f) Aspirin
g) P2Y12 inhibitor
c
What is used to prevent cardiac remodeling?
a) Beta-Blocker
b) CCB
c) ACEi/ARB
d) Aldosterone Antagonist
e) statins
f) Aspirin
g) P2Y12 inhibitor
ACEi/ARB, aldosterone antagonist, statin, aspirn
If we decide to additional meds, which do we continue indefinitely? (4)
recommended for all patients, continue for 3 years; normal function; indefinite for LV dysfunction
Beta-Blocker notes? (3)
a,c,d
Which is recommended for patients with LV dysfunction?
a) Beta-Blocker
b) CCB
c) ACEi/ARB
d) Aldosterone Antagonist
e) statins
f) Aspirin
g) P2Y12 inhibitors
LV dysfunction (EF<40%) on BB, ACEi/ARB; HF symptoms or DM
Which patients are aldosterone antagonists recommended for?
f; may be falsely low after ACS event
We should choose the statin based off the LDL level. T/F?
continue indefinitely, 81 mg, if allergic use clopidogrel
Aspirin therapy notes? (3)
continue agent patient started on, a minimum of 12 months (Class I), high bleeding risk
P2Y12 therapy notes? (3)
liver dysfunction, age >75 use moderate intensity
Pre-cautions with Statin therapy? (2)
a
After 12 months, which option involves continuing ASA & discontinuing P2Y12?
a) option 1
b) option 2
c) option 3
d) option 4
b
After 12 months, which option involves continuing BOTH ASA & P2Y12?
a) option 1
b) option 2
c) option 3
d) option 4
c
After 12 months, which option involves changing the P2Y12 inhibitor to Ticagrelor 60mg BID?
a) option 1
b) option 2
c) option 3
d) option 4
d
After 12 months, which option involves discontinuing the P2Y12 inhibitor and starting Rivaroxaban 2.5 mg BID?
a) option 1
b) option 2
c) option 3
d) option 4
hypotension, brady/tachycardia, RV infarction, 5' phosho inhibitors
Nitroglycerin should be used with Caution in? (4)
sildenafil; vardenafil
Avoid using _______ & _______ 24 hrs after using Nitroglycerin.
tadalafil
Avoid using ________ 48 hours after using Nitroglycerin.
prevent by having 10-14 hour nitrate-free interval daily
How do we prevent Nitroglycerin Tolerance?
IV, sublingual, oral, ointment, patch
Rank the NTG products in terms of speed of action. (fastest-slowest)
keep in og dark container, keep close by, once opened needs to be refilled, contact 911 if first SL NTG doesn't relieve angina, take while sitting down
NTG patient education? (5)
BP < 130/80, A1c< 7%, pneumoccoal/influenza vaccines
What are our BP, DM, and vaccine goals for Post-Acute Care?
thienopyridine (p2y12), RAS, oxygen, morphine, beta blocker, invasive cardiac intervention, nitroglycerin, statin/salicylate
What is the treatment plan for Post-Acute care? (THROMBINS2)
hypotension/shock, SCr >2.5 (men) > 2.0 (women), K+ > 5
Aldosterone Antagonists should be used with caution if? (3)