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WorksheetsCARDIO EXAM 3 DRUGS/MOA/BBW/DETAILS P1
Total questions: 74
Worksheet time: 4hrs 4mins
Which of the following drugs Induce or Exacerbate HF by having Negative inotropic effects? Select all that apply
Verapamil
Aspirin
Diltiazem
Glucocorticoids
Non-DHP CCB
Which of the following drugs Induce or Exacerbate HF by Sodium and water retention ? Select all that apply
NSAIDs, Thiazolidinediones
Androgens
estrogens
Glucocorticoids
COX-2 inhibitors
Which of the following drugs Induce or Exacerbate HF by Sodium and water retention ? Select all that apply
Rosiglitazone
Pioglitazone
Thiazolidinediones
Amlodipine
DHP CCB
Which of the following drugs Induce or Exacerbate HF by having other effects? Select all that apply
Nifedipine
DPP4 inhibitors (alogliptin and saxagliptin)
Cilostazol
Sympathomimetic (cocaine, caffeine)
Amlodipine
Which of the following are drugs that decreases Morbidity and Mortality (M&M)? Select all that apply
ACE inhibitor
Beta Blockers
Angiotensin Receptor Neprilysin inhibitor (ARNI)
(Sacubitril/valsartan (Entresto®)
Hydralazine and Nitrates
Sodium glucose co-transporter 2 (SGLT2) inhibitors
(Dapagliflozin & Empagliflozin)
Which of the following is TRUE about drugs that decreases Morbidity and Mortality (M&M)?
Diuretics
Digoxin
Mineralocorticoid/Aldosterone Receptor Antagonists (MRAs/ ARAs)
Ivabradine (Corlanor®)
Furosemide
Which of the following are drugs decrease symptoms only in HF? Select all that apply
Diuretics
Digoxin
Ivabradine (Corlanor®)
Hydralazine and Nitrates (Selected patients ONLY)
Beta Blockers
Which of the following is recommended in all patients with HFrEF with current or prior symptoms unless contraindicated?
Verapamil
Diltiazem
Beta Blockers
Non DP Calcium Channel Blockers
Which of the following are TRUE about benefits of β-blockade (when added to an ACE inhibitor)? Select all that apply
Diuretics decreased mortality
Digoxin decreased hospitalizations
Decreased hospitalizations
Decreased mortality
Which of the following statements are TRUE about β-Blockers in HF ? Select all that apply
Recommended in all patients with HFrEF with current or prior symptoms unless contraindicated
Decreased mortality
Not a class effect
Decreased hospitalizations
Carvedilol also provides α1-blockade
Which if the following statements are TRUE about the target dose for Carvedilol? Select all that apply
80 mg daily
50 mg bid
25 mg bid if ≤ 85 Kg
3.125 mg bid
Which if the following statements are TRUE about the target dose for Metoprolol succinate?
3.125 mg bid
200 mg daily
12.5-25 mg daily
10 mg daily
Which if the following statements are TRUE about the target dose for Coreg CR?
80 mg daily
10 mg daily
200 mg daily
25 mg bid if ≤ 85 Kg
50 mg bid
Which if the following statements are TRUE about the starting dose for Metoprolol succinate?
3.125 mg bid
12.5-25 mg daily
10 mg daily
1.25 mg daily
Which if the following statements are TRUE about the starting dose for Carvedilol?
10 mg daily
3.125 mg bid
12.5-25 mg daily
1.25 mg daily
Which if the following statements are TRUE about the starting dose for Coreg CR?
3.125 mg bid
12.5-25 mg daily
10 mg daily
1.25 mg daily
Which of the following statements are TRUE when adding Beta Blockers to existing ACEi therapy?
at high dose when HF symptoms are stable, and patients are euvolemic
at least at a low dose when HF symptoms are stable, and patients are euvolemic
when HF symptoms are unstable, and patients
All of them are correct
Which of the following are TRUE about Beta Blockers dosing and administration? Select all that apply
Add to existing ACEi therapy when HF symptoms are stable, and patients are euvolemic
Start low and increase (double) the dose every 2 weeks or as tolerated to target dose
Avoid abrupt discontinuation
Should be considered even in patients with reactive airway disease or asymptomatic bradycardia
Should not be prescribed without diuretics in patients with current or recent history of fluid retention
Aim to achieve target dose in 8–12 weeks
Which of the following are TRUE if hypotension alone is a concern when taking higher doses of Beta Blockers and ACE Inhibitors as well?
try reducing the Beta Blocker dose first
try reducing the ACE inhibitor dose first
Remove both medications and refer to your doctor
try reducing the Beta Blocker target dose first
Which of the following cause a reduction in arterial blood pressure and thereby afterload?
Beta Blockers
ACE inhibitors
Calcium Channel Blockers
Non DP CB
Which of the following are recommended in all patients with HFrEF and current or prior symptoms, unless contraindicated? Select all that apply
Angiotensin Receptor Blockers (ARBs)
Ace Inhibitors
Aliskiren Inhibitor
Beta Blockers
Which of the following are recommended in all patients with HFrEF and current or prior symptoms, who are unable to tolerate an ACEi?
Bisoprolol
Beta Blockers
Angiotensin Receptor Blockers (ARBs)
Carvedilol
Ace Inhibitors are contraindicated in patients who? Select all that apply
has an increased in Mg
have experienced angioedema
has Diabetes
are pregnant or plan to become pregnant
Which of the following ACE Inhibitors has a target dose in HF of 10-20 mg bid?
Enalapril
Lisinopril
Ramipril
Captopril
Which of the following ACE Inhibitors has a target dose in HF of 20-40 mg daily?
Captopril
Enalapril
Lisinopril
Ramipril
Which of the following ACE Inhibitors has a target dose in HF of 10 mg daily?
Enalapril
Ramipril
Lisinopril
Captopril
Which of the following ACE Inhibitors has a starting dose in HF of 2.5mg bid ?
Enalapril
Lisinopril
Ramipril
Captopril
Which of the following ACE Inhibitors has a starting dose in HF of 2.5 - 5 mg daily ?
Lisinopril
Enalapril
Ramipril
Captopril
Which of the following ACE Inhibitors has a starting dose in HF of 1.25 –2.5 mg daily?
Enalapril
Ramipril
Lisinopril
Captopril
Which of the following are TRUE about using ACE Inhibitors? Select all that apply
Monitor Mg levels
Monitor SCr and K
Monitor BP and symptoms of hypotension
may cause cough
Which of the following is TRUE when taking or starting ACE Inhibitors?
Monitor SCr and Mg 1–2 weeks after starting or increasing the dose
Monitor SCr and K+ 1–2 weeks after starting or increasing the dose
Combining ACE Inhibitors and Angiotensin Receptor Blockers (ARBs) is No longer recommended due to which of the following? Select all that apply
renal dysfunction
increased risk of hypotension
hepatoxicity
hyperkalemia
increased risk of bleeding
Which of the following is considered the initial daily dose for Losartan (ARBs) ?
40 mg bid
25-50 mg daily
80 mg daily
4-8 mg daily
Which of the following is considered the initial daily dose for Valsartan (ARBs) ?
4-8 mg daily
25-50 mg daily
40 mg BID
80 mg BID
Which of the following is considered the target dose for Valsartan (ARBs) ?
40 mg BID
80 mg BID
160 mg BID
25-50 mg BID
Which of the following is considered the target dose for Losartan (ARBs) ?
25-50 mg QD
40 mg BID
160 mg BID
50-150 mg QD
Which of the following drugs is a direct renin inhibitor that showed no benefit and is Not recommended in HF?
Sacubitril and valsartan (Entresto®)
Aliskiren Inhibitor
Captopril
Carvedilol
Which of the following is TRUE about Sacubitril and valsartan (Entresto®)? Select all that apply
Aliskiren Inhibitor
Angiotensin Receptor Neprilysin inhibitor (ARNI)
PARADIGM-HF Trial: FDA approval: 2015
Reduce the risk of hospitalization and cardiovascular death
Direct renin inhibitor showed no benefit
Indicated in NYHA Class II-IV to reduce hospitalization and death
Which of the following is usually administered in conjunction with other heart failure therapies, in place of an ACEi or ARB?
Arixtra
Digoxin
Aliskiren Inhibitor
Sacubitril and valsartan (Entresto®)
Argatroban
Which of the following are the available strengths for Sacubitril in the Entresto? Select all that apply
24mg
26mg
49mg
97mg
103mg
Which of the following are the available strengths for Valsartan in the Entresto? Select all that apply
103mg
26mg
49 mg
51mg
24 mg
Which of the following are the available strengths for Entresto? Select all that apply
Entresto 24/26 mg
Entresto 49/51 mg
Entresto 97/103 mg
Entresto 99/106 mg
Which of the following should be monitored when using Sacubitril and valsartan (Entresto®)? Select all that apply
BP
K
angioedema
renal function
liver enzymes
Which of the following statements is TRUE when when starting Entresto? Select all that apply
No washout period required with an ACEi
36-hours washout period with an ACEi
No washout period required with an ARB
36-hours washout period with an ARB
Which of the following contraindications are TRUE about Entresto? Select all that apply
Concomitant use of an ACEi/ARB
No washout period required with an ARB
36-hours washout period with an ACEi when starting Entresto
H/o angioedema
Which of the following statements are TRUE about Hydralazine/Isosorbide Dinitrate? Select all that apply
Recommended in patients with HFrEF self-described as African Americans with NYHA class III-IV
In addition to ACEi and β-blockers to reduce M&M
Recommended in patients with HFrEF self-described as African Americans with NYHA class II-III
May also be useful in patients with current or prior symptoms of HFrEF who are unable to tolerate an ACEi or an ARB
Which of the following statements are TRUE about Hydralazine/Isosorbide Dinitrate? Select all that apply
Recommended in patients with HFrEF self-described as African Americans with NYHA class III-IV
Hydralazine is an arterial vasodilator
Isosorbide dinitrate stimulates nitric acid
In addition to ACEi and β-blockers to reduce M&M
May also be useful in patients with current or prior symptoms of HFrEF who are unable to tolerate an ACEi or an ARB
Which of the following is the fixed dose for hydralazine plus isosorbide dinitrate?
BiDil (hydralazine 75 mg plus isosorbide dinitrate 20 mg)
BiDil (hydralazine 37.5 mg plus isosorbide dinitrate 20 mg)
BiDil (hydralazine 75 mg plus isosorbide dinitrate 37.5 mg)
BiDil (hydralazine 20 mg plus isosorbide dinitrate 75 mg)
Which of the following must be monitored when taking BiDil? Select all that apply
Hypotension
Drug-induced lupus erythematous (DILE)
Headache
Hyperkalemia
We DO NOT start therapy of Aldosterone Receptor Antagonist (ARAs) in HF patients with? Select all that apply
SCr >2.5 mg/dL (males); Scr >2 mg/dL (females)
K > 5 mEq/L
eGFR < 30 ml/min/1.73m2
eGFR greater 30 ml/min/1.73m2
In the absence of hypokalemia (K < 4 mEq/L) supplemental K is not recommended when taking an aldosterone antagonist.
True
False
When taking Spironolactone or Eplerenone patients must monitor? Select all that apply
Gynecomastia with Spironolactone
K and SCr within 2–3 days and again at 7 days after starting therapy; then monthly for first 3 months; then every 3 months thereafter.
Hypomagnesium
Hepatoxicity
Which of the following SGLT2 Inhibitors is FDA approved in HFrEF without diabetes?
Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
Which of the following SGLT2 Inhibitors is an alternative to Dapagliflozin (Farxiga) recommended by guidelines?
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
Canagliflozin (Invokana)
Which of the following SGLT2 Inhibitors SHOULD NOT be initiated if eGFR <20 mL/min/1.73m2?
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
Which of the following are the Adverse Drug Reactions for SGLT2 Inhibitors? Select all that apply
Edema
Weight loss
Increased thirst
Increased urination
Which of the following is indicated in patients with evidence of fluid retention? Select all that apply
Spironolactone
Aldosterone Receptor Antagonist (ARAs)
Diuretics
Furosemide
Which of the following are TRUE about Diuretics? Select all that apply
Indicated in patients with evidence of fluid retention
Not to be used as monotherapy for HF
No benefit on mortality
Start with a low initial dose
If a patient has fluid overload, initiate and adjust therapy to result in 1–2 lbs. of weight loss per day (may be more aggressive in the inpatient setting).
While using Diuretics we must monitor and replace K and Mg as needed, especially with loop diuretics (goal with CV disease is K of 4.0 mEq/L or greater and Mg of 2.0 mEq/L or greater to minimize the risk of arrhythmias).
True
False
Loop Diuretics are preferred for patients with HF and symptoms related to hypervolemia.
True
False
Not all patients with HF will require loop diuretic therapy.
True
False
If hypotension or increases in SCr occur, decrease the diuretic first and maintain the ACE inhibitor if possible.
True
False
If hypotension or increases in SCr occur, decrease the ACE inhibitor first and maintain the diuretic if possible.
True
False
Loops diuretics has no impact on mortality.
True
False
When taking Loops Diuretics which of the following must be monitored? Select all that apply
BUN
Check for orthostasis routinely (sitting, standing BP, and HR)
K
SCr
Liver enzymes
If diuretic resistance to Loops Diuretics, which of the following drugs can be used in combination with Loop diuretics? Select all that apply
Eplerenone
Metolazone
Spironolactone
HCTZ
Mr. Jones is receiving Lasix 60 mg PO BID. What is the equivalent Bumex dose?
5 mg
20 mg
3 mg
13 mg
Mr. Sanchez is receiving Bumetanide 0.5 mg PO BID. What is the equivalent Torsemide dose?
40 mg
5 mg
20 mg
1 mg
Mr. Sanchez is receiving Torsemide 10 mg PO DAILY. What is the equivalent Furosemide dose?
30 mg
15 mg
20 mg
40 mg
Which of the following are TRUE about IV to PO Conversions in Diuretics? Select all that apply
Furosemide:
IV to PO- 1:1
Furosemide:
IV to PO- 1:2
Bumetanide and ethacrynic acid IV to PO- 1:1
Bumetanide and ethacrynic acid IV to PO- 1:2
Furosemide injection should be stored at room temperature
True
False
Which of the following are TRUE about Ivabradine (Corlanor®)? Select all that apply
HCN Channel Blocker (Hyperpolarization-activated Cyclic Nucleotide-gated)
reduce the risk of hospitalization in patients who are in sinus rhythm with resting heart rate ≥ 70 bpm
reduce the risk of hospitalization in patients on maximally tolerated doses of beta-blockers or have a contraindication to beta-blocker use
reduce the risk of hospitalization in worsening HF in patients with symptomatic (Class II & III) stable, chronic HF with EF ≤ 35%
Know what is highlighted!
Yes
No
Which of the following are TRUE about Digoxin? Select all that apply
No effect on mortality
decrease hospitalizations in patients with HFrEF
It is a cardiac glycoside derived from foxgloveplant (Digitalis purpurea)
has a Positive inotrope and a Negative chronotrope
0.125 mg/day and 0.125 mg every other day for > 70 years; renal insufficiency; low lean body mass
