Blood pressure goals: Pre: < 140 and <90 (lifestyle modifications) Stage 1 HTN 140-159 or 90-99 (lifestyle and medications) Stage 2 HTN > 160 or >100 (lifestyle and 2 meds) JNC 8 When to start treatment Goal >=60 years old >=150/90 <150/90 <60 years old >=140/90 <140/90 >=18 years old + DM or CKD >=140/90 […]
Beta-Blockers
B1 Selective Blockers Non-Selective Blockers (B1 and B2) Mixed Blockers (Beta and alpha) Hydrophilic acebutolol, atenolol, bisoprolol (both), esmolol nadolol, pindolol, sotalol Lipophilic bisoprolol (both), metoprolol, nebivolol propranolol carvedilol, labetalol Some points: Avoid mixed and non-selective agents in asthma. Alpha blockade causes vasodilation, decreases peripheral resistance, and causes no reflex tachycardia. (acronym: Can Let No […]
AHA Lipid Guidelines
Risk Group Intensity of Therapy Desired LDL-C Lowering Moderate ASCVD Moderate Intensity Statin 30-50% Established ASCVD or DM + 10 year risk > 7.5% High-intensity statin >50% High-Intensity Statins atorvastatin – 40-80 mg rosuvastatin – 20-40 mg Moderate Intensity Statins atorvastatin – 10-20 mg rosuvastatin – 5-10 mg simvastatin – 20-40 mg pravastatin – 40-80 mg lovastatin […]
Unusual Cases of MI
Right MI Right MI is preload dependent, avoid nitro and morphine (both decrease preload) Early PCI is recommended unless liver or pulmonary failure or cancer, acute chest pain and low likelihood of ACS, patients who will not consent to revascularization. These patient patients should get ASA or clopidogrel or ticagrelor. Cocaine-Induced MI Acute cocaine use is […]
Pharmacoeconomic Studies
The easy thing is to memorize this chart and pick out the keywords from the questions. These are easy to get correct. Method: Cost-minimization Drugs are equal Only cost is considered. For example, choosing which ACEI goes on the formulary Cost-effectiveness Drugs are not equal, $$$ Looking at outcomes (decrease in BP, decrease in glucose). […]
Unsafe Abbreviations
Read through the ISMP’s Unsafe Abbreviation Guide. It’s more comprehensive than the Joint Commission’s and they overlap. Here are a few things you should know. You may use range orders according to your hospital protocol. PRN range orders must include a symptom. Pain PRN meds must include some type of scale. You shouldn’t have multiple […]
References to Know
There may be questions on the test about “where would you go to find [info]” or “Which online database would this study be found in.” The are easy to guess if you know at least what most databases contain and how often they are updated. Medline: Most of us know how Medline works, but: Know […]
Vitamin B12
Vitamin B12 needs to be transported to be absorbed. Some people don’t transport well. That’s why we supplement over RDA (saturation also increases absorption). Cyanocobalamine works better, especially in older adults. You don’t acidity to absorb it. You can give 1000 mcg twice a week, 2500 mcg once a week or 25-100 mcg daily.