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94 Cards in this Set
- Front
- Back
Ace Inhibitor common ending
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PRIL
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Ace inhibitors cause increase potentiol for _______kalemia
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hyper- the decrease te excretion of potassium by suppressing aldosterone secretion
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ARB common ending
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SARTANS
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Common ending for CCB's
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dipines - also includes Dilitazem (Cardizem) and Verapimil
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CCB's work by ________ arterioles
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dilating
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A patient with hypotension is ordered a CCB would you give this drug
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No- the dilated arterioles decrease BP
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Ace Inhibitors stop the conversion of
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Angiotensin I to Angiotension II
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ARB's stop angiotensin II from causing
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Vasoconstriction
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Aldosterone Receptor Blockers block
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Aldosterone
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When an Ace inhibitor is given it blocks _________ and increases __________
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Angiotensin II, Bradykinin
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When Angiotensin II is blocked the result is
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Vasodilation, decreased blood volume, decreased cardiac and vascular remodeling, potassium retention and fetal injury
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When Bradykinin is increased the result is
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Vasodilation, Cough and Angioedema(rare)
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These therapeautic uses are for which drug class- HTN, Heart failure, MI, Diabetic and non diabetic nephropathy, prevention of MI and stroke or death in clients at high cardiovascular risk
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ACE INHIBITORS
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ACE inhibitors work on nephropathy by
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increasing kidney perfusion
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Cardiac Remodeling is
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Bad- ventricles dilate, hypertrophy, heart more sperical, increased wall stress and decreased LV function
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This drug class has been shown to prolong life by causing a stand still or reversal of cardiac remodeling
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ACE INHIBITORS
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What is the #1 reason to stop ace inhibitors
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cough
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ACE INHIBITORS are given at night. Why?
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Hypotension - they also cause first dose hypotension
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This ace inhibitors is bad in lupus, scleraderma and collage disorders
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Captopril
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A patient with Bilateral Kidney stenosis should not recieve which drugs
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ACE INHIBITORS and ARB's
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This class of drugs interacts with Diuretics, antihypertensive agents, lithium and NSAIDS
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Ace inhibitors
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What happens when Lithium and Lisinopril are taken together
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As with any ace inhibitor the lithium level can accumulate to toxic amounts
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What happens when you take a NSAID with an ACE
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The ace inhibitors is decreased in effect
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Which labs would you monitor in a pt taking a Ace inhibitor
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WBC (neutropenia) and K+ if impaired renal fx
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ARBS therapeutic uses are the same as Ace inhibitors except they are also used for
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migranes
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Your HR, Contractility, blood volume and venous return make up what?
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cardiac output
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Which diuretics will you get more diuresis with? Thiazide or Loop?
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Loop (bumix, lasix)
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Therapeutic dig level is
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0.5-0.8ng/ml
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Primary htn has
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no identifiyable cause, chronic and progressive
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Secondary HTN has
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a treatable underlying cause
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Hydralazine dilates (veins or arterioles)
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Arterioles, the direct action is on the vascular smooth muscle
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Drugs that work on arterioles can cause what adverse reaction
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Reflex tachycardia- there is a decrease in arterial pressure,
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What med would you give to prevent reflex tachycardia?
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B blocker
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With prolonged use of hydralazine or Nitro what adverse effect may you get
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Increased Blood Volume- the low BP causes increasedaldosterone which tells the kidney to hold onto Na+ and H20
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What is the medication used for increased blood volume
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diuretic
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Hydralazine is the _____ choice for HTN
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3rd
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Nitroglycerines major adverse effect
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Postural Hypotension- due to relaxation of smooth muscle.
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Cardiac Output is a combination of
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HR, Contractility, blood volume and venous return
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Ionotropin is
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force of contraction
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Chronotropin is
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HR
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Normal PR
QRS |
PR 0.12 QRS 0.10
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Heart block pts would have a PR interval over
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0.20
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Afib that is asymptomatic is usually treated with
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Only coumadin to decrease risk of clots
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If you have a prolonged QRS you will have
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decreased contraction increase in heart failure
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What is the difference between ST elevation MI and non st elevated MI
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ST elevated MI is worse it means there has been a full occlusion with tissue death, A non ST elevated is a partial occlusion
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Criteria for Vtach
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No P wave, QRS > 0.12 Ventricle rate of 150-200
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Automaticity is
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the hearts ability to GENERATE electrical impulse
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Epoetin Alfa increases production of __________
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RBC's in bone marrow
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2 types of hematopoietic growth factors are
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Erythropoietin (RBC's)
Leukopoietic (WBC's |
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This drug is to decrease the risk of infection in myelosuppressive chemo pts, after a bone marrow transplant and to treat neutropenia
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Filgrastim (Neupogen)
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These 2 growth factors can be given SQ or IV
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Filgrastim (Neupogen) and Epoetin Alfa (procrit, epogen)
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Adverse effects of Epoetin Alfa include (3)
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HTN, Autoimmune pure red aplasia, cardiovascular events
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Adverse effects of Neupogen include
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Bone pain, leukocytosis
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With Epoetin Alfa what is the target Hgb and Max Hgb
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10-12gm/dl, MAX is 12
(Hgb should be monitored 2x wk |
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Sargramostim (Leukine) is used after ______________ to increase _____________
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bone marrow transplant, bone marrow recovery
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Leukine is given
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IV only
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Adverse effects of Leukine are
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Diarrhea, weakness, rash, malaise, bone pain, LEUKOCYTOSIS, thrombocytosis
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What lab should be monitored while on Leukine? At what value should the drug be stopped
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CBC 2x/wk
IF WBC > 50,000 stop drug |
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Oprelvekin (Interleukin-11) is a _______________ growth factor and is used to _____________
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Thrombopoietic,
Increase production of platelets |
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Oprelvekin (Interleukin-11) is given only
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SQ
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Oprelvekin (Interleukin-11) is used for
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myelosuppressive chemo to minimize platelet deficience and decrease need for transfusion
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Oprelvekin (Interleukin-11) adverse effects are
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Fluid retention(peripheral)
Cardiac Dysrhythmias, effects on eye, sudden death from hypokalemia, anaphylaxis |
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Calcium regulates _____________ in _____________
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contraction in vascular smooth muscle
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CCB's have ______ effect on veins
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NO
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The 2 coagulation pathways are
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Intrinsic and extrinsic
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Verapamil blocks ___________ in blood vessels and heart
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calcium channels
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Verapimil is used for
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Angina pectoris, essential hypertension and cardiac dysrhythmias
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Side effects of verapimil include
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Constipation, dizziness, flushing, HA, bradycardia, AV block
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Verapimil and Diltiazem have the same indications, Diltiazem causes less _____________
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constipation
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Nifedipine is a ___________ that works on
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CCB, Arterioles
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Nifedepine is more likely than verapamil to cause
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reflex tachycardia
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What are the therapeautic uses for Nifedepine
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Angina, hTN
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S/s of Dysrhythmias
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Dizziness, weakness, decreased exercise tolerance, dyspnea, fainting, palpations
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All drugs used to treat dysrhythmias also
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cause dysrythmias
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Quinidine is used to
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maintain SR in pts with AF who were converted with dig or cardioversion
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Class 1 dysrhthmics are ___________
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Sodium channel blockers
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Lidocaine is a class ____ it is used for
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1B, symptomatic VT, PVC's and prevention of V-fib
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When giving Lidocaine how is it given? What special considerations are there?
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IV, have crash cart and o2 avaiable
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Therapeutic level for Lidocaine
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2-5mcg/ml
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Class II antidysrhythmics are
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Beta Blockers
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Beta Blockers are used in SVT to
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slow ventricular rate of contraction
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Class III antidysrhythmics are
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Potassium Channel Blockers
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Which Drug is in class 3
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Amiodorone
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Amiodorone can be given _______ but the uses are different
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IV or Oral
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IV amiodorone
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Slows conduction thru AV node, prolong refractory period, used for acute suppression of VT and VFib, Onset is several hours
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Oral Amiodorone is used to
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treat recurrent VT or Vfib, maintain NSR after conversion, onset in days-a week
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Amiodorone can cause
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hypothyroidism, it is iodine rich
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Other side effects of Amiodorone
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Pulm fibrosis, myocardial depression, hypotension, bradycardia, hepatic dysfunction, CNS disturbance, bluish skin, peripheral neuropathy and muscle weakness
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What drug can cause a fatal reaction if given with IV verapamil
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IV propranolol, bradycardia and hypotension
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Myocardial perfusion only takes place during ______
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diastole
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Angina Pectoris is a
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sudden pain beneath sternum radiating to left shoulder and arm often
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During Angina Pectoris O2 supply is ___________ this is caused from ____________ leading to __________
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insufficent, plaque, CAD
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CAD progresses from ANgina to _______
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MI
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3 types of antianginal drugs are
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Organic nitrates, Beta Blockers, CCBS
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