pharm final

Factors that can lead ASCVD

HTN, Diabetes, obesity, smoking, seditary lifestyle, poor diet and high cholesterol levels.

Prevention for ASCVD

lifestyle and diet changes

What is ASCVD

plaque build up in the arteries resulting in poor to no perfusion.

effects of poor perfusion

Legs= arterial occlusion

brain= stroke

coronary= agina, ACS (MI/unstable)

What blood test is used to indicate an MI

troponin

Symptoms of stable angina

relived by nitrate, 1-3 minutes, SOB/irritated by activity, “controlled”

Unstable/Acute MI

worsens, unstable or ruptured, stemi/nonstemi, call 911, not relieved by rest

MI patient quotes

“elephant on chest” “heavy pressure”

nitrate mechanism

decrease preload

sign that nitroglycerin works

headache and tingles (normal)

what do diuretics do

inhib sodium channel, increased urination.

example of diuretic

hydrochlorothiazide

mechanism of ace inhibitor

inhibits angeotensin conversion to angiotensin 2.

are ace inhib safe with pregnancy?

no

main complication with ace inhibitor

angioedema

mechanism of ace inhibitor

vasodilator and relax blood vessel

remember ace inhib by…

“prils”

type 1 etiology?

destruction of beta cells—autoimmune no insulin

type 2 etiology?

insulin resistances/impairments

3 key signals to diabetes?

polyuria, polyphagia, polydispia (piss, hunger, thirst)

risk factors for 1

genetic predespoition

risk factors for 2

diet, age, lifestyle, fam history, a

acute complication of type 1

DKA

what is present in DKA that isn’t HHS

Ketones

type 1 doesn’t have enough insulin to not have ketones used, type 2 has just enough to not have ketones

treatment for type 1

insulin

treatment for type 2

insulin plus life changes

rapid acting insulin

lispro (30-3 hrs)sh

short acting (R)

Regular insulin

intermidiate acting insulin

NPH

long acting insulin

lantus

metformin info

first line

• decrease glucose prod and absorp, improver peripheral uptake and utilizing

  • stop for radiation and monitor kidney

GLP1 agonists

“tide”

• stim insulin, diet management

  • monitor weight

diabetic injury

neuropathy, retinopathy, myopathy

SGLT2 inhib

diabetes manage: flozin—farxiga

• increase glucose excretion, reduce blood glucose

  • adverse: hypovolemia, fungal/uti

DPP4 inhibit

blocking DPP4, increase insulin. “liptin”

• SJS, heartfailure, pancreatitis

• Sitagliptin (januvia)

Sulfonylureas

increase insulin by beta: g…ide

S.E: low salt, weight gain, anemia, liver issues

hypoglycemia

Thiazolidinediones

Pioglitazone

• adipose, muscle, liver increase glucose utilization, decrease production

• heart failure

Lab values for diabetes

below 5.6 A1C norm

5.6-6.5 pre diabetic

6.5 or more diabetic