Boards Numbers through Dyslipidemia

spironolactone HF dose

12.5-50mg qd

spironolactone HTN dose

50-100mg qd

eplerenone HF dose

25-50mg qd

eplerenone HTN dose

50-100mg qd

carvedilol HF dosing

3.125-25mg BID with food

carvedilol HTN dosing

initial: 6.25mg BID → 12.5-50mg BID with food

metoprolol succinate HF dosing

12.5-200mg qd

bisoprolol HF dosing

1.25-Co10mg qd

Coreg IR (BID) to ER (qd)

3.125mg IR = 10mg ER

nitrate BP cutoff

SBP < 90mmHg

Nitrolingual, NitroMist repriming and EXP

Nitrolingual q6wk w/ 5 sprays, EXP 2yr

NitroMist q6wk w/ 10 sprays, EXP 3yr

enoxaparin renal dosing for VTE ppx

CrCl < 30: 30mg SQ qd

enoxaparin VTE ppx in knee surg

30mg SQ q12h x 7-10d

enoxaparin VTE ppx in hip surg

30mg SQ q12h OR 40mg SQ qd x 7-10d

enoxaparin abd surg

40mg SQ qd, start 2h preOP and continue up to 12d

enoxaparin VTE tx

1.5mg/kg SQ qd OR 1mg/kg SQ q12h

enoxaparin renal dosing in VTE tx

CrCl < 30: 1 mg/kg SQ qd

enoxaparin MI/UA/thrombolytic dosing

< 75 y/o: 30mg IV bolus + 1mg/kg SQ q12h

> 75 y/o: 0.75mg/kg SQ q12h

enoxaparin syringes

30mg/0.3mL, 40mg/0.4mL, 60mg/0.6mL, 80mg/0.8mL, 100mg/1mL, 120mg/0.8mL, 150mg/1mL

enoxaparin multi-dose vial

300mg/3mL

enoxaparin injection angle

90 degrees

how long is dabigatran good for once original bottle opened?

4m

mechanical prosthetic heart valve INR goal

2.5-3.5

heparin DVT tx flat rate dose

5000-10000 u bolus, then 1000 u/h

heparin DVT tx wt based dose

80 u/kg bolus, then 18 u/kg/h

heparin VTE ppx dose

5000-10000 u SQ q8-12h with 25G needle

heparin aPTT monitoring

q6h. if two therapeutic → q24h

when to check INR for heparin/warfarin bridge

3-5d

when to d/c heparin for warfarin bridge

INR > 2.0 for two consecutive days

aPTT < 35sec

80 u/kg bolus, increase rate by 4 u/kg/h 

aPTT 35-45s

40 u/kg bolus, increase rate by 2 u/kg/h

aPTT 71-90s

decrease rate by 2 u/kg/h

aPTT > 90s

hold infusion x1h, decrease rate by 3 u/kg/h

fondaparinux CrCl cutoff

30

DVT ppx in HIT pts

2.5 mg SQ qd

HCTZ max

50mg

sotalol CrCl cutoff

40

Entresto BP cutoff

SBP < 100mmHg

digoxin CHF levels

0.5-0.8 ng/mL

digoxin Afib lvls

0.8-2.0 ng/mL

digoxin dosing

0.125mg qd/QOD in renal pt or > 70 y/o

0.25mg qd otherwise

when to check digoxin levels

7d

clopidogrel dose

300-600mg LD, then 75mg qd

clopidogrel d/c preOP

5d

prasugrel d/c preOP

7d

ticagrelor d/c preOP

5d

prasugrel dosing

60mg LD, then 10mg qd

ticagrelor dosing

180mg, then 90 mg BID

thrombolytic timing in MI

w/in 12h

thrombolytic timing for ischemic stroke

3-4.5h

how long does alteplase last?

8h

how long does reteplase last

4h

tenecteplase stroke dosing

0.25mg/kg IV bolus over 5s, MAX 25mg

STEMI TNKase dosing

30-50mg IV bolus over 5s

alteplase stroke dosing

0.9mg/kg IV, max 90mg

10% bolus, remaining 90% CIVI over 1h

dabigatran VTE tx dosing

after 5d parenteral AC → 150mg BID

dabigatran CrCl cutoff (except Afib)

CrCl < 30

dabigatran VTE ppx hip surg

110mg x1 → 220mg qd x 28-35d

dabigatran VTE 2° ppx

150mg BID

dabigatran Afib dosing

CrCl > 30 150mg BID

CrCl 15-30 75mg BID

dabigatran preOP holding

CrCl >50 1-2d

CrCl <50 3-5d

fondaparinux VTE dosing

5-10mg SQ qd

rivaroxaban VTE tx dosing

15mg BID x21d → 20mg qd

rivaroxaban CrCl cutoff

15

rivaroxaban Afib dosing

CrCl > 50 20mg qd

CrCl < 50 15mg qd

rivaroxaban preOP hold

24h

rivaroxaban VTE ppx post knee/hip surg

knee 10mg qd x12d

hip 10mg qd x 35d

rivaroxaban reduction of CV event risk in CAD/PAD

2.5mg BID with ASA

apixaban Afib dosing

2.5-5mg BID

apixaban VTE tx dosing

10mg BID x7d → 5mg BID

apixaban post knee/hip surg

knee 2.5mg BID x12d

hip 2.5mg BID x35d

edoxaban Afib dosing

CrCl 50-95 60mg qd

CrCl 15-50 30mg qd

edoxaban VTE tx dosing

30-60mg qd

edoxaban CrCl cutoff

15

edoxaban VTE dose reduction criteria

<60kg, CrCl 15-50, concomitant Pgp inhibitors

warfarin preOP hold

5d

warfarin initial dosing

2.5-5mg qd x2d → titrate OR

10mg qd x2d → titrate

AC for cardioversion, Afib < 48h onset

cardiovert ASAP → 4wk AC

AC for cardioversion, Afib > 48h onset

clot on ECHO → 4wk AC → cardiovert → 4wk AC

no clot on ECHO → cardiovert → 4wk AC

AHA CHADSVASc females

>=3

AHA CHADSVASc males

>=2

adenosine dosing

6mg

if ineffective after 1-2min → 12mg → 12mg

BP goal in stroke for tPA INELIGIBLE

220/120

use prasugrel within how many days of container opening?

30

ASA stroke/MI dose

162-325mg x1, then 81mg qd

ASA sensitivity

salicylate, tartrazine dyes

when do troponin levels rise in MI?

3-6h

how long can troponin levels stay elevated for in MI

1 week

morphine SBP cutoff

90mmHg

NTG and PDE5i washout

tadalafil: 48h, others: 24h

transfer to PCI capable hospital within how long

120 min

rosuvastatin starting dose in Asians

5mg, max 20mg

gemfibrozil dosing

600mg BID before meals

weekly fish servings

1-2

niacin regular release dosing

6mg qd

niacin ER dosing

2mg qd

how to separate bile acid sequestrants from meds

1-2h before, 4-6h after other meds

statins efficacy monitoring

lipids 4-12 wks, then q3-12m

rosuvastatin renal dosing

10mg MAX if CrCl < 30

simvastatin dosing with nonDHP CCBs

10mg