CSC Pharmacology & Treatment Protocols Flashcards

Which medication is used to chemically cardiovert atrial fibrillation in a hemodynamically stable patient?

Answer: Ibutilide or flecainide

Ibutilide (IV) and flecainide (oral, in structurally normal hearts) are antiarrhythmics used for pharmacologic cardioversion of recent-onset atrial fibrillation.

Diuretics such as furosemide help in heart failure by:

Answer: Reducing intravascular volume and preload to relieve congestion

Loop diuretics like furosemide promote renal excretion of sodium and water, reducing preload and pulmonary/peripheral congestion in decompensated heart failure.

SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin) are now guideline-recommended in HFrEF because they:

Answer: Reduce hospitalizations and cardiovascular death regardless of diabetic status

SGLT2 inhibitors reduce heart failure hospitalizations and cardiovascular mortality in HFrEF patients regardless of diabetes status, now forming part of quadruple therapy.

Adenosine should be avoided in patients with:

Answer: Severe reactive airway disease (asthma) or high-degree AV block

Adenosine can cause severe bronchospasm in asthmatic patients and worsens high-degree AV block by further depressing AV nodal conduction.

The antidote for warfarin-induced life-threatening bleeding is:

Answer: 4-factor prothrombin complex concentrate (4F-PCC) plus vitamin K

4-factor PCC rapidly reverses warfarin by replacing factors II, VII, IX, and X, combined with IV vitamin K for sustained reversal in life-threatening bleeding.

Mineralocorticoid receptor antagonists (e.g., spironolactone) are added in HFrEF to:

Answer: Reduce mortality by blocking aldosterone-mediated cardiac fibrosis

Aldosterone antagonists block harmful aldosterone effects including myocardial fibrosis and sodium retention, providing additional mortality reduction in HFrEF beyond RAAS blockade.