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3. Mondays > 308 Cardiovascular drugs: 1 and 2 > Flashcards

308 Cardiovascular drugs: 1 and 2 Flashcards

1
Q

What is HBPM?

A

Home BP Monitoring

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2
Q

What are the symptoms of hypertension?

A

None – ‘Silent Killer’
Headache
Blurred vision
Dizziness
Shortness of breath
Palpitations
Epistaxis

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3
Q

What is a fundoscopy?

A

Ophthalmoscopy

Detects eye problems, such as glaucoma, macular degeneration, eye cancer, optic nerve problems, or eye injury

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4
Q

What are some non-drug treatments for hypertension?

A

Weight reduction
DASH eating plan
Dietary sodium restriction
Physical activity
Alcohol moderation

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5
Q

What are the target blood pressures for different ages?

A

140/90 mmHg in people aged under 80

150/90 mmHg in people aged 80 and over

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6
Q

What are some reasons why treatment for hypertension may fail?

A

-Pseudo-resistant Hypertension (Non adherence; white coat effect; multiple intolerance to antihypertensive drugs)
-Secondary Hypertension
-Resistant Hypertension

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7
Q

What is the difference between and hypertensive emergency and urgency?

A

Emergency:
Severe “hypertension”
(BP≥ 180/120 mmHg) with acute damage to the target organs
Lower BP in minutes to hours

Urgency:
Severe “hypertension” without acute damage to the target organs
Lower BP after a review within 7 days

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8
Q

What are some clinical features of a hypertensive crisis?

A

Asymptomatic
Headache
Epistaxis
Presyncope
Palpitations

Chest pain
Dyspnoea
Neurological deficit

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9
Q

What are some acute signs of target organ damage for a hypertensive crisis?

A

Eyes (papilloedema)
Brain (encephalopathy, stroke)
Heart (pulmonary oedema, MI)
Kidneys (AKI)
Aortic dissection

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10
Q

What are some non-acute signs of target organ damage?

A

-Fundoscopy – Hypertensive retinopathy
-Urinalysis – Proteinuria
-ECG – LVH, AF
-Blood tests – U&E

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11
Q

What is the treatment for a hypertensive emergency?

A

Same day specialist review

IV Therapy – Labetalol, GTN, Sodium nitroprusside, Esmolol

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12
Q

What is the treatment for a hypertensive urgency?

A

Check for target organ damage
ABPM/HBPM
GP follow up within 7 days
Oral treatment

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13
Q

What is Ezetimibe therapy?

A

Used to treat primary hypercholestrolaemia in adults where initial statin therapy didn’t work or is contraindicated

Can be co-administered with statins

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14
Q

What is QRISK used for?

A

Risk of cardiovascular disease in the next 10 years

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15
Q

What are the risk factors for AF?

A

-Hypertension
-Age
-Cardiac disorders - Valvular heart disease; Coronary artery disease; Cardiomyopathy; Congenital heart disease; Previous cardiac surgery; Pericarditis
-Lung disease - PE, Pneumonia, COPD, OSAS
-Hyperthyroidism
-Alcohol, High BMI, Smoking
-Electrolyte disorders – Magnesium; Potassium
-Diabetes

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16
Q

What are the different types of AF?

A

-Lone AF
-Paroxysmal (<7 days)
-Persistent (>7 days)
-Permanent (>7 days ± Cardioversion)

17
Q

What are clinical features of AF?

A

Asymptomatic
Palpitations
SOB
Chest pain
Syncope
Pre-syncope
Heart failure

18
Q

What are the different treatment strategies for AF?

A

Rate control
Rhythm control
Anticoagulation

19
Q

When do you do rhythm control vs rate control to treat AF?

A

<48hrs: rhythm control
>48hrs: rate control

20
Q

When is rhythm control treatment preferred?

A

Symptom improvement
Younger patient
Inadequacy of rate control
Heart failure related to AF

21
Q

Name some beta-blockers

A

Non-cardioselective:
Propanolol
Carvedilol
Sotalol

Cardioselective:
Atenolol
Bisoprolol
Esmolol
Metoprolol
Nebivolol

Vasodilatory:
Labetalol
Carvedilol

22
Q

Name some rate limiting calcium channel blockers

A

Verapamil
Diltiazem

23
Q

What is the CHA2DS2 VaSc score?

A

The risk of developing a stroke with AF

24
Q

At what CHA2DS2 VaSc score are DOAC’s or warfarin prescribed?

A

> 2

25
Q

What is the HAS-BLED score?

A

Estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in atrial fibrillation care

H – Hypertension = 1
A – Abnormal renal/liver function = 1 point each
S – Stroke in the past = 1
B – Bleeding history = 1
L – Labile INRs = 1
E – Elderly = 1
D – Drugs/Alcohol concomitantly = 1 point each

26
Q

What is the ORBIT score?

A

Estimates the risk of major bleeding for patients on anticoagulation for AF

27
Q

What are some non-drug treatments for AF?

A

Radiofrequency catheter or cryo-ablation – pulmonary veins
(Useful for paroxysmal AF)

Left atrial appendage occlusion (LAAO)

28
Q

What are some reversible causes of AF?

A

Hypoxia
Hypovolemia
Hypo/hyperkalemia/metabolic
Hypothermia

Tension pneumothorax
Tamponade
Toxins
Thromboembolism

29
Q

What is the initial management for STEMI?

A

Morphine/Diamorphine (+antiemetic)
Oxygen
Nitrates ie. GTN infusion
Aspirin
Clopidogrel/Prasugrel/Ticagrelor

Percutaneous Coronary Intervention (PCI)

30
Q

What is Percutaneous Coronary Intervention (PCI)?

A

Minimally invasive procedures used to open clogged coronary arteries

31
Q

Name some ACE inhibitors

A

Ramipril
Lisinopril
Enalapril
Perindopril

32
Q

What are the causes about causes of sudden SOB?

A

Acute bronchospasm
Arrhythmia
Anxiety
Pulmonary oedema
Pneumothorax
Pulmonary embolism

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