308 Cardiovascular drugs: 1 and 2 Flashcards
What is HBPM?
Home BP Monitoring
What are the symptoms of hypertension?
None – ‘Silent Killer’
Headache
Blurred vision
Dizziness
Shortness of breath
Palpitations
Epistaxis
What is a fundoscopy?
Ophthalmoscopy
Detects eye problems, such as glaucoma, macular degeneration, eye cancer, optic nerve problems, or eye injury
What are some non-drug treatments for hypertension?
Weight reduction
DASH eating plan
Dietary sodium restriction
Physical activity
Alcohol moderation
What are the target blood pressures for different ages?
140/90 mmHg in people aged under 80
150/90 mmHg in people aged 80 and over
What are some reasons why treatment for hypertension may fail?
-Pseudo-resistant Hypertension (Non adherence; white coat effect; multiple intolerance to antihypertensive drugs)
-Secondary Hypertension
-Resistant Hypertension
What is the difference between and hypertensive emergency and urgency?
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
What are some clinical features of a hypertensive crisis?
Asymptomatic
Headache
Epistaxis
Presyncope
Palpitations
Chest pain
Dyspnoea
Neurological deficit
What are some acute signs of target organ damage for a hypertensive crisis?
Eyes (papilloedema)
Brain (encephalopathy, stroke)
Heart (pulmonary oedema, MI)
Kidneys (AKI)
Aortic dissection
What are some non-acute signs of target organ damage?
-Fundoscopy – Hypertensive retinopathy
-Urinalysis – Proteinuria
-ECG – LVH, AF
-Blood tests – U&E
What is the treatment for a hypertensive emergency?
Same day specialist review
IV Therapy – Labetalol, GTN, Sodium nitroprusside, Esmolol
What is the treatment for a hypertensive urgency?
Check for target organ damage
ABPM/HBPM
GP follow up within 7 days
Oral treatment
What is Ezetimibe therapy?
Used to treat primary hypercholestrolaemia in adults where initial statin therapy didn’t work or is contraindicated
Can be co-administered with statins
What is QRISK used for?
Risk of cardiovascular disease in the next 10 years
What are the risk factors for AF?
-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
What are the different types of AF?
-Lone AF
-Paroxysmal (<7 days)
-Persistent (>7 days)
-Permanent (>7 days ± Cardioversion)
What are clinical features of AF?
Asymptomatic
Palpitations
SOB
Chest pain
Syncope
Pre-syncope
Heart failure
What are the different treatment strategies for AF?
Rate control
Rhythm control
Anticoagulation
When do you do rhythm control vs rate control to treat AF?
<48hrs: rhythm control
>48hrs: rate control
When is rhythm control treatment preferred?
Symptom improvement
Younger patient
Inadequacy of rate control
Heart failure related to AF
Name some beta-blockers
Non-cardioselective:
Propanolol
Carvedilol
Sotalol
Cardioselective:
Atenolol
Bisoprolol
Esmolol
Metoprolol
Nebivolol
Vasodilatory:
Labetalol
Carvedilol
Name some rate limiting calcium channel blockers
Verapamil
Diltiazem
What is the CHA2DS2 VaSc score?
The risk of developing a stroke with AF
At what CHA2DS2 VaSc score are DOAC’s or warfarin prescribed?
> 2
