AF Flashcards
What is CHA2dS2Vasc used for?
To determined the 1 year risk of ischaemic stroke in non-anticoagulated patient with AF
What does CHA2DS2 Vasc stand for?
Congestive Heart Failure Hypertension Age 75 or more Age 65-74 Diabetes mellitus Stroke/TIA/thrombo-embolism Vascular disease Sex female
What is HAS BLED used for?
Estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in atrial fibrillation care.
What does HASBLED stand for?
Hypertension Abnormal liver function Abnormal renal function Stroke Bleeding Labile INRs Elderly (Age>65) Drugs Alcohol
Which DOAC cannot go in a dossette box?
Dabigatran
Which DOAC is BD?
Apixaban
ACEi and spironolactone greatly increases the risk of what?
Hyperkalemia
What are the symptoms of hyperkalaemia?
Nausea, fatigue, muscle weakness, palpitations, tingling and numbness sensations
What CHADS2-VASc score should you offer an anticoagulant for a patient?
2 or more
Which DOACs are not easily reversed?
Rivaroxaban, apixaban, edoxaban
Which DOAC now has an antidote?
Dabigatran
Should a person with AF under 65 and no risk factors other than their sex be offered anticoagulation?
No
Anticoagulation should be offered to men with a CHADS2-VASc score of what?
1 or above
Which DOACs can go in a dossette box?
Apixaban, Rivaroxaban or Edoxaban
What does the INR need to be for someone switching from warfarin to the following drugs:
a) dabigatran
b) Rivaroxaban
c) Apixaban
d) Edoxaban
a) <2
b) 3 or less
c) <2
e) 2.5 or less
Which DOAC should not be used in patients above 80?
Dabigatran 150mg BD
What is the BCAP forumlary prefferedd DOAC?
Apixaban 5mg BD
Do not offer aspirin monotherapy solely for stroke prevention to people with AF. True or False?
True
What are the symptoms of AF?
Irregular pulse, breathlessness, palpitations, syncope/dizziness, chest discomfort, stroke/TIA
What would be classes as poor anticoagulation control?
2 INR values higher than 5 or 1 INR value higher than 8 within the past 6 months
2 INR values less than 1.5 within the past 6 months
TTR less than 65%
What should be offered as monotherapy to people with atrial fibrillation who need drug treatment as part of a rate control strategy?
Either a standard beta blocker (not sotalol) or a rate limiting calcium channel blocker
If monotherapy for rate control does not control symptoms what should be offered?
Combination therapy with any 2 of the following:
Beta blocker
Diltiazem
Digoxin
What are the symptoms of AF?
Breathlessness/dyspnoea Palpitations Syncope/dizziness Chest discomfort Stroke/transient ischaemic attack
What should be offered as combination therapy if beta blocker/CCB does not work alone?
a beta blocker
diltiazem
digoxin
Should amiodarone be offered as long term rate control for AF?
No
What should be considered being started 4 weeks before and for up to 12 months after electrical cardioversion to maintain sinus rhythm?
Amiodarone
