Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BNF Cardiovascular > Arrythmia > Flashcards

Arrythmia Flashcards

1
Q

If etopic beats are troublesome, how can they be treated?

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If a patient has AF what 2 assessments can be carried out to assess risk?

A

CHADVASC + HASBLED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At what score on the CHADVASC would you consider treating?

A

more than or equal to 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If a patient has a HASBLED of <1 can they be treated?

A

Yes. 0-1 can be anticoagulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What score on the HASBLED tool is anticoagulation not suitable?

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 2 ways can AF be controlled?

A

Ventricular rate or attempting to restore sinus rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Presentation of AF patient

A

Palpitation, fatigue, SOB, syncope, chest discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 2 cardiac assessments to diagnose for AF

A

ECG + ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When must emergency electrical cardioversion be offered?

A

if patient presents with life threatening haemodynamic instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If a patient presents acutely without life threatening haemodyamic instability what type of treatment should be offered

A

if < 48 hours - Rate / rhythm

If > 48 hours - Rate preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If a patient is going to undergo cardioversion what drug options can be given IV

A

Amiodarone or Flecanide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What 2 drugs are used for urgent rate control?

A

IV beta blocker + verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long should a patient have been anticoagulated for if they have had AF >48 hours and are going to undergo cardioversion?

A

3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long after cardioversion should a patient be anticoagulated for?

A

4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

First line rate control drugs

A

Beta blocker + RL CCB (diltiaziem or verapamil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In what patients is Digoxin consider for rate control?

A

Sedentary patients or if they have CHF + AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why is Digoxin only considered for sedentary patients or CHF in AF?

A

It is only effective for controlling ventricular rate at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drug treatment post cardioversion

A

Beta blocker or oral anti-arrythmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Examples of oral anti-arrythmics

A

Flecanide, Propafone, Amiodarone, Dronedarone, Soltalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How many weeks prior to cardioversion can amiodarone be started?

A

4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How many months after cardioversion is amiodarone continued for?

A

12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If there is no ischaemic heart disease what 2 anti-arrhythmics cannot be given?

A

Flecanide or propafenone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What approach can be utilised in paraoxysmal AF?

A

Pill in pocket - with flecanide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should be offered to all patients wiht new onset AF?

A

Anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How is paroxysmal SV tacycardia treated?
Usually terminates spontaneously, if not give IV adenosine
26
Examples of Class 1 anti-arrthymics
1A: Quinidine 1B: Lidocaine, Mexiltene 1C: Flecanide, Propafenone
27
Examples of Class II anti-arrthymics
Beta blockers
28
Examples of Class III anti-arrthymics
Amiodarone, Soltalol, Dronedarone
29
Examples of Class IV anti-arrthymics
Verapamil, diltiaziem
30
What blood abnormality can lidocaine cause?
Methylhaemoglobinaemia ( treated wiht methylthionium chloride)
31
If flecanide is given concurrently with amiodarone what does the BNF recommend?
Reduce dose by half
32
What may soltatolol prolong?
QT interval
33
What 2 electrolyte imbalances must soltalol be avoided in?
HypOkalaemia + HypOmagnesemia
34
Dose regime of Amiodarone
200mg TDS 7 days, 200mg BD 7 days, 200mg OD maintenance
35
IV amiodarone dose
5mg/kg over 20-120 mins
36
What hep C drug can cause severe bradycardia wiht amiodarone
Sofosbuvir
37
Four major side effects of amiodarone
1. Corneal microdeposits 2. Pulmonarytoxicity 3. Thyroidtoxicity 4. Hepatoxicity
38
How is hypothyroidism associated with amiodarone treated?
Levothyroxine
39
What symptoms suggest amiodarone associated pneumonitis?
SOB, new persistent cough
40
What should you monitor with amiodarone therapy?
TFT (baseline + 6 months), LFTs ( baseline + 6 months), CXR (baseline), Potassium (baseline)
41
What should be monitored with IV amiodarone?
ECG
42
What should patients be advised about in regards to photosensitivity reactions with amiodarone?
Use SPF daily, shield from sunlight during and on several months of discontinuning ( long t1/2)
43
What route should adenosine be given by?
Large or centeral vein
44
What should be monitored wiht adenosine?
ECG
45
MHRA warning with soltalol
QT prolongation - can cause life threatening arrhythmias. Avoid in low K+ and Mg2+
46
What electrolyte imbalance should you be cautious of with Dronedarone?
Low K+ and low Mg2+
47
When should you discontinue treatment with Dronedarone in liver injury
If 2 consecutive alanine aminotransferase concentrations exceed 3 x ULN
48
If a patient hasa dry cough and are on dronedarone why do we need to be cautious?
Risk of pulmonary toxicity
49
Monitoring with Dronedarone
ECG< monitor for HF, serum creatinine (baseline + 7 days from initiation), LFT (baseline, 1 week and 1 month then monthly for 6 months then every 3 months)
50
How should adenosine be given?
Large central vein
51
Example of a caridac glycoside
Digoxin
52
At what HR limit should Digoxin be held?
<60bpm
53
If patient is in sinus rhythm with HF do they need digoxin loading?
No a satisfactory digoxin level can be achieved over one week
54
How often should Digoxin maintenance dosing be given?
OD dosing ( can split to BD if nausea is an issue)
55
What 2 factors add to the likelihood of unwanted side effects with digoxin?
1. Concentration of Digoxin | 2. Sensitivity of myocardium
56
What digoxin range is likely to indicate toxicity?
1.5 - 3 mcg/L
57
What electrolyte imbalance predisposes patients to digoxin toxicity?
Hypokalaemia (can be managed by adding in K+ sparring diuretics / supplements)
58
If Digoxin toxicity occurs, what is the antidocte?
Digoxin specific antibodies
59
How does Digoxin work?
Increases force of myocardial contractility and reduces conduction at the AV node
60
Dose of digoxin for rapid digitialisation
750 to 1500 mcg over 24 hours in divided doses
61
Maintenance dose of Digoxin in AF
125 - 250 mcg OD
62
Maintenance dose of Digoxin in HF
62.5 to 125mcg OD
63
If a patient is on concurrent amiodarone / dronedarone / quinine what does the BNF suggest to do to the Digoxin dose?
Reduce by half
64
By how much does the digoxin dose need to be increased by if switching from IV to PO?
20 - 33% in order to maintain same digoxin level
65
If digoxin monitoring is indicated, when should it be carried out?
6 hours post dose (ideal 8 - 12 hours) after at least 7 days of treatment
66
Target level of Digoxin (general)
0.8 to 2ng/mL
67
Target level of Digoxin in HF patients
0.6 - 0.8ng/L
68
Target level of Digoxin in AF patients
1 - 2 ng/L
69
Signs of Digoxin toxicity
Blurred yellow vision, nausea, Arrhythmia, Rash, conductive disturbances
70
How is the digoxin elixir administered?
Using pipette

BNF Cardiovascular (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions