Cardiac

Question 1

What is the contra-indications for warfarin

Answer 1

Avoid use within 48 hours postpartum, haemorrhagic stroke, significant bleeding

Question 2

Common side effects of warfarin

Answer 2

Haemorrhage

Question 3

What are the monitoring requirements for warfarin

Answer 3

1. Baseline prothrombin time
2. INR to be done daily or on alternate days once commenced on medication
3. (depending on response) INR up to every 12 weeks

Question 4

What are the cautions for warfarin

Answer 4

Significant bleeding risk
First DVT without continuing provoking risk factors (e.g thrombophilia) for longer than 6 weeks (no proven benefit)
First PE without continuing provoking risk factors for longer than 12 months (no proven benefit)

Question 5

What are the indications for warfarin

Answer 5

Prophylaxis of embolisation in rheumatic heart disease and atrial fibrillation
Prophylaxis after insertion of prosthetic heart valve
Prophylaxis and treatment of venous thrombosis and PE
TIA

Question 6

What are the Indications for Clopidogrel

Answer 6

Prevention of atherothrombotic events in percutaneous coronary intervention (adjunct with aspirin) in patients not already in clopidogrel
Prevention of atherothrombotic events in peripheral arterial disease or within 35 days of MI or within 6 months of ischaemic stroke
Prevention of atherothrombotic events and thromboembolic events in patients with AF and at least one risk factor for vascular event (with aspirin) and for whom are not suitable for warfarin

Question 7

What is the contra-indication for clopidogrel

Answer 7

Active bleeding

Question 8

Common Side effects of clopidogrel

Answer 8

Diarrhoea, gastrointestinal discomfort, haemorrhage, skin reactions

Question 9

Indications for Bisoprolol

Answer 9

Hypertension
Angina
Adjunct to heart failure

Question 10

Contra-indications for Bisoprolol

Answer 10

Beta blockers

Question 11

Common side effects of Bisoprolol

Answer 11

Abdominal discomfort, bradycardia, confusion, depression, diarrhoea, dizziness, dry eyes, dyspnoea, erectile dysfunction, heart failure, nausea, peripheral coldness, peripheral vascular disease, rash, sleeping disorders, visual impairment, vomiting

Question 12

Monitoring requirements for Bisoprolol

Answer 12

Monitor lung function (in pts with hx of obstructive airway disease)

Question 13

Cautions with Bisoprolol

Answer 13

Diabetics with frequent hypos
Bradycardia
Pts prescribed a non selective beta blockers with a hx of asthma requiring treatment (increased risk of bronchospasm)