Cardio Flashcards
Step 2 hypertension
Over 55 and Afro Caribbean - CCB or thiazide
Heart failure combination - 1st line
ACE + BB
Cholestyramine mechanism of action
Bile acid sequestration which binds to bile acids and promotes hepatic conversion into bile acids.
Cholestyramine counselling points
Other drugs should be taken at least 1 hour before or 4-6 hours after bile acid sequestrants.
What antifungal does simvastatin interact with?
Miconazole
Which antiarrythmic drug does simvastatin interact with?
amiodarone - so atorvastatin would be 1st line instead
normal triglyceride level
<1.8mmol/l. fenofibrate to be added if statin does not lower to normal range
what to prescribe if someone has tried two statins
colestyramine
what would you prescribe if qrisk is 15%
atorvastatin 20mg
would you stop simvastatin during pregnancy
yes
which macrolide does simvastatin interact with
clarithromycin
colestipol counselling point
other medicines to be taken 1 hr before/4hrs after
can bumetanide/furosemide be taken in the evening
no
which is more potent - bumetanide or furosemide?
bumetanide so give if pt is resistant to furosemide
furosemide electrolyte disturbance
hypokalaemia
hypokalaemia signs
fatigue, weakness, tiredness
salbutamol and furosemide can cause…
hypokalaemia
amisulpiride and furosemide can cause…
ventricular arrhythmias
inr 8.3, withheld now gums bleeding
give phytomenadione
high inr means…
blood is not clotting
should diet change with warfarin
no
what do you do if inr is high
stop warfarin for 1 day then return to usual 5mg warfarin od recheck inr in 7 days
warfarin in end of stage renal causes…
a rash
what is the inr target for af pts
2.5
tranexamic acid age
18+
maximum number of days tranexamic acid can be used
4
which drug is given just before pci
prasugrel
action required if nstemi pt is taking nifedipine
continue and refer to gp
positive d-dimer results means…
LMWH is needed
which class has a lower risk of heparin-induced thrombocytopenia?
LMWH
list the LMWH
enoxaparin, dalteparin, tinzaparin
35 yr old in third trimester with PE, crcl 84…
enoxaparin inj 80mg SC BD
enoxaparin side effect…
thrombocytopenia
how long is enoxaparin contraindicated for in a stroke
2 months
factor xa inhibitors/doacs list
apixaban, rivaroxaban
what do you give to someone who travels a lot to prevent a dvt
rivaroxaban
which drug do you stop and start after a tia/af
stop clopidogrel, start rivaroxaban
dose of rivaroxaban for nstemi and they’re taking aspirin
rivaroxaban 2.5mg bd for 12 months
tx and dose of dvt/pe
rivaroxaban 15mg bd for first 3 weeks then 20mg od for 3 months, if crcl is 15-49 15mg od
Prophylaxis of stroke with AF and one other risk factor (drug&dose)
rivaroxaban 20mg od/apixaban
5 apixaban tests
body weight, creatinine, u&e, lfts, fbc
initial ischaemic stroke tx and dose
aspirin 300mg od for 2 weeks and antiplatelet
aspirin 6 overdose symptoms
hyperventilation, vomiting, tinnitus, deafness, sweating, metabolic acidosis
what does not increase risk of haemorrhage with dabigatran
obesity
which hyper does amiodarone cause and name symptoms
hyperthyroidism - palpitations, sweating, irritable, weight loss, tired
what should you wear with amiodarone
suncream
three word symptom caused by amiodarone
toxic epidermal necrolysis
amiodarone tests
chest xray, tfts, lfts, potassium
which test can amiodarone increase
inr
which ccb does amiodarone interact with and what does it cause
diltiazem and bradycardia
which antipsychotic does amiodarone interact with and what does it cause
quetiapine and qt prolongation
afro Caribbean htn and type 2 diabetes
CCB and ACEi
which ccb needs to be the same brand
diltiazem
which ccb causes ankle swelling and oedema
amlodipine
which ccbs should not be used with bb
verapamil and diltiazem
which thiazide won’t work for egfr less than 30
bendroflumethazide
bendroflumethazide side effects
gout, hyperglycaemia, lithium toxicity, hypokalaemia
two things chlorothiazide can increase and two side efffects
urate and glucose, joint pain and swelling
As well as htn spironolactone treats…
ascites
spironolactone side effects
moobs and hyperkalaemia
which electrolyte disturbance is caused by digoxin
hypokalaemia
which score is used for AF
chadvasc
what is the htn target for diabetics?
130/80
which lab test do you check for a cvd?
c-reactive protein
if you took digoxin and indapamide together it can cause…
hypokalaemia
what should you do if a pt has had a recent fall and hypotension and they take ramipril?
change ramipril
what should you do if a pt has high levels of creatinine and takes ramipril?
stop ramipril immediately
frequency of pancreatitis with lisinopril
<0.01%
what would happen if you drank alcohol with ACEi and doxazosin?
faint
what would happen if you took digoxin and bisoprolol?
bradycardia
tx for heart failure
ace and bisoprolol
beta blockers exacerbate…
asthma
side effect of propanalol
fatigue
bbs are contraindicated in…
severe peripheral vascular/arterial disease
propanalol and adrenaline can cause…
bradycardia
which antihypertensive is least likely to cause mouth ulcers?
bbs
which two electrolyte disturbance is caused by bb and the se associated?
hypo/hyperglycaemia - tingly
se of carvedilol and overdose symptom
anaemia and cardiac arrest
do you need to adjust carvedilol in renal impairment?
no
which alpha blocker enhances carvedilol
doxazosin
nitrates interact with
sildenafil and tadalafil
action to be taken if isosorbide mononitrate increased from 40 bd to 60 bd
discuss with gp meds need to be reviewed
how long does gtn effect last
20-30 mins
apixaban indications
dvt
pe
prophylaxis of stroke and non-valvular AF
gtn indications
angina
congestive HF
anal fissure
spironolactone and ramipril causes…
hyperkalaemia
which test should be conducted if myopathy with atorvastatin
creatinine kinase
how many compressions and rescue breaths
30 and 2
1st line for AF
BB except sotalol
dabigatran counselling point
same time each day
what to report - pt taking theophylline for first time
vomiting and palpitations
typical symptoms of toxicity
nausea and vomiting
dabigatran mechanism of action
thrombin inhibitor
rate control tx for af
bb(not soltatol) or verapamil/diltiazem
