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PSA > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is a mnemonic to remember the management of unstable angina

A

H-MOAT

Heparin 
Morphine 
Oxygen 
Aspirin 
Ticagrelor
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2
Q

What antithrombin therapy is usually given in unstable angina

A

Fondaparinux

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3
Q

What dose, route, timing of fondaparinux is given

A

FONDAPARINUX
2.5mg
SC
OD

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4
Q

When is UFH given as an alternative to fondaparinux in unstable angina

A

Immediate angiography planned or creatinine >256

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5
Q

What creatinine means UFH should be given over fondaparinux

A

> 256

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6
Q

How long is fondaparinux continued for

A

8-days post discharge

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7
Q

What dose of UFH is given, what route

A

HEPARIN (UNFRACTIONATED)

5000 units loading dose STAT.
18units/Kg/hour continuous IV infusion

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8
Q

What dose, timing, route is morphine given in unstable angina

A

OROMORPH
10mg. 4-hourly
PO

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9
Q

What dose of morphine is given to an elderly patient with unstable angina

A

5mg, 4-hourly

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10
Q

In management of unstable angina what score is used

A

GRACE Score

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11
Q

When should unstable angina receive PCI

A
  1. Immediately - if haemodynamically unstable

2. 72h if a GRACE score more than 3

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12
Q

What dual antiplatelet therapy is the individual given in unstable angina is low risk of bleeding

A

Ticagrelor

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13
Q

What dual antiplatelet therapy is the individual given in unstable angina if high risk of bleeding

A

Clopidogrel

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14
Q

What is the dose/route for aspirin in unstable angina

A

ASPIRIN
300mg
PO

(Loading dose 300)

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15
Q

What is the dose/route for clopidogrel in unstable angina

A

CLOPIDOGREL
300mg
PO

(Loading dose 300)

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16
Q

What is the dose/route for ticagrelor in unstable angina

A

TICAGRELOR
180mg
PO

(Loading dose 180)

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17
Q

What is the MOA of fondaparinux

A

Enhanced anti-thrombin that inhibits F10

18
Q

What are 3 side effects of fondaparinux

A
  • Bleeding
  • Bruising at injection site
  • HYPERKALAEMIA
19
Q

What is a contraindication to Fondaparinux

A

At-risk of bleeding

20
Q

Give 4 patients that may be at risk of bleeding on fondaparinux

A
  • Renal impairment
  • Uncontrolled HTN
  • Coagulation disorder
  • Recent surgery
21
Q

If required, what monitoring is done for fondaparinux

A

Antifactor Xa activity

22
Q

What is the MOA of unfractionated heparin

A

Increases action anti-thrombin, inhibiting F2 and F10

23
Q

What are 3 adverse effects of UFH

A
  • Bleeding
  • Injection site brusing
  • Hyperkalaemia
24
Q

What is a rare, but serious, adverse event of UFH

A

Heparin induced thrombocytopenia (HIT)

25
Q

When is UFH beneficial

A

Renal impairment

26
Q

What is a contraindication to UFH

A

At-risk bleeding

27
Q

What agent can be used to reverse UFH

A

Protamine sulphate

28
Q

What blood tests should be ordered prior to starting UFH

A

Renal Profile
FBC
Coagulation profile

29
Q

What is used to monitor efficacy of UFH

A

APTT

30
Q

If someones been on UFH for more than 4-days what should be checked

A

U+E

Platelets (FBC)

31
Q

What are 3 adverse events of aspirin

A
  • Bronchospasm
  • GI irritation, peptic ulcer
  • Tinnitus
32
Q

How does aspirin OD present

A
  • Hyperventilation, changes in hearing, metabolic acidosis, convulsions, cardiovascular collapse
33
Q

What are 3 absolute CI of aspirin

A
  • Hypersensitivity
  • Under 16 (Reye Syndrome)
  • 3rd trimester pregnancy
34
Q

Why is aspirin CI in the 3rd trimester of pregnancy

A
  • Causes pre-mature closure of the ductus arteriosus
35
Q

What are two relative CI of aspirin

A
  • Gout

- Peptic Ulcers

36
Q

What drugs interact with aspirin to cause bleeding

A
  • Anti-platelets

- Anti-thrombotic agents

37
Q

What are 3 side effects of ticagrelor

A
  • Bleeding
  • GI upset: diarrhoea, abdominal pain, dyspespsia
  • Thrombocytopenia
38
Q

What derrangement can Ticagrelor cause on FBC

A

Thrombocytopenia

39
Q

What is a CI to ticagrelor

A

Active bleeding

40
Q

What drugs interact with ticagrelor

A

CYP450 inducers and inhibitors

41
Q

What drugs interact with clopidogrel

A
  • CYP450 Inducers and Inhibitors
  • Antiplatelets
  • Antithrombin
42
Q

Explain PPIs and clopidogrel

A

Omeprazole has activity on CYP450. Therefore lansoprazole or pantoprazole should be given for GI protection if on clopidogrel.

PSA (3 decks)

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