Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pre Reg > Cardiovascukar System > Flashcards

Cardiovascukar System Flashcards

1
Q

Class I anti-arrthymic drugs

A

Membrane stabilising drugs ; Na+ blockers
Disopyramide
Lidocaine
Flecainide/ propafenone

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

When are flecainide/propafenone contraindicated

A

Asthma
Severe COPD
Avoid in structural/ ischaemic heart disease

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

Class II anti arrthymic drugs

A

Beta blockers
Propranolol
Esmolol
-olol

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

Class III anti arrthymic drugs

A

K+ channel blockers
Amiodarone
Sotalol
Dronedarone

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

Amiodarone dose after electrical cardioversion

A

4 weeks before and 12 months after to increase success

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

Dronedarone side effects

A

Hepatotoxicity and HF side effect

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

Class IV anti arrthymic drugs

A

Calcium channel blockers (rate limiting)
Verapamil
Diltiazem

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

Diltiazem is it a licensed or unlicensed CCB

A

Unlicensed

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

Other anti arrthymic drugs

A

Adenosine
Digoxin

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

Advantage of digoxin

A

Effective in sedentary patients with non - paroxysmal AF and in patients with associative congestive HF

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

What is atrial fibrillation

A

Abnormal, disorganised electrical signals fired cause the atrial to quiver or fibrilate = rapid and irregular heartbeat

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

Symptoms of atrial fibrillation

A

Heart palpitations = pounding/fluttering
Dizziness, SOB, tiredness

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

Complications of atrial fibrillation

A

Stroke and heart failure

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

Type of atrial fibrillation

A

Paroxysmal - episode stop within 48hrs without treatment
Persistent - episode more than 7 days
Permanent - present all the time

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

Two types of treatment

A

Rate control - control ventricular rate
Rhythm control - restores and maintains sinus rhythm

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

What are the two types of cardioversion

A

Cardioversion is type of rhythm control
1. Electrical - direct current
2. Pharmacological - anti arrthymic

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

When is rhythm control not suitable

A

If symptoms more than 48 hours and increases risk of stroke

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

When is electrical cardioversion preferred

A

If more than 48 hours
Must wait until fully anticoagulated for 3 weeks before cardioversion and continue four weeks after

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

What type of cardioversion if haemodynamically unstable

A

Electrical - give parental anticoagulant and rule out left atrial thrombus immediately before procedure

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

Treatment for acute new onset of AF

A

Life threatening haemodynamic instability - electrical cardioversion
Without life threatening haemodynamic instability - < 48 hours = rate or rhythm control (electrical or Amiodarone/flecainide
>48 hours = rate control (verapamil, beta blocker)

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

Maintenance treatment for atrial fibrillation

A

First line: rate control
Beta blockers (not sotalol) , rate limiting CCB, digoxin
Mono therapy —-> dual therapy —-> rhythm control

Second line; beta blockers or oral anti arrthymic drug
Ie. Sotalol, Amiodarone, flecainide, propafenone, Dronedarone

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

Paroxysmal and symptomatic AF treatment

A

Ventricular or rhythm control = standard BB or oral anti arrthymic drug
Pill in pocket if infrequent episodes - self treatment = flecainide or propafenone restores sinus rhythm if episode occurs

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

Atrial flutter treatment

A

Similar to AF but catheter ablation more suitable

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

When to give Anticoagulant in stroke prevention

A

If risk of thromboembolic stroke > the risk of bleed HAS-BLED

25
Q

Risk of stroke tool and meaning

A

CHA2DS2VASC TOOL
C - chronic heart failure or left ventricular dysfunction
H- hypertension
A2- age ur+
D- diabetes mellitus
S2- stroke/TIA/VTE history
V- vascular disease
A- 65-74 years
Sc- sex category ie. Female

26
Q

What score on CHA2DS2VASC to give anticoagulant

A

If 2 or more
No anticoagulant if male =0 or female = 1

27
Q

New onset of AF treatment

A

Parenteral anticoagulant

28
Q

Diagnosed AF treatment

A

Warfarin or NOAC

29
Q

What is NOAC

A

Novel oral anticoagulant in non valvular AF with >= 1 risk factor ( 75+, heart failure, htn, dm, previous stroke or TIA

30
Q

What is the different types of ventricular tachycardia and the treatment

A

Pulseless or fibrillation - immediate defibrillation and CPR, IV Amiodarone is given refractory to defib
Unstable sustained VT - direct current cardioversion, if this fails give IV Amiodarone and repeat direct current
Stable sustained VT - IV anti arrthymic drug (Amiodarone preferred)
Non sustained VT- beta blocker

31
Q

Maintenance of ventricular tachycardia treatment

A

For high risk of cardiac arrest-
Most patients = cardioverter defibrillator implant Some pt also require drug ; Sotalol, bb alone or bb with Amiodarone

32
Q

What is torsade de pointes

A

Prolonged QT interval

33
Q

Treatment and cause of prolonged QT interval

A

Treat - magnesium sulphate
Causes -Sotalol and other drugs that prolong QT interval, hypokalaemia and bradycardia

34
Q

Paroxysmal supraventricular tachycardia

A

Terminates spontaneously or with reflex vagal nerve stimulation or. Valsalva manoeuvre, carotid sinus massage or immersing face in ice cold water— > IV adenosine (CI- COPD/ASTHMA)— ->IV verapamil

35
Q

Treatment of haemodynamically unstable paroxysmal supraventricular tachycardia (PST)

A

Direct current cardioversion

36
Q

Treatment of recurrent paroxysmal supraventricular tachycardia

A

Catheter ablation OR drugs (verapamil, Diltiazem, BB, flecainide, propafenone

37
Q

Amiodarone

A

Class III anti arrthymic used in supraventricular and ventricular arrhythmia

38
Q

Amiodarone dose

A

Loading dose 200mg TDS for 7 days
200mg BD FOR 7 days and then
200mg OD as maintenance

39
Q

Amiodarone side effects -eyes

A

Corneal micro deposits
Pt counselling ; night time glares when driving
Optic neuropathy/neuritis (blindness)
Pt counselling : STOPif impaired vision

40
Q

Amiodarone side effects ; skin

A

Phototoxicity (burning, erythema)
Slate grey skin on light exposed areas
Pt counselling; shield skin from light during treatment, use wide spectrum, high spf for months after stopping

41
Q

Amiodarone side effects ;nerves

A

Peripheral neuropathy
Pt counselling; numbness, tingling in hands and feet, tremors

42
Q

Amiodarone side effects ;lungs

A

Pneumotitis, pulmonary fibrosis
Pt counselling: SOB, dry cough

43
Q

Amiodarone side effects: liver

A

Helatotoxicity
Pt counselling ; report jaundice, nausea, vomiting, malaise, itching, bruising, abdominal pain - due to 3x raised liver transaminases)

44
Q

Amiodarone side effects; thyroid dysfunction (Amiodarone contains iodine)

A

Hyperthyroidism (eg. Weight loss, heat intolerance, tachycardia)
- give carbimazole if necessary and withdraw Amiodarone
Hypothyroidism (weight gain, cold intolerance, bradycardia)
-Start levothyroxine without withdrawing Amiodarone

45
Q

Amiodarone monitoring

A

Annual eye test
Chest c ray before treatment
Liver function tests every 6 months
Monitor TSH, T3,T4 before treatment and every six months
Blood pressure and ECG (can cause hypotension and bradycardia)
Serum potassium (causes hypokalaemia, enhances arrthymogenjc effect of Amiodarone)

46
Q

Amiodarone interactions

A

Has a long half life ~ 50days
Danger of interactions for several months after stopping
- increased plasma Amiodarone concentrations = grapefruit juice (enzyme inhibitor)
-Amiodarone is an enzyme inhibitor * warfarin, phenytoin, digoxin (half dose)
-increased risk of myopathy = statins
- bradycardia, AV block and myocardial depression = beta blockers, rate limiting CCB ie. Verapamil and Diltiazem
- QT prolongation = increased risk of ventricular arrthymia = quinolones, macrolides, TCAs, SSRIs, lithium, quinine, hydroxychloroquine, anti-malarial (chloroquines, mefloquine), antipyschotics(esp. sulpride, pimozide, amisulpride)

47
Q

Digoxin class and moa

A

Cardiac glycoside
1-2mcg /L
High risk drug
Increases force of myocardial contraction (positive into rope)
Reduces conductivity in the AVnode (negative chronotrope)

48
Q

Therapeutic level of digoxin

A

1-2mcg/L (desired plasma concentration 6 hours after dose)
Regular monitoring is not required during maintenance treatment unless toxicity suspected OR in renal impairment (Renally cleared)

49
Q

Digoxin dose

A

Loading doses required due to long half life
Maintenance OD : atrial flutter and non - paroxysmal AF in sedentary patients ; 125-250mcg
Worsening or severe heart failure (in sinus rhythm); 62.5-125mcg

50
Q

Different bioavailability’s of different formulation for digoxin

A

Elixir = 75%
Tablet = 90%
IV =100%

51
Q

Risk and Signs of digoxin toxicity

A

Risk of toxicity in hypokalemia, hypomagnesaemia, hypercalcemia, hypoxia and renal impairment

Symptoms ; bradycardia/heart locks
-nausea , vomiting and diarrhoea, abdominal pain
- blurred or yellow vision
- Confusion, delirium
- Rash

52
Q

Treatment for digoxin toxicity

A

Withdraw and correct electrolyte imbalance
Digoxin specific antibody ; for life threatening ventricular arrhythmias unresponsive to atropine

53
Q

Digoxin interactions

A

Ihypokalaemia predisposes digoxin toxicity
- diuretic (loop/thiazide), B2 agonist, steroid, theophylline (if potassium levels < 4.5mmol/L; give potassium supplements or potassium sparing diuretics (preferred)

Increased plasma digoxin concentration = toxicity
- Amiodarone (half digoxin dose), rate limiting CCB, macrolides, ccilosporin (enzyme inhibitors)
Decreased plasma digoxin concentration = sub therapeutic = St John’s wort, rifampicin ( enzyme inducers)

Reduced renal excretion = toxicity (digoxin renally excreted)
- NSAIDs, ACEi/ARBs

54
Q

Digoxin interaction pneumonic

A

CRASED
C - CCB (VERAPAMIL)
R - RIFAMPICIN
A - AMIODARONE
E- ERYTHROMYCIN ( macrolide)
D- DIURETIC

55
Q

Two types of venous thromboembolism (VTE)

A

Venous thromboembolism
1. Deep vein thrombosis (DVT)
2. Pulmonary Embolism (PE)

56
Q

What is DVT

A

A blood clot occurs in a deep vein, usually in calf of one leg

57
Q

What is pulmonary embolism

A

Detachment of blood clot which travels to lungs and blocks the pulmonary artery

58
Q

VTE risk assessment

A

For all pt admitted to hospital
- immobility
- obesity BMI> 30
- malignant disease
- 60+ years
- personal history of VTE = thrombophyllic disease, 1st degree of relative with VTE
- HRT / Combined contraception = varicose veins with phlebitis
- pregnancy = critical care, significant co - morbidities.

Pre Reg (1 decks)

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