Cardiovascular Drugs 1 Flashcards
what is the pathophysiology of AF?
chaotic atrial electrical activity
what is the Fibrosis and loss of atrial muscle mass related to?
Ageing
- Chamber dilatation
- Inflammation
- Genetic
Risk factors of AF?
Hypertension Valvular heart disease Coronary artery disease Cardiomyopathy Congenital heart disease Previous cardiac surgery Pericarditis Lung disease - PE, Pneumonia, COPD Hyperthyroidism Alcohol
how is AF classified?
Lone AF
Paroxysmal (<7 days)
Persistent (>7 days)
Permanent (>7 days ± Cardioversion)
clinical features of AF
Asymptomatic Palpitations SOB Chest pain Syncope Pre-syncope Heart failure
what are the treatment options for AF?
rate control
rhythm control
anticoagulation
if <48 hours recent onset AF, how would you manage?
rhythm control
if >48 hours AF, mx?
rate control
when is rhythm control preferred?
Symptom improvement
Younger patient
Heart failure related to AF
Adequacy of rate control
what is 1st and 2nd line rate control for AF in those with no HF?
- Beta blocker
2. CCB such as verapamil or diltiazem
what is 1st and 2nd line rate control for AF in those with HF?
- digoxin/ amiodarone
2. amiodarone
what do you use for rhythm control?
- fleicanide and sotalol.
if the heart is abnormal then amiodarone.
give 2 examples of rate limiting CCB
verapamil
diltiazem
cut off for chadsvasc ?
> /= 2
cut off for hasbled ?
> /= 3
who do we offer a statin to ?
To people who have a 10% or greater 10‑year risk of developing CVD.
Adults with type 1 diabetes
People with chronic kidney disease
Offer atorvastatin for the secondary prevention of CVD in any patient who has had a stroke or MI.
what is ezetimibe used for?
Ezetimibe monotherapy is recommended as an option for treating primary (heterozygous‑familial or non‑familial) hypercholesterolaemia in adults in whom initial statin therapy is contraindicated or not tolerated
which drugs dont reduce mortality in HF patients?
Diuretics
digoxin
what is the treatment for CCF?
diuretics
ace inhibitors beta blockers
spirinolactone
when is ivabradine used in HF pts?
Ivabradine – Used with or in place of beta blocker if heart rate too high (>75 bpm)
what other forms of therapy can you use in HF?
Coronary revascularisation
Cardiac resynchronisation therapy
Cardiac transplantation
