cardiovascular medications

Question 1

how much statin should be started for someone with known CVD including peripheral arterial disease?

Answer 1

80mg atorvastatin

Question 2

What is a contraindication to taking statins?

Answer 2

macrolide antibiotics- statins should be stopped until a course of erythromycin/ clarythromycin is complete

Question 3

when should statins be taken?

Answer 3

at night, as this is when cholesterol synthesis takes place (ON)

Question 4

what is the dose of atorvastatin used in primary prevention?

Answer 4

20mg

Question 5

what is the first line antihypertensive in >55

Answer 5

amlodipine

Question 6

what is the first line antihypertensive if >55 and type 2 diabetic?

Answer 6

ace inhibitor

Question 7

what is the first line antihypertensive if black

Answer 7

amlodipine

Question 8

what is the first line antihypertensive if <55

Answer 8

ace inhibitor

Question 9

what drug would you give a <55 with HTN and asthma, unable to tolerate ace-i?

Answer 9

ARB- losartan for e.g.

Question 10

what is the blood pressure target for <80?

Answer 10

140/90 in clinic

135/85 ABPM

Question 11

what is the blood pressure target for >80?

Answer 11

150/90 in clinic

145/85 ABPM

Question 12

Which 4th antihypertensive should you add depending on potassium?

Answer 12

if potassium <4.5- low dose spironolactone

if >4.5 add alpha blocker (doxazocin) or beta blocker (bisoprolol)

Question 13

what is considered stage 1 HTN?

Answer 13

clinic Bp >140/90

Home >135/85

Question 14

what is stage 2 HTN?

Answer 14

clinic bp >160/100

home >150/95

Question 15

what is considered severe HTN?

Answer 15

clinic systolic >180

clinic diastolic >110

Question 16

who should be treated if they have stage 1 HNT?

Answer 16

<80 AND

- Target organ damage 
established CVD 
renal disease 
diabetes 
10 year cardiovascular risk >10%

Question 17

which drugs should be avoided in heart failure?

Answer 17

• flecanaide and verapamil as they have negatively inotropic effects
• thiazolidinones- e.g. pioglitazone- which is used for diabetes as it can cause fluid retention
• NSAIDS and glucocorticoids shouldd be used with caution as they can cause fluid retention

Question 18

why should beta blockers and verapamil never be prescribed together?

Answer 18

risk of life threatening bradycardia

Question 19

which hormonal therapy should be avoided in ischaemic heart disease?

Answer 19

• oestrogens

Question 20

what are features of digoxin toxicity?

Answer 20

generally unwell, lethargy, nausea & vomiting, anorexia, confusion, yellow-green vision
arrhythmias (e.g. AV block, bradycardia)
gynaecomastia

Question 21

what investigations should be done if you suspect digoxin toxicity?

Answer 21

• And E

- ECG

Question 22

When should digoxin be monitored?

Answer 22

at least 6 hour post dose

Question 23

what is given for rapid relief of pulmonary oedema?

Answer 23

20mg furosemide iv

Question 24

what is an adverse reaction of amioderoine?

Answer 24

pulmonary fibrosis and thyroid dysfunction

Question 25

what are adverse effects of ACEi?

Answer 25

cough

hyperkalaemia

Question 26

which medications should be stopped in acute heart failure?

Answer 26

• NSAIDS- ibuprofen

- CCB- verapamil and diltiazem