cardiovascular medications Flashcards
how much statin should be started for someone with known CVD including peripheral arterial disease?
80mg atorvastatin
What is a contraindication to taking statins?
macrolide antibiotics- statins should be stopped until a course of erythromycin/ clarythromycin is complete
when should statins be taken?
at night, as this is when cholesterol synthesis takes place (ON)
what is the dose of atorvastatin used in primary prevention?
20mg
what is the first line antihypertensive in >55
amlodipine
what is the first line antihypertensive if >55 and type 2 diabetic?
ace inhibitor
what is the first line antihypertensive if black
amlodipine
what is the first line antihypertensive if <55
ace inhibitor
what drug would you give a <55 with HTN and asthma, unable to tolerate ace-i?
ARB- losartan for e.g.
what is the blood pressure target for <80?
140/90 in clinic
135/85 ABPM
what is the blood pressure target for >80?
150/90 in clinic
145/85 ABPM
Which 4th antihypertensive should you add depending on potassium?
if potassium <4.5- low dose spironolactone
if >4.5 add alpha blocker (doxazocin) or beta blocker (bisoprolol)
what is considered stage 1 HTN?
clinic Bp >140/90
Home >135/85
what is stage 2 HTN?
clinic bp >160/100
home >150/95
what is considered severe HTN?
clinic systolic >180
clinic diastolic >110
who should be treated if they have stage 1 HNT?
<80 AND
- Target organ damage established CVD renal disease diabetes 10 year cardiovascular risk >10%
which drugs should be avoided in heart failure?
- 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
why should beta blockers and verapamil never be prescribed together?
risk of life threatening bradycardia
which hormonal therapy should be avoided in ischaemic heart disease?
- oestrogens
what are features of digoxin toxicity?
generally unwell, lethargy, nausea & vomiting, anorexia, confusion, yellow-green vision
arrhythmias (e.g. AV block, bradycardia)
gynaecomastia
what investigations should be done if you suspect digoxin toxicity?
- And E
- ECG
When should digoxin be monitored?
at least 6 hour post dose
what is given for rapid relief of pulmonary oedema?
20mg furosemide iv
what is an adverse reaction of amioderoine?
pulmonary fibrosis and thyroid dysfunction
