Cardiovascular Part 4 Flashcards
What antidepressants interact with warfarin?
SSRIs
What are the side effects of amiodarone?
Corneal deposits
Phototoxicity
Slate-grey skin
Peripheral neuropathy
Pulmonary fibrosis
Hepatoxicity
Thyroid dysfunction
What are the contraindications for aspirin?
Active peptic ulceration
Bleeding disorders
Children under 16 due to risk of Reye’s syndrome - unless Kawasaki disease
Haemophilia
Previous peptic ulceration (analgesic dose)
Severe cardiac failure
What is the adrenaline dose for anyone >12?
500mcg IM (0.5ml)
OR
300mcg (0.3ml) if child is small or prepubertal
What is the adrenaline dose for children between 6-12?
300mcg IM (0.3ml)
What is the adrenaline dose for children <6?
150mcg (0.15ml)
What are the side effects of CCBs?
Dizziness
Flushing
Headache
Hypotension
Palpitations
Ankle swelling
Angioedema
ED
Gingival hyperplasia
Constipation - most likely with verapamil
Bradycardia, AV block and HF - with verapamil
What are the ADR of Ivabradine?
Visual effects (luminous phenomena)
Which heparin poses a higher risk of heparin-induced thrombocytopenia and osteoporosis?
Unfractioned heparin
Which heparin is preferred in renal impairment?
Unfractioned heparin
Which heparin is longer acting?
LMWH
Who should you not offer compression stockings to?
A patient admitted to the hospital with acute stroke or those that have:
- peripheral arterial disease
- peripheral neuropathy
- severe leg oedema
- local conditions
How quickly should you start thromboprophylaxis?
Within 14 hours of hospital admission
What type of surgical patients is fondaparinux preferred for?
Patients undergoing abdominal, bariatric, thoracic, and cardiac surgery or patients with lower limb immobilisation or fragility fractures to the pelvis, hip or proximal femur
What is the thromboprophylaxis treatment for a patient undergoing elective hip replacement?
Option 1: LMWH for 10 days followed by low dose aspirin for 28 days
Option 2: LMWH for 28 days with anti-embolism stockings until discharge
Option 3: rivaroxaban
If unsuitable, consider apixaban and dabigatran
What is the thromboprophylaxis treatment for a patient undergoing elective knee replacement?
Option 1: low-dose aspirin for 14 days
Option 2: LMWH for 14 days with anti-embolism stockings until discharge
Option 3: rivaroxaban
If unsuitable, consider apixaban and dabigatran
How do you treat proximal DVT or PE?
Apixaban or rivaroxaban
if unsuitable offer either:
- LMWH for at least 5 days followed by dabigatran or edoxaban
- LMWH with a vitamin K antagonist for at least 5 days or until INR at least 2 for 2 executive readings followed by a vitamin K antagonist on its own (this option is not routinely recommended fot proximal DVT/PE unless patient has renal impairment or at increased risk of bleeding)
What is the renal impairment limit for dabagatran?
Should not be used in eGFR <30ml/min
What do you use to reverse Heparin action?
Protamine sulfate
What is a transient ischaemia stroke (TIA)?
A stroke that only lasts a few minutes
Should receive aspirin immediately
