Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacy Pre-reg exam 2020-2021 > Cardiovascular system > Flashcards

Cardiovascular system Flashcards

1
Q

Why do we tell patients to change sites of tinzaparin injections?

A

Risk of lipodystrophy - drug can accumulate and not absorb properly.

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

Why are platelets checked with heparins?

A

Heparin-induced thrombocytopenia - low platelet count.

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

Monitoring parameters for tinzaparin and Co

A

U&Es, especially K, platelets

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

Which class of beta-blockers can cause sleep disturbances and nightmares and why?

A

Lipid-soluble - able to cross BBB

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

Which enzyme do Statins inhibit?

A

HMG-CoA reductase

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

What to do if you forgot take a Warfarin dose?

A

Remember before midnight - take it. If not - take the next one as usual, and let the GP/INR clinic know.

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

Foods to avoid on Warfarin

A

Grapefruit and cranberry juice, mango

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

What is Torsades des Pointes?

A

Type of ventricular tachycardia that can lead to sudden cardiac death. Associated with long QT

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

What are the two main ways (two types of control) to manage arrhythmia?

A

Rate control (ventricular rate) and Rhythm control (restore and maintain sinus rhythm)

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

Is rate or rhythm control a generally preferred first line for AF?

A

Rate control

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

Which type of control is preferred in onset of AF >48hrs or unknown?

A

Rate control

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

When is Digoxin preferred in AF management?

A

If AF is accompanied by congestive heart failure.

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

Rate-control medication examples

A

B-blockers, verapamil, diltiazem, digoxin

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

Rhythm-control medication examples

A

Sotalol, Amiodarone, flecainide acetate, dronedarone

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

Which is the first line rhythm-control medication?

A

Amiodarone

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

What else is needed as part of general AF management, apart from rhythm & rate control?

A

Stroke prevention - anticoagulation

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

Which medications are used in atrial flutter?

A

IV B-blockers, verapamil &diltiazem, digoxin

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

Which medications are used to manage torsades de pointes?

A

IV magnesium sulphate, b-blockers.

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

Name classes of anti-arrhythmic drugs (1-4) and examples

A

Class 1: membrane stabilising drugs - Lidocaine, flecainide
Class 2: Beta-blockers
Class 3: Amiodarone, Sotalol
Class 4: Verapamil, Diltiazem

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

Drug of choice in acute supraventricular arrhythmia?

A

IV Adenosine

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

In which case is digoxin and verapamil contraindicated?

A

In supraventricular arrhythmia associated with conductive pathways issues (WPW syndrome)

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

Which class of AF medication does verapamil interact and what is the nature of interaction?

A

B-blockers - increased risk of severe hypotention and bradycardia - AVOID

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

What kind of half-life does amiodarone have?

A

Very long half-life (weeks)

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

Which parameters do we monitor with Amiodarone?

A

LFTs, Thyroid Function, Pulmonary toxicity, Eyesight (corneal microdeposition), ECG on IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Why does amiodarone affect thyroid gland?
It contains iodine
26
Advice for patients on amiodarone regarding photosensitivity
Protect skin from light during and several months after discontinuation
27
Does the QT prolongation in someone on Amiodarone indicate toxicity?
No
28
What checks do we need to do before Amiodarone initiation?
Potassium, ECG, Chest X-ray, LFTs, thyroid function
29
Which LFT in particular do we monitor for Amiodarone liver toxicity?
Transaminases
30
Which drugs are contraindicated with Amiodarone due to the risk of torsades de pointes?
Sotalol, Co-trimoxazole, Erythromycin, Chlorpromazine, Haloperidol, Amisulpride, Amitriptyline, Anti-malarials
31
Which drugs should be avoided or initiated under close supervision together with Amiodarone?
QT prolongators
32
Which AF management drugs should be avoided with Amiodarone?
B-blockers, diltiazem, verapamil
33
Which drug class should be avoided with Amiodarone due to the risk of hypokalaemia?
Stimulant laxatives
34
Amiodarone action on CYP enzymes and consequences?
Enzyme inhibitor - plasma concentration of a large variety of drugs will be increased - consider and monitor everything
35
What is the rescue drug for severe bradycardia following too rapid IV amiodarone admin?
Atropine
36
Usual dose of Amiodarone?
200mg TDS for 1 week, then 200mg BD for 1 week, then 200mg OD
37
MAO of Digoxin
Increases force of myocardial contraction + reduces conductivity in AV node
38
When do you reduce the dose of Digoxin by 50%
With Amiodarone and Quinine
39
How do you switch from IV Digoxin to oral
Increase the dose by 20-33% to achieve the same concentration
40
When do you take sample for Digoxin lvls
6 hrs post dose
41
When are compression stocking contraindicated
Acute stroke, peripheral arterial disease, peripheral neuropathy, leg oedema
42
What is the VTE prophylaxis of choice in renal impairment?
Unfractioned heparin
43
Immediate management of acute ischaemic stroke
Alteplase - 4-5hrs post event High-dose aspirin if >24hrs
44
Long-term management of TIA/Ischaemic Stroke
Statin (initiated within 48hrs) + Clopidogrel
45
When do we need to consider target INR of 3.5?
If patient already on anticoagulant with INR >2 still having recurrent VTE
46
Duration of warfarin treatment in provoked VTE
3 months
47
When is aspirin contraindicated?
16
48
Symptoms of aspirin overdose
Hyperventilation, tinnitus, deafness
49
When do we avoid DOACs
CrCl <15ml/min
50
What can unfractioned heparin cause during prolonged exposure in pregnancy
Maternal osteoporosis
51
Maximum INR monitoring interval for warfarin
3 months
52
Common interactions with Warfarin
Miconazole, NSAIDs, Amiodarone, Co-trimoxazole, Bezafibrate, Erythromycin, St John`s Wort
53
What is the target BP for diabetic patient with CVD or end organ damage
130/80
54
Which HTN medication has a special benefit in diabetes
ACE inhibitors due to their renoprotective action
55
Which HTN medication is first line in gestational hypertension
Labetalol
56
Hypertensive crisis teratment
IV sodium nitroprusside, nircadipine, labetalol
57
Why do we titrate ACEinhibitors (and other BP meds slowly)
To avoid rapid fall in BP
58
Examples of water-soluble b-blockers (3)
atenolol, nadolol, sotalol
59
Examples of cardio-selective b-blockers (4)
atenolol, bisoprolol, metoprolol, nebivolol
60
Side-effects of b-blockers
fatigue, cold extremities, glucose derangement (caution in diabetes), nightmares
61
When are b-blockers contraindicated
2nd & 3rd degree heart block
62
When do we avoid CCBs and what is the only exception
Heart failure Except amlodipine
63
What is the special side-effect for CCBs
Gingival hyperplasia
64
When are thiazide diuretics cautioned
gout, diabetes, hyperaldosteronism, SLE
65
When are thiazide diuretics ineffective
eGFR<30
66
Primary cardiovascular prevention
Low-dose statin (atorvastatin 1st line) Correct BP if HTN Fibrates only if need to reduce triglycerides
67
Secondary prevention
Aspirin or Clopidogrel High-dose statin Fibrates only if need to reduce triglycerides Correct BP if HTN
68
Why do we want to avoid high-dose simvastatin
Increased risk of myopathy
69
HF managements
ACEinhibitor (or ARB) + b-blocker | Loop diuretics for oedema
70
b-blockers licenced for HF
bisoprolol, carvedilol, nebivolol
71
Doses of spironolactone in HF & oedema
100-400mg in oedema 25-50mg in HF
72
What can spironolactone cause
benign breast neoplasms & breast pain
73
Dose adjustments of simvastatin with fibrates; verapamil, diltiazem, amlodipine & amiodarone; ticagrelor
10mg 20mg 40mg max dose respectively
74
Stable angina management
b-blocker GTN spray/long-acting nitrates statin + aspirin
75
Unstable angina/NSTEMI/STEMI acute management
``` Oxygen Nitrates for pain Diamorphine for pain Metoclopramide for nausea (from opioids) High-dose aspirin Heparins b-blocker ```
76
Long-term management post STEMI/NSTEMI
``` Aspirin + Clopidogrel (12 months after NSTEMI/unstable angina) b-blockers ACEis/ARBs Nitrates Statin ```
77
MAO of nitartes
Reduce venous return and relieve ventricular workload | Vasodilators
78
Doses of adrenaline by age
1 month - 5 years - 150 microgram 6-11 years - 300 microgram 12 years and above - 500 micrograms
79
Where in the kidneys do thiazide diuretics work
Distal convoluted tubules
80
What can loop diuretics precipitate
hepatic encephalopathy
81
What can loop diuretics exacerbate
gout and diabetes
82
What HTN medicine should you avoid using together with K-sparing diuretics and why
ACEis/ARBs - risk of hyperkalaemia

Pharmacy Pre-reg exam 2020-2021 (20 decks)

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