Chapter 4

Question 1

Initial management for someone with acute LVF heart failure?

Answer 1

Abcde assessment + O2

Hx/exam, find cause

Sit patient up

Moprhine 10mg iv + metoclop 10mg iv

Furosemide 40-80mg iv

GTN sublingual or spray

+/- isosorbide dinitrate +/- CPAP

CCU

Question 2

Treatment for patient in torsade de pointe

Answer 2

IV magnesium 2g over 10 mins

Question 3

Management for someone in stable narrow complex tachycardia?

Answer 3

Vagal maneuveres first then adenosine 6mg stat, repeat 12mg 2x IFN.

Question 4

Management for someone with stable fast AF?

Answer 4

Beta blocker? Diltiazem? Digoxin or amiodarone

Question 5

What to do if broad complex QRS tachycardia?

Answer 5

Amiodarone 300mg over 10-20 mins then 900mg over 24 hrs

Question 6

What to do if patient unstable and tachycardic?

Answer 6

DC shock up to 3 times, then give amiodarone 300mg over 10-20 mins, then shock again, and 900mg amiodarone over 24 hours.

Question 7

Is domperidone safe to use in patients with parkinson’s diseae?

Answer 7

Yes because it doesn’t cross the BBB

Question 8

Most important blood parameter to check after starting on ACEi?

Answer 8

Creatinine/kidney function (eGFR)

Question 9

What is diltiazem used for?

Answer 9

Hypertension, AF, angina

Question 10

Side effect of all CCBs?

Answer 10

Flushing, peripheral edema, constipation

Question 11

What 4 drugs to be cautious about if someone is in AKI?

Answer 11

DAMN

Diuretics
ACEi
Metformin
NSAIDs

Question 12

What blood parameter to check if starting someone on sodium valproate?

Answer 12

ALT I.e. LFTs

Question 13

If someone has been started on digoxin, what blood parameter is most important to check?

Answer 13

Potassium - hypokalaemia increases risk of digoxin toxicity

Question 14

If rate control is indicated in someone with fast AF, what drugs can be considered?

Answer 14

Diltiazem and verapamil

Betablocker if no asthma