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CV Qs Flashcards

1
Q

CCB + bisoprolol

A

peripheral oedema

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2
Q

Ticagrelor + inhibitor (clari)

A

increased exposure of ticagrelor

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3
Q

Secondary prevention: Stroke and CV events

A

ASAP BB
Antiplatelet
Statin
ACEi/ARB
PPI
Beta blocker

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4
Q

INR 9.5 and no bleeding

A

PO phyto 2.5mg

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5
Q

Which ONE of the following is LEAST likely to occur as a result of hypersensitivity to aspirin?
- Angioedema
- Bronchospasms
- Haemorrhagic stroke
- Rhinitis
- Urticaria

A

Haemorrhagic stroke

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6
Q

Aspirin hypersensitivity

A
  • Angiodema
  • Bronchospasms
  • Urticaria, rhinitis
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7
Q

Ischaemic stroke: which antiplatelet should be prescribed?

A

Aspirin or clopidogrel
- Prasugrel and ticragelor CI fot ischaemic stroke

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8
Q

Dipyrimadole SE

A

Headache

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9
Q

GTN patch counselling

A
  • apply the patch to the lateral chest every 24hrs
  • does not need to be removed for showering/bathing
  • not prn, regular use
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10
Q

Which antihypertensive causes constipation?

A

CCB

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11
Q

If pt has heart failure with preserved ejection fraction
AF
Pulmonary oedema
What drug do we offer?

A

Furosemide

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12
Q

Amiodarone MOA

A

Inhibits myocardial ATPase activity via Na K channel inactivation

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13
Q

Treatment for Delayed cerebral ischaemia

A
  1. Nimodipine 60mg PO ever 4 hrs for 21 days
    - CCB reduces incidence and severity of neurological defecits following subarachnoid haemmorrhage
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14
Q

Heparin induced thrombocytopenia (HIT)

A
  • Severe drug reaction to heparin
  • Switch to danaparoid
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15
Q

Acute ischaemic stroke initial treatment

A
  • Alteplase IV
  • Administered within 4.5hrs
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16
Q

Initial treatment for acute DVT: rivaroxaban

A
  • 15mg BD for 21 days, then 20mg OD
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17
Q

ACEi counselling

A

empty, morning, 30-60 mins before food

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18
Q

Pt with non V AF INR target

A

2-3

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19
Q

Tranexamic acid: ADR

A
  • Colour vision changes due to toxicity to retina
  • Rare but serious
  • STOP + opthalm
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20
Q

Which DOAC is least likely to be chosen with renal impairment?

A

Dabigatran

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21
Q

Abx which decrease anticoagulant effect of warfarin

A

Rifampicin

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22
Q

Abx which increase anticoagulant effect of warfarin

A

Clarithromycin
Doxycyline
Erythromycin
Metronidazole

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23
Q

What is the dose for rivaroxaban in patients with DVT/PE?

A

15mg BD (twice daily) for 21 DAYS then 20mg OD (once daily)

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24
Q

Eplenerone and amiodarone dose adjustment

A

max 25mg
- Eplerenone is primarily metabolized by CYP3A4
- amiodarone is a potent CYP3A4 inhibitor
- increase eplerenone levels, necessitating a dose adjustment.

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25
Q

What calcium channel blocker is commonly prescribed for prophylaxis of cluster headache?

A

Verapamil

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26
Q

Nitrates can lead to tolerance and reduced therapeutic effects if long-acting preps used/transdermal preps used - what can be done to overcome this

A

reduce blood nitrate conc for 4-12 hours each day to avoid tolerance

27
Q

What antifungals must the patient temporarily withhold their atorvastatin treatment for?

A

keto/intraconazole - azole antifungals

28
Q

What are the specifics of dispensing dipyridamole?

A

1) modified-release capsules should be dispensed in original packs
2) capsules should be discarded after 6 weeks after opening

29
Q

How many days prior to elective surgery should ticagrelor be stopped?

A

5 days

30
Q

is ACEi or ARB preferred in afro

A

ARB

31
Q

Ischaemic stroke initial treatment

A

Aspirin 300mg OD for 14 days
Clopidogrel 75mg OD long term

32
Q

When is apixaban 2.5mg bd indicated?

A

Creatinine clearance is 15-29mL/min
or the following TWO apply from:
1) 80 +
2) 60kg or less
3) serum creatinine 133 micromol/L or over.

33
Q

what is the maximum daily dose of simvastatin that can be taken with bempedoic acid?

A

20mg

34
Q
A
35
Q

What drug should be avoided for short-term whilst on atorvastatin?

A

oral fusidic acid - avoid during and 7 days after treatment

36
Q

What is the max daily dose of atorvastatin that a patient can take whilst on tipranavir?

A

10mg OD

37
Q

Statins SE

Remember STATIN

A
  • Sugars raised (hyperglycaemia)
  • Transanimase (raised LFT)
  • Aches and pain (rhabdo)
  • Tendon disorder
  • Interstitial lung disease
  • Nausea

report coughing, dyspnoea, weight loss, muscle aches

38
Q

Which antiplatelet can cause a throbbing headache as a SE

A

Dypirimadole

39
Q

Levothyroxine counselling: initial dosing

A
  • If metabolism increases too rapidly (causing diarrhoea, nervousness, rapid pulse, insomnia, tremors and sometimes anginal pain where there is latent myocardial ischaemia),
  • reduce dose or withhold for 1–2 days and start again at a lower dose.
40
Q

How many days should you STOP clopidogrel prior to elective surgery?

A

7

41
Q

What calcium channel blocker is commonly prescribed for raynaud’s syndrome?

A

Nifedipine

42
Q

What effect does drinking grapefruit juice have on plasma levels fo CCBs?

A

may increase levels of calcium channel blockers (dihydropyridine CCBs - cardioselective ones)

43
Q

In diarrhoea and vomiting which medication should be stopped?

A

stop ACEi for 1-2 days until they recover

44
Q

Dyspepsia and gatro oesophageal reflux in 56 y o for the first time

A

calcium carbonate and refer to the pt ASAP for referral for non-urgent endoscopy

45
Q

Ibandronic acid counselling

A

Remain upright for at least 1 hr
Report ear discharge
Report signs of groin pain
OD

46
Q

Carbamazepine + apixaban

A

decreases exposure to apixaban

47
Q

HF with REF beta blocker preferred

A

carvedilol

48
Q

GRACE score is ≤3%

A
  • predicted 6month mortality is low
  • elderly pt = angiography is not recommended
49
Q

Anticoagulation for SPAF

A
  • Antiplatelet is NOT effective.
  • The anticoagulant of choice for SPAF = DOAC
  • Warfarin is no longer recommended as first line.
50
Q

Which pharmacological option is preferred in pregnant patients with a history of deep vein thrombosis

A

LMWH

51
Q

What pharmacological parenteral anticoagulant option is preferred for patients with renal impairment

A

Unfractionated Heparin

52
Q

What is the reversal agent of LMWHs→

A

Protamine Sulfate

53
Q

For elderly patients (80+) what is the target BP?

A

Under 150/90 mmHG

54
Q
A
55
Q

Switching warfarin to dabigatran

A

o Yes in diabetes
o No in GI ulcer, prosthetic heart valve, recent surgery, malignant neoplasm

56
Q

What eGFR should TLD be avoided

A

Less than 30 ml/min

57
Q

If a loop diuretic (e.g., bumetanide, furosemide, co-amilofruse) is needed twice daily, when should the doses be taken

A

ONE in the morning and ONE before 4pm - no later than this as nocturia

58
Q

Paroxysmal AF treatment

A

PILL POCKET with fleicanide

59
Q

Which juice increases INR?

A

Pomegranate

60
Q

Chronic HF 1st line

A
  1. BB
  2. ACEi
  3. Loop diuretic

If symptoms persist = ENTRESTO

61
Q

When is ivabradine CI

A

HR less than 75bpm

62
Q

Pharmacological cardiocersion for patients with normal cardiac function and no structural heart disease

A

Fleicanide
Amiodarone

Amiodarone preferred in heart disease

63
Q

Simvastatin + amiodarone

A

Amiodarone inhibits metabolism of simvastatin = increased plasma levels and risk of myopathy

Qs (27 decks)

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