CVS Flashcards
What are the 3 counselling points of Dipyridamole?
- Take 30-60 mins before food
- Special container: Keep capsules in this
- 6 week expiry date
What is stage 1 hypertension?
- Clinical BP less than 140/90
- Less than 135/85 hbpm
- Only treat if target organ damage or other health conditions or CVD risk over 20%
What is stage 2 hypertension?
- 160/100
- Treat all cases
What is stage 3 hypertension?
- Over 180 or 100
- Emergence
What is the BP target for patients under 80?
- 140/90
- 130/80 if other risks
What is BP target for patients over 80?
-150/90
What is BP target in renal disease?
- 140/90
- 130/80 if CKD or also diabetes or proteinuria
What is the BP target in diabetes?
- 140/90
- 130/80 if complications
What is the BP target in pregnancy?
- 150/100 if chronic
- 140/90 if target organ damage or after birth
Which Beta blockers have ISA? What is the significance of this
- Pindolol
- Acebutolol
- Celiprolol
- Oxprenolol
- Significance is they cause less bradycardia and coldness of extremities
Which Beta blockers are water soluble? What is the significance of this
- Celiprolol
- Atenolol
- Nadolol
- Sotalol
- Significance is they cause less nightmares and dose needs reduced in renal impairment
Which Beta blockers are cardio-selective? What is the significance of this
- Bisoprolol
- Atenolol
- Metoprolol
- Nebivolol
- Acebutolol
- Significance is they have lesser side effects on airways
Which Beta blockers are given once daily?
- Bisoprolol
- Atenolol
- Celiprolol
- Nadolol
Which drug class interacts with beta blockers to cause hyperglycaemia?
-Thiazide-like diuretics
At what eGFR are thiazides ineffective?
-Less than 30
What is step 1 of heart failure treatment?
- ACEI plus Beta blocker
- Loop diuretic if fluid overload
What is step 2 of heart failure treatment?
- Spironolactone or eplerenone
- Entresto if LVEF less than 35%
What is step 3 of heart failure treatment?
- Ivabradine or digoxin
- Hydralazine and isosorbide are alternative given by specialist
What are target cholesterol levels?
- 5 or less for total
- 3 or less for LDL
- 1 or more for HDL
- Less than 1.7 for triglycerides
What must be corrected before initiating statin treatment?
-Hypothyroidism
What statins are considered high intensity? (>40% LDL reduction)
- Atorvastatin 20-80mg
- Rosuvastatin 10-40mg
- Simvastatin 80mg
-Simvastatin 20mg is the max dose with what drugs?
- Amiodarone
- Amlodipine
- Verapamil or diltiazem
Simvastatin 10mg is the max dose with what drugs?
-Fibrates
Atorvastatin 10mg is max dose with which drug?
-Ciclosporin
Rosuvastatin 10mg is max dose with which drug?
-Clopidogrel
When would long term prophylaxis be needed in angina?
-If using GTN more than twice weekly
-How long after opening must GTN tablets be discarded?
8 weeks
What is step 1 angina treatment after GTN spray?
-Beta blocker or calcium channel blocker (Such as diltiazem)
What is step 2 angina treatment?
-Beta blocker plus dihydropyridine calcium channel blocker
What is step 3 angina treatment?
- Long acting nitrate
- Ivabradine
- Ranolazine
Which condition are rate limiting calcium channel blockers contraindicated in
Heart failure
What special considerations are there with nicorandil?
- For use in adults only
- Can cause serious ulcers
- Can impact ability to drive
What is special about isosorbide dinitrate?
It is active sublingually so can be used as prophylaxis or symptomatic relief of angina
What is emergency treatment of unstable angina or NSTEMI?
-Aspirin 300mg stat and GTN prn
What is emergency treatment of STEMI?
- Aspirin 300mg stat and GTN prn
- IV morphine/diamorphine and metoclopramide
What is emergency treatment of cardiac arrest?
- CPR (30c/2b 100cpm)
- IV adrenaline or IV amiodarone if in ventricular fibrillation
What electrolyte imbalances differ with thiazides and loop diuretics?
- Thiazides cause hyperCa
- Loops cause hypoCa
What is significant about metolazone?
-It can be used when eGFR is less than 30
What counselling is needed with the potassium sparing diuretic triamterene?
May make urine look blue in some lights
