Heart And Blood Flashcards

1
Q

What does amiodarone treat?

A

Arrhythmias

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2
Q

What are the side effects of amiodarone?

A

Mnemonic: Please Check Patient’s Tired Livers

  • Pulmonary toxicity,
  • Corneal micro deposits (reversible),
  • Phototoxicity,
  • Thyroid dysfunction (hypo/hyperthyroidism),
  • Liver disorders (jaundice etc.)

Additional:

Nausea,
vomiting,
taste disturbance,
slate grey discolouration,
tremor,
sleep disorder,

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3
Q

What are the main interactions with amiodarone?

A

Mnemonic: We Beat Quickly Like Steel Drums Can

  • Warfarin – amiodarone inhibits warfarin metabolism, enhancing the anticoagulant effects
  • Beta blockers – increased risk of bradycardia, AV block and myocardial depression
  • QT prolonging drugs - risk of QT Prolongation
  • Lithium – risk of ventricular arrhythmias
  • Simvastatin - max 20mg
  • Digoxin – plasma concentration of digoxin increased by amiodarone
  • CYP3A4 inhibitors
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4
Q

What are the indications of the digoxin?

A
  • Atrial fibrillation,
  • tachycardia,
  • heart failure
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5
Q

What is the mechanism of action of digoxin?

A

It is a positive inotrope – it increases the force of myocardial contraction and reduces conductivity within the AV node

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6
Q

What monitoring is required for digoxin?

A

Serum electrolytes, especially potassium and renal function

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7
Q

How can you manage the risks of developing digoxin toxicity?

And what group are most susceptible?

A

Digoxin toxicity is made worse by hypokalaemia.
To combat this, give potassium-sparing, diuretics, or potassium supplements

  • the elderly are more susceptible to digoxin toxicity
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8
Q

What are the main side-effects of digoxin?

A

Nausea, vomiting, diarrhoea, dizziness, blurred vision

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9
Q

What are the main interactions with digoxin?

A

Mnemonic: EARS DC

Amiodarone – plasma concentration is increased by amiodarone
Erythromycin – plasma concentration is increased by erythromycin (enzyme inhibitor)
Rifampicin – plasma concentration is reduced by rifampicin (enzyme inducer)
St John’s wort– plasma concentration is reduced by Saint Johns wort (enzyme inducer)
Diuretics – increased toxicity if hypokalaemia occurs with a loop and thiazide
Calcium channel blockers – plasma concentration is increased by calcium channel blockers

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10
Q

What are the symptoms of bradycardia? (HR<60bpm)

A
  • Fatigue
  • Dizziness
  • Confusion
  • Shortness of Breath
  • Chest Pain
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11
Q

What drugs cause Bradycardia?

A

Mnemonic: BAD CAB

  • Beta Blockers
  • Alpha Agonists (Clonidine)
  • Digoxin
  • Calcium Channel Blockers
  • Anticholinergics (Donepezil)
  • Baclofen
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12
Q

What are the main side effects of DOACs?

A

Mnemonic: BARE LOT

  • Bleeding/Bruising
  • Angioedema
  • Renal Failure
  • Epidermal Necrolysis
  • Low BP
  • Oedema
  • Tachycardia
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13
Q

What monitoring is required for DOACs?

A

Before and During: FBC, U+Es, LFTs

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14
Q
A
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