Practise of Treating CV Patients Flashcards
Treatment for hypertensive patient younger than 55
- start ACEi/ARB
- add CCB
- add diuretic if necessary
- B-blocker/A-blocker/spironolactone
- ACD
Treatment for hypertensive patient older than 55
- start CCB
- add ACEi/ARB if necessary
- add diuretic if necessary
- B-blocker/A-blocker/spironolactone
Order of treatment of heart failure
- DAB (unless contraindicated)
( Diuretic, ACEi, and B-blocker) - spironolactone/epleronone
- selected treatments
What are the selected treatments for chronic heart failure?
- dapagliflozin
- cardiac resynchronisation therapy
- sacubitril/valsartan to replace ACEi/ARB
- implantable defibrillators
What drugs can cause angioneurotic oedema?
sacubirtil-valsartan
What treatments prolong survival in angina patients?
- SAAB
- statin
- ACEi
- aspirin
- B-blocker
What treatments relieves symptoms in angina patients?
- B-blocker
- CCBs
- nitrates
- coronary angiopalsty
- ivabradine/ranolazine
- coronary artery surgery
What are the 4 entities of acute chest pain?
- STEMI
- NSEMI
- troponin negative unstable angina/ACS
- non-cardiac chest pain
STEMI treatment
emergency:
- aspirin
- angioplasty (near hospital)
- thrombolysis (far from hospital)
and:
- aspirin and clopidogrel/ticagrelor
- low MW heparin/fondaparinux
- SAAB
NSTEMI treatment
- aspirin and clopidogrel/ticagrelor
- fondaparinux
- angioplasty
- SAAB
Treatment of troponin negative unstable angina/ACS
- aspirin and clopidogrel
- selective use of angioplasty
- SAAB
Atrial fibrillation treatment
- warfarin/rivaroxaban/NOACs (prevent emboli)
- B-blocker/digoxin (control HR)
- DC cardioversion/amiodarone (if HF)/sotalol/flecainide (if structure normal) – (to control rhythm)
What causes strokes?
- cerebral thrombosis
- cerebral embolus
- cerebral haemorrhage
How would you treat a stroke?
- CT to differentiate between haemorrhage or clot
- no haemorrhage: thrombolysis
- thrombectomy
- aspirin for 2 weeks
- then clopidogrel
- also SAAB
ACEi common side effects
- cough
- renal dysfunction
- angioneurotic oedema
- don’t use in pregnancy
ARB common side effects
- renal dysfunction
- don’t use in pregnancy
B-blocker side effects
- bradycardia
- tired
- asthma (don’t use in asthma)
CCB side effects
ankle oedema for amlodipine
heart block for veramapil/diltaziem
Diuretic side effects
- hypokalaemia
- diabetes
- gout
