Prescribing, drug management & the BNF Flashcards
What are the 5 risk factors for cardiovascular disease?
Heart disease Being a smoker Dyslipidaemia Hypertension Type 2 diabetes
What may be reduced in order to reduce the oxygen demand of the heart?
Heart rate
Contractility
Afterload
Preload
What does nitric oxide do?
Its a vasodilator
What happens to nitric oxide production in atherosclerotic vessels?
Less nitric oxide is produced
How do beta blockers work
They block beta 1 receptors on cardiac tissue which blocks the affect of adrenaline/noradrenaline reducing angiotenisn II, vasoconstriction and afterload
What effect do nitrates have on vessels
Dilates them
What effect do nitrates have on preload, afterload and contractility
Preload= falls and blood pools in dilated veins Afterload= falls as heart has to work less hard to eject blood due to lower peripheral resistance Contractility= no change
What are the two types of CCBs and what is the difference between them?
Dihydropiridines= affect the heart muscle Non-dihydropiridines= affect vessels not the heart muscle
What drug is used to treat stable angina in an acute setting and long term?
Acute= GTN
Long term= beta blockers
In which patients do you have to be most careful prescribing drugs and how?
Liver and kidney patients
Always consider if the drug is needed and if it is, give the lowest dose possible as they have issues with clearance
Certain drugs are toxic for them so make sure not to prescribe those
How is prescribing different for pregnant women?
Most drugs will get across to the foetus so you have to be extremely careful what you prescribe to pregnant women and women of child bearing age
How is dosage different for pregnant women?
A of of the time they require a higher dosage as their clearance etc all increase
