The Practice of Treating Cardiovascular Patients Flashcards
Which of hypertension, heart failure and angina would an ACE inhibitor (A) be used to treat?
All three
Which of hypertension, heart failure and angina would beta blockers (B) be used to treat?
All three
Which of hypertension, heart failure and angina would calcium antagonists (C) be used to treat?
Hypertension and angina
NOT heart failure
Which of hypertension, heart failure and angina would a diuretic (D) be used to treat?
Hypertension and heart failure
NOT angina
What would the order of drugs used in a hypertensive patient under 55 years of age be?
A
C
D
Either B, alpha blocker or spironolactone
What would the order of drugs used in a hypertensive patient under 55 years of age be?
C
A
D
Either B, alpha blocker or spironolactone
What is the order of drug usage in step 1 of cardiac failure treatment?
DAB
What is the order of drug usage in step 2 of cardiac failure treatment?
Spironolactone/ Eplerenone
What is the order of drug usage in step 3 of cardiac failure treatment?
Cardiac Resynchronisation Therapy
((= Biventricular Pacing)
to those with long QRS on ECG)
What can be used in sever cases?
Implantable Cardiac Defibrillator (ICD)
In what CVD is sacubitril-valsartan used in the treatment of?
Chronic heart failure
What two categories can angina treatment be broken down into?
Prolong survival
Alleviate symptoms
What 4 key treatments are used to prolong survival in angina patients?
SAAB: Statin Aspirin ACE inhibitor Beta Blocker
How would you progressively alleviate symptoms of angina?
Beta Blocker
Calcium Antagonist or Nitrates Coronary Angioplasty
New antianginals: Ivabradine and Ranolazine
Coronary artery surgery
What is the treatment for STEMI in an emergency situation?
Aspirin
Angioplasty (if near hospital)
Thrombolysis ( if far away)
What should be administered after this?
Aspirin and Clopidogrel or Ticagrelor
Low MW Heparin or Fondaparinux
And further to that…? (STEMI treatment)
SAAB
What is fondaprinux?
Synthetic pentasaccharide that inhibits activated factor x
List treatments for NSTEMI.
Aspirin and Clopidogrel OR Ticagrelor Fondaparinux
Angioplasty (not as emergency)
SAAB
What is treatment for troponin negative ACS?
SAAB with selective use of angioplasty
If chest pain is ongoing after treatment, what should be administered?
Glycoprotein IIb/IIIa Inhibitor
e.g Tirofiban
What type of drugs are ticagrelor and prasugrel?
Antiplatelets
What are the 3 crucial goals you must try to achieve in treating AF?
Prevent emboli Control rate (crucial) Control rhythm (seldom done, since fairly ineffective)
How are emboli prevented in AF?
Warfarin/Rivaroxaban
How is the rate controlled?
Beta blockers
Digoxin
How can rhythm control be achieved?
DC Cardioversion
Amiodarone if heart failure
Sotalol (II/III) possible
Flecainide (Ic) only if heart structure/function normal
List 3 causes of stroke.
Cerebral Thrombosis
Cerebral Embolus
Cerebral Haemorrhage
If there is no cerebral haemorrhage shown on the CT scan, what drugs are administered to a stroke patient?
Aspirin for 2 weeks
Thereafter, clopidogrel
List 3 additional drugs used in stroke treatment.
Statin
ACE inhibitor
Indapamide
What are the common side effects of ACE inhibitors?
Cough
Renal dysfunction (worsen or improve) ANGIONEURMTIC OEDEMA (life-threatening)
Never in pregnancy
What are the common side effects of beta blockers?
Bradycardia /Heart Block
Tired
Asthma (Not in asthmatics)
What are the common side effects of calcium antagonists?
Ankle oedema for Amlodipine
Heart Block for Diltiazem & Verapamil
What are the common side effects of diuretics?
Hypokalaemia
Diabetes
Gout
What are the common side effects of angiotensin blockers?
Renal dysfunction (worsen or improve) Never in pregnancy
