The Practice of Treating Cardiovascular Patients Flashcards
what drugs do ABCD stand for?
A- ace inhibitor+ Angiotensin 2 receptor blockers
B- beta blocker
C- calcium antagonist
D- diuretic
what drug treatment is used for hypertension?
primary: A, C, D- especially thiazide like diuretics
secondary: alpha blocker- Doxazosin, aldosterone blocker- spironolactone
what is the drug treatment plan for patients with hypertension under 55?
A then C then D if still necessary
afterwards: beta, alpha or spironolactone
what is drug treatment method for patients with hypertension over the age of 55?
C then A then D last and if still you can add the beta, alpha and spironolactone
briefly describe chronic heart failure.
heart damaged by some disease and as a result the damaged parts of the heart doesn’t contract as well as the rest of the heart and therefore there is a reduced CO
what is the drug treatment for chronic heart failure?
D- loop diuretic- get rid of fluid accumulated due to poor CO
A
B
if still breathless spironolactone or eplerenone which is more specific can be given
why would you use eplerenone over spironolactone?
spironolactone blocks androgens also hence males have less testosterone- gynecomastia
what devices can be used to treat chronic heart failure?
- cardiac resynchronisation therapy
- implantable cardiac defibrillators- sense heart rhythms and life threatening ones
in severe heart failure what drug now replaces A?
sacubitril- Valsartan
- valsartan is an ARB
- sacubitril inhibits enzyme Neprilysin which breaks down vaso active peptides such as B-type nasoactive peptide hence this is increased
What drug treatment is given to prolong the survival of angina patients?
- statin
- aspirin
- A
- B
what drugs are used to relieve angina symptoms allowing patient to exercise more?
- B
- C
- anticoagulants- Ivabradine, Ranolazine
what other treatments are used to relieve angina symptoms?
- coronary angioplasty
- coronary artery surgery
How is acute chest pain classified?
Troponin negative- acute coronary syndrome, unstable angina, severe ischaemia
Troponin positive- MI- ST or Non ST elevation
How is STEMI treated? emergency? long term?
-treatment must be rapid
emergency- aspirin, angioplasty or if unable then thrombolysis
long term- aspirin and either tiagrelor or clopidogel (anti platelet drugs), low molecular weight heparin, fondaparinux
give: statin, A and B also
how is NSTEMI treated? what prophylaxis treatment is give?
- aspirin+ clopidogel or tiagrelor
- fondaparinux
prophylaxis: statin, A and B
