The Practice of Treating Cardiovascular Patients Flashcards
What drugs can be given in hypertension?
- ACE Inhibitors
- Beta Blockers
- Calcium antagonists
- Diuretics
What drugs can’t be given in heart failure?
Calcium antagonists
What drugs can’t be given in angina?
Diruetics
What is the order drugs are given in hypertension?
- A - ACEI or ARB
- B - [Beta Blocker] - religated
- C - Calcium Antagonist
- D - Diruetic
- Spiromolactone
*8Alpha blocker (doxazosin)
Sequence of treating hypertension in a patient younger than 55
- Start A
- Add C
- Add D
- Thein either, B, alpha blocker or spironolactone (preferance)
Sequence of treating hypertension if the patient is older than 55 or of African/Caribbean descent
- Start C
- Add A
- Add D
- Then either B, alpha blocker or spinonolactone
What is recommended treatment in chronic heart failure?
Give DAB to all
- Diruetic
- ACE I or ARB
- Beta blocker
Spironoloactone/eplerenone
**Selected treatments may be required
What are the selected treatments in chronic heart failure?
- Cardiac resynchronisation therapy (biventricular pacing) to those with a long QRS
- Sacubitril/Valsartan to replace ACEI/ARB
- Implantable cardiac defibrillators;
What is a severe side effect of ACEI or sacubitril-valsartan
angioneurotic oedema
What is the action of valsartan
ARB - angiotensin receptor blocker
What is the action of sacubitril?
inhibits neprilysin which degrades BNP and other vasoactive peptides
What do patients with angina get to prolong survival?
- ASpirin
- Statin
- ACE I
- Beta blocker
**SAAB
What do patients with angina sequentially recieve to relieve symptoms?
- Beta blocker
- Calcium antagonists or nitrates
- Coronary angiplasty
- New antianginals
- Ivabradine
- Ranolazine
- Coronary artery surgery
What are the 4 entities of chest pain?
- ST elevation MI (STEMI)
- Non-ST evelation MI (NSTEMI)
- Troponin negtaive unstable angina/ACS
- Non cardiac chest pain
How to treat a STEMI in an emergency
- Aspirin
- Angioplasty (if near hospital)
- Thrombolysis (if far away)
What is given post emegerency for a STEMI?
- Aspirin and clopidogral/ticagreglor
- Low MW heparin/fondaparinaux
What is the subsequent treatment after a STEMI?
- Statin
- Beta blocker
- ACE I
- Aspirin
**SAAB
What is fondaparinux?
synthetic pentasaccharide that inhibits activated factor X
What is the treatment for an NSTEMI?
- Aspirin and clopidogrel/ticagrelor
- Fondaparinaux
- Angioplasty (not as am emergency)
- SAAB
No thrombolysis in an NSTEMI
What is given in the treatment of Unstable Angina?
- Aspirin and clopidogrel
- Selective use of angioplasty
- SAAB
What is given in atrial fibrilation to prevent emboli?
Warfarin/DOCAs
What is given in atrial fibrillation to control rate?
- Beta blocker
- Digoxin
What is given in atrial fibrillation to control rhythm
- DC cardioversion
- Amiodarone (if in heart failure)
- Sotalol (II/III) possible
- Flecainide (Ic) only if heart structure/function is normal
CVA =
Cerebral vascular accident
