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Pharmacology MD3001 > Treatment of CV patients > Flashcards

Treatment of CV patients Flashcards

1
Q

What is not a use of a calcium antagonist?

A

In heart failure

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2
Q

What is not a use of a diuretic?

A

In angina

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3
Q

Describe the treatment of patients with type 2 diabetes and those under age 55 with hypertension

A

1) ACEi or ARBs.
2) Adding a CCB or thiazide diuretic.
3) Adding CBB AND thiazide diuretic. (ACD)
4) Confirm resistant hypertension and consider spironolactone or alpha/beta-blocker.

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4
Q

Describe the treatment of hypertension in patients over age 55 and Black African/afro-Caribbean origin.

A

1) Calcium Channel Blocker
2) Add an ACEi/ARB or thiazide diuretics
3) same as under age 55 (CAD)
4) Same as under age 55

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5
Q

Generally, what medication is used in treatment of hypertension?

A

ABCD:

  • ACEi/ARBs
  • Beta Blockers (less commonly used)
  • Calcium antagonists
  • Diuretics.
  • Then also can use alpha blockers like doxazosin and spironolactone.
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6
Q

Briefly describe how you treat chronic heart failure

A

1) DAB unless contraindicated.
2) Give spironolactone/eplerenone.
3) Selected treatment: SGLT2 inhibitors eg, Dapagliflozin, Sacubitril/valsartan, or ICDs or CRT

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7
Q

Describe features of Sacubitril/Valsartan combination?

A

More effective than ACEi/ARBs.

Valsartan - ARB

Sacubitril - Neprilysin inhibitor which prevents degradation of BNP and ether vasoactive peptides.

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8
Q

What is the treatment to prolong survival in Angina Pectoris?

A

SAAB

  • Statins,
  • Aspirin,
  • ACE inhibitors,
  • Beta Blocker.
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9
Q

What is the treatment to relieve symptoms in Angina Pectoris

A
  • New Antianginal drugs (Ivabradine, Ranolazine),
  • Beta blockers,
  • Calcium antagonists or Nitrates
  • Coronary angioplasty/ Coronary artery surgery
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10
Q

Cardiac pain with troponin negative could be?

A

Troponin negative unstable angina/acute coronary syndrome

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11
Q

Chest pain can be caused by four entities?

A
  • STEMI
  • NSTEMI
  • Troponin negative unstable angina/ACS
  • Non cardiac chest pain
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12
Q

What is the treatment for STEMIs?

A

Emergency - Aspirin, Angioplasty (if near hospital), or thrombolysis (if hospital too far).
Also - Aspirin and clopidogrel/ Ticagrelor. Low molecular weight heparin or fondaparinux. Statins, ACEi and BBs.

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13
Q

Describe the treatment for NSTEMI?

A
  • Aspirin and clopidogrel/ticagrelor.
  • Angioplasty (not emergancy)
  • Statins, ACEi and BBs
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14
Q

What is the treatment of Troponin Negative Unstable angina/ ACE

A
  • Aspirin and clopidogrel,
  • Selective use of angioplasty
  • ACE inhibitor
  • Beta blockers
    -Statins
    SAAB plus selective angioplasty
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15
Q

What is the treatment atrial fibrillatio?

A

1) prevent emboli via warfarin/Rivaroxaban/NOACs
2) Control the rate (crucial) via Beta blcokers or digoxin.
3) Control rhythm (seldom done) via DC cardioversion, amiodarone if HF, Sotalol or flecainide.

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16
Q

What are the causes of stroke/cerebral vascular accident?

A

Cerebral thrombosis, cerebral embolus or cerebral haemorrhage.

17
Q

Describe the management of strokes?

A

MUST CT scan to differentiate haemorrhage from clot. If there is no haemorrhage then need emergency thrombolysis, possibly thrombectomy is available and aspirin and clopidogrel. Also then statins, ACE inhibitors and Indapamide.

18
Q

What are the common side effects of ACE inhibitors?

A
  • Cough.
  • Renal dysfunction (improve/worsen).
  • Angioneurotic oedema (SO SERIOUS)
  • Never ever in pregnancy.
19
Q

What are the common side effects of angiotensin blockers?

A
  • Renal dysfunction (improve or worsen).

- Never ever in pregnancy

20
Q

What are the common side effects of beta blockers?

A
  • Bradycardia/Heart block.
  • Tired.
  • Contraindicated in asthma.
21
Q

What are common side effects of calcium antagonists?

A
  • Ankle oedema for amlodipine.

- Heart block for verapamil and diltiazem

22
Q

What are the common side effects for diuretics?

A

Hypokalaemia, diabetes and gout.

Pharmacology MD3001 (14 decks)

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