Tricky CPT

Question 1

amiloride vs amiodarone vs amlodipine

Answer 1

amiloride- potassium sparing diuretic

amiodarone- antiarrhythmic

amlodipine- CCB antihypertensive

Question 2

amiloride

Answer 2

potassium sparing diuretic (usually coupled with other diuretics s e.g. furosemide to reduce change of hypokalaemia)

uses: oedema, hypertension, nephrotic syndrome, heart failiure

• Block eNac channels
• Less active Na/K ATPase
• Less potassium pumped out into tubule

Question 3

amlodipine

Answer 3

calcium channel blocker

(prevents release of intracellular calcium, preventing peripheral vasculature vasoconstriction–> decrease TPR= decrease BP)

• hypertension
• angina

Question 4

amiodarone

Answer 4

antiarrythmic

This includes ventricular tachycardia, ventricular fibrillation, and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia.

Question 5

adensoine vs atropine

Answer 5

adenosine

• Supraventricular tachycardia
• Terminating re-entrant SVT
• Diagnosis of coronary artery disease

atropine

• Vagal Bradycardia

Question 6

heparin vs warfarin

Answer 6

both anticoagulants

Question 7

Indications for use of heparins

Answer 7

• Prevention of venous thromboembolism
  
  • perioperative prophylaxis with LMWH - duration and dose is dependant on risk
• During pregnancy used as do not cross placenta – monitored with caution
• Venous Thromboembolism (VTE)–DVT and PE
  
  • initial treatment prior to oral agents (see later slides)
  • Long term in some patient group
  • Cancer related VTE
• Acute Coronary Syndromes (ACS)
  
  • short term - reducing recurrence and or extension of coronary artery thrombosis post STEMI- PCI and non PCI patients
  • NSTEMI

Question 8

Indications for use of warfarins

Answer 8

• Venous thromboembolism
• PE
• DVT (and secondary prevention Superficial vein thrombosis)
• Atrial fibrillation with high risk of stroke (use CHA2DS2Vasc)
• Patients who need cardioversion
• Heart valve replacement bio prosthetic and some mechanical
• Generally used in longer term anticoagulation compared to heparins
• Slow onset of action likely to require heparin cover (see later slides) if anticoagulation needed immediately

Question 9

anticoagulants vs antiplatelets

Answer 9

both anti-thrombotic agents

Anticoagulants, more commonly referred to as “blood thinners,” work by inhibiting the clotting factors.

• target coagulation cascade

Antiplatelets work by inhibiting the enzymes that cause the platelets to clump together.

• target platelets