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GPhC Exam > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Ectopic beats treatment

A
  • ectopic beats are spontaneous - rarely need treatment
  • if treatment required - b-blockers
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2
Q

Atrial fibrillation treatment summary

A
  • stroke risk
  • ventricular rate or sinus rhythm control
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3
Q

Life threatening AF treatment

A
  • haemodynamic instability = emergency electrical cardioversion ASAP for anticoagulation
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4
Q

AF onset < 48 hours - acute treatment

A

rate OR rhythm control

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5
Q

AF onset > 48 hours - acute treatment

A

rate control

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6
Q

What is used for urgent rate control

A
  • IV b-blocker OR
  • verapamil LVEF > > 40 %
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7
Q

If cardioversion (rhythm control) agreed:

A
  • pharmacological = flecainide or amiodarone
  • electrical = IV anticoagulation to rule out left atrial thrombus
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8
Q

AF maintenance treatment

A
  1. rate control monotherapy - b-blocker (not sotalol) or RLCCB (digoxin - sedentary in non-paroxysmal)
  2. rate control dual therapy
  3. rhythm control - electrical or pharmacological cardioversion
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9
Q

AF > 48 hours - maintenance treatment

A
  • electrical preferred = risk of clotting so fully anticoagulated for at least 3 wks before and 4 wks after
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10
Q

Drug treatment post cardioversion

A

b-blocker OR 1 of:
Sotalol
Propafenone
Amiodarone
Flecainide

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11
Q

What is used with electrical cardioversion to improve success of procedure

A

amiodarone 4 wks before and up to 12 months after

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12
Q

Paroxysmal AF treatment

A
  1. ventricular rhythm control = b-blocker
  2. SPAF
    - episodes of symptomatic paroxysmal AF = ‘pill-in-pocket’ - felcainide/propafenone PRN on symptoms
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13
Q

CHA2DS2VASc score

A
  • congestive HF - 1
  • hypertension - 1
  • age 75+ - 2
  • diabetes - 1
  • stroke/tia - 2
  • vascular disease - 1
  • age 65-74 - 1
  • sex = female = 1
  • men > >1, women > >2 = thromboprophylaxis
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14
Q

Stroke risk treatment AF

A

DOAC in non-valvular AF or warfarin

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15
Q

Atrial flutter treatment

A
  • rate or rhythm control but less effective
  • rate control temporary until sinus rhythm restored = b-blocker or RLCCBS
  • rhythm control = direct current cardioversion for rapid control. pharmacological, catheter ablation for recurrent flutter
  • assess for stroke risk
  • anticoagulant for 3 weeks if flutter lasted > 48 hours
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16
Q

Paroxysmal supraventricular tachycardia treatment

A
  1. terminate spontaneously/alone - no tx
  2. reflex vagal stimulation - valsalva manoeuvre with ECG monitoring - face in ice cold water/carotid sinus massage
  3. IV adenosine
  4. IV verapamil
    - recurrent = catheter ablation, prophylaxis = b-blockers or RLCCBs
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17
Q

Ventricular tachycardia treatment

A
  • pulseless VT or VFib = resuscitation (ECG = random)
  • unstable sustained VT = direct current cardioversion - IV amiodarone - repeat current cardioversion
  • stable VT = IV amiodarone - direct current cardioversion not sustained VT = b-blocker
  • high risk cardiac arrest = maintenance = implantable cardioverter defibrillator, can add b-blocker alone or with amiodarone
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18
Q

Torsade de pointes (QT prolongation) treatment

A
  • drug induced or caused by hypokalaemia and severe bradycardia = amiodarone, sotalol, macrolides, haloperidol, SSRIs, TCAs, antifungals
  • self limiting but can be recurrent - impaired consciousness
  • if not controlled = Vfib = death
  • treat with IV magnesium sulfate
  • b-blocker (not sotalol) and atrial/ventricular pacing considered
  • no anti-arrhythmias = prolongs QT interval = worsens condition
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19
Q

Anti-arrhythmic drugs

A
  • classified into acting on: supraventricular arrhythmias, ventricular arrhythmias or both
  • also according to electrical behaviour:
    1. membrane stabilising drugs (lidocaine, flecainide)
    2. b-blockers
    3. amiodarone, sotalol
    4. RLCCBs ONLY - not ‘pines’
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20
Q

Warfarin and INR limits

A
  • INR 2.5 = VTEs, AF, cardioversion, MI, cardiomyopathy
  • INR 3.5 = recurrent VTEs or mechanical heart valves
  • major bleed = stop warfarin - IV phytomenadione & dried prothrombin
  • INR > 8, minor bleed - stop warfarin & IV vit K
  • INR > 8, no bleeding - stop warfarin & oral vit K
  • INR 5-8, minor bleed - stop warfarin & IV vit K
  • INR 5-8, no bleed - withhold 1-2 doses of warfarin
  • start warfarin when INR < 5
  • monitor INR every 1-2 days in early tx, then very 12 weeks
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21
Q

Warfarin MHRA warning

A

skin necrosis & calciphylaxis (painful skin rash)

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22
Q

Warfarin side effects

A
  • haemorrhage - vit K
  • teratogenic - avoid in 1st and 3rd trimester - use contraception
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23
Q

Warfarin interactions

A
  • vit K foods (leafy greens) - reverses warfarin
  • pomegranate and cranberry juice - increase INR
  • miconazole (OTC daktarin gel) - increases INR
  • CYP 450 inhibitors/inducers - increase/decrease warfarin conc
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24
Q

Warfarin and surgery

A
  • minor, low bleeding risk = INR < 2.5, warfarin restarted within 24 hours
  • risk of bleeding = stop warfarin 3-5 days before, INR <1.5 day before surgery (vit K to reduce), if high risk VTE bridge with LMWH - stop LMWH 24 hours before restart LMWH 48 hours after
  • emergency surgery = IV vit K and prothrombin complex, if can be delayed 6-12 hours - IV vit K alone
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25
Q

Apixaban VTE dose

A

10mg BD for 7 days then 5mg BD

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26
Q

Apixaban AF dose

A
  • 5mg BD
  • 2.5mg BD of 2 of: 80 yrs +, < < 60kg, CrCl > > 133 mol/L
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27
Q

Rivaroxaban VTE dose

A

15mg BD for 3 weeks then 20mg OD - with food

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28
Q

Rivaroxaban AF dose

A

20mg OD - with food

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29
Q

Dabigatran VTE dose

A
  • 150mg BD aged 18-74
  • 110-150mg BD aged 75-79
  • 110mg BD aged 80+
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30
Q

Dabigatran AF dose

A
  • 150mg BD aged 18-74
  • 110-150mg BD aged 75-79
  • 110mg BD aged 80+
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31
Q

Edoxaban VTE dose

A
  • 60mg OD
  • 30mg OD if weigh <61kg
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32
Q

Edoxaban AF dose

A
  • 60mg OD
  • 30mg OD if weigh <61kg
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33
Q

Amiodarone loading dose

A

200mg TDS for 7 days then BD for 7 days then OD maintenance

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34
Q

Amiodarone side effects

A
  • reduce HR so avoid in bradycardia and heart block
  • corneal microdeposits - reversible - blurred/dazzled headlights
  • thyroid disorders - hypo/hyper due to iodine content
  • photosensitivity reactions - avoid sun, use sunscreen for months after tx ends - long t1/2
  • hepatotoxicity - stop if jaundice, dark urine, abdo pain, NV, pale stools
  • pulmonary toxicity - SOB, cough
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35
Q

Amiodarone interactions

A
  • long t1/2 = potential for months after ending
  • drugs that cause hypokalaemia, QT prolongation, bradycardia - b-blockers, RLCCBs
  • CYP substrates (amiodarone = inhibitor)
  • grapefruit (inhibitor)
  • warfarin, contraceptives, statins
  • 1/2 digoxin dose with amiodarone - digoxin = enzyme inhibitor
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36
Q

Amiodarone monitoring

A
  • LFTs, TFTs - before tx, then 6 monthly
  • CXR - before tx, serum conc of K+ - before tx
  • annual eye examinations
  • IV use = ECG and liver transaminase
  • sofosbuvir, daclatasvir, simeprevir, ledipasvir = extreme monitoring, risk of severe heart block = fatal
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37
Q

Digoxin AF loading dose

A
  • 125-250mcg OD
  • different formulations = different bioavailability
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38
Q

Digoxin therapeutic range

A
  • 0.7 - 2.0 ng/ml
  • toxicity from 1.5 - 3.0 ng/ml - tx with digoxin-specific antibody (digifab)
  • levels 6 - 12 hours after dose, monitor electrolytes & renal function
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39
Q

Digoxin toxicity

A

bradycardia, SA/AV block, DV, dizziness, confusion, depression, blurred or yellow vision. Sick and slow

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40
Q

Digoxin interactions

A
  • b-blockers = increased risk of AV block and increases in plasma concs
  • TCAs - can induce arrhythmias
  • drugs that cause hypokalaemia - increased risk of digoxin toxicity
  • CYP 450 inducers - reduces plasma concs
  • CYP 450 inhibitors - increases plasma concs
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41
Q

What is VTE

A

clot in vein - obstructs bloods flow

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42
Q

What is DVT

A

in legs or pelvis - unilateral localised pain or swelling

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43
Q

What is PE

A

in lungs - chest pain or SOB

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44
Q

Risk factors of VTE

A

surgery, trauma, immobility, malignancy, obesity, pregnant, COC, HRT

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45
Q

Diagnostic test for VTE

A

d-dimer

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46
Q

VTE prophylaxis

A

mechanical (stockings), or pharmacological (anticoags) - start within 14 hours of admission, VTE > bleed, ORBIT or HASBLED

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47
Q

VTE prophylaxis - surgery

A
  • mechanical until mobile/discharged
  • pharmacological when VTE > bleed
  • LMWH suitable in all general and ortho surgeries
  • UFH in renal impairment - lower t1/2 than LMWH
  • fondaparinux for lower limb immobilisation or pelvis fragility fractures
  • at least 7 days post op, or until sufficient mobility
  • 28 days after cancer surgery in abdomen
  • 30 days after spinal surgery
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48
Q

VTE prophylaxis in elective hip replacement

A
  • LMWH 10 days then 75mg aspirin 28 days OR
  • LMWH 28 days + stockings until discharge OR
  • rivaroxaban 10mg OD for 35 days
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49
Q

VTE prophylaxis elective knee replacement

A
  • 75mg aspirin for 14 days OR
  • LMWH 14 days + stockings until discharge OR
  • rivaroxaban 10mg OD for 35 days
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50
Q

General medicine patients with increased risk of VTE

A

pharmacological prophylaxis for at least 7 days or mechanical until mobile

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51
Q

VTE prophylaxis in pregnancy

A
  • if VTE > bleeding - LMWH during admission until no risk of VTE or discharged
  • birth/miscarriage/abortion in past 6 wks = LMWH 4-8 hours after event, min 7 days + mechanical if immobilised until mobile/discharged
  • Tx of VTE = LMWH; UFH if increased risk of haemorrhage
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52
Q

Proximal DVT or PE treatment

A
  • apix or rivarox - 3 months min (3-6 months if active cancer)
  • if unsuitable = LMWH 5 days min then dabigatran or edoxaban OR LMWH + warfarin 5 days min or until INR > > 2 x 2 in a row then warfarin alone
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53
Q

Distal DVT treatment

A
  • 6 weeks tx
54
Q

Provoked DVT/PE treatment

A
  • e.g. immobile/COC - stop at 3 months if provoking factor resolved
55
Q

Unprovoked DVT/PE treatment

A

3 months +

56
Q

Recurrent DVT/PE treatment

A

longterm

57
Q

All heparins information

A
  • avoid in heparin-induced thrombocytopenia
  • can cause hyperkalaemia
  • haemorrhage = tx with protamine sulfate - only effective for UFH
58
Q

UFH information

A
  • quick initiation & elimination
  • good for increased bleeding risk (monitor APTT)
  • increased risk of heparin induce thrombocytopenia
  • preferred in renal impairment
59
Q

LMWH information

A

preferred in pregnancy

60
Q

Bleeding disorders information

A
  • bleeding disorder = cant stop blood from running (doesn’t clot)
  • tx help formation of clots
  • tranexamic acid for surgeries, dental extraction, menorrhagia = GI, NV
  • desmopressin for mild-mod haemophilia and von willebrands disease
61
Q

Haemorrhagic stroke management

A
  • manage BP (will be very high)
  • avoid statins
62
Q

Ischaemic stroke initial management

A
  • initial = 300mg aspirin
  • TIA = 300mg daily until diagnosis established
  • ischaemic = 300mg for 14 days following alteplase within 4.5 hours
63
Q

Ischaemic stroke long-term management

A
  1. clopidogrel 75mg OD
  2. dipyridamole MR and aspirin 75mg
  3. dipyridamole MR or aspirin 75mg
    - start high intensity statin 48 hours after as troke
    - manage hypertension to achieve < 130/80
    - DONT use b-blockers
64
Q

Stage 1 hypertension targets

A
  • 140/90 - 159/99 - clinic
  • 135/85 - 149/94 - ambulatory
  • tx if < 80 yrs with kidney disease, diabetes, CVD, or QRISK > 10 %
  • drug tx and lifestyle if < 60 yrs with QRISK < 10%
  • drug tx if > 80 yrs with BP over 150/90
65
Q

Stage 2 HTN targets

A
  • 160/100 - 180/120 - clinic
  • > 150/95 - ambulatory
  • tx all
66
Q

Stage 3 HTN targets

A
  • > 180/120
  • medical emergency
67
Q

HTN treatment <55 yrs or T2DM

A
  1. ACEi or ARB
  2. & CCB or TLD
  3. ACEi/ARB + CCB + TLD
  4. K+ < 4.5 = spiro, K+ > 4.5 = a or b-blocker
68
Q

HTN treatment > 55 year or afro-carribbean

A
  1. CCB
  2. & ACEi or ARB
  3. ACi/ARB + CCB + TLD
  4. K+ < 4.5 = spiro, K+ > 4.5 = a or b-blocker
    - ARB in black, ACEi in diabetes, black and diabetes = ARB
69
Q

HTN in pregnancy treatment

A
  • high risk of pre-elampsia if kidney disease, diabetes, autoimmune disease
  • aspirin from week 12 until birth
  • if BP > 140/90:
    1. labetolol - avoid in asthma
    2. nifedipine - avoid in HF
    3. methyldopa - stop 48 hours after birth
  • BP target = 135/85 - clinical
70
Q

BP Targets

A
  • age < 80 = 140/90 (clinical)
  • age > 80 = 150/90 (clinical)
  • renal disease = 140/90 (clinical)
  • pregnancy = 135/85 (clinical)
  • diabetes = 140/90
  • diabetes + > 80 years = 150/90
  • diabetes + kidney disease = 130/80
71
Q

ACEi side effects

A
  • Cough (ARB instead)
  • Hyperkalaemia
  • Hepatic impairment
  • Angioedema
  • Renal impairment
  • Dizziness & headaches
    CHHARD
72
Q

ARB side effects

A

same side effects as ACEi (CHHARD) except cough and angioedema

73
Q

ACEi/ARB interactions

A
  • increased risk of renal failure - ARBs, K+ sparing diuretics, NSAIDs
  • hyperkalaemia - heparins, NSAIDs, Ksparing diuretics, b-blockers
  • risk of volume depletion - diuretics
  • increased plasma levels of lithium
74
Q

Cardioselective b-blockers

A
  • less likely to cause bronchospasms (better in asthma)
  • Bisoprolol
  • Atenolol
  • Metoprolol
  • Acebutolol
  • Nebivolol
  • BAtMAN
75
Q

Water soluble b-blockers

A
  • less likely to cross BBB = less nightmares
  • Celiprolol
  • Atenolol
  • Nadolol
  • Sotalol
  • water CANS
76
Q

Intrinsic sympathomimetic b-blockers

A
  • less likely to cause cold extremities
  • Pindolol
  • Acebutolol
  • Celiprolol
  • Oxprenolol
  • Ice PACO
77
Q

b-blockers side effects

A
  • bradycardia or HF
  • blunts effects of hypoglycaemia (palpitations, tremors, sweating)
  • can cause hyperglycaemia
  • bronchospasm - contraindicated in asthma
78
Q

b-blockers interactions

A
  • digoxin, Amiodarone - heart block/bradycardia
  • any other hypotensive drugs
79
Q

Dihydropyridine CCBs

A

amlodipine, felodipine, lacidopine, lercanidipine, nifedipine

80
Q

Rate limiting CCBs

A

diltiazem, verapamil

81
Q

CCBs side effects

A
  • dizziness
  • gingival hyperplasia
  • vasodilatory effects (flushing, headaches, ankle oedema) - more in dihydropyridines
  • complete AV block - more in RLCCBs
82
Q

Cholesterol level ranges

A
  • total cholesterol = 5 or below
  • HDL (good) = 1 or above
  • LDL (bad) = 3 or below
  • non-HDL (bad) = 4 or below
  • triglycerides = 2.3 or below
83
Q

Lipid lowering agents offered in:

A
  • under 85 with QRISK > 10%
  • T2DM with QRISK > 10%
  • T1DM with age > 40, diabetes for > 10 years, established nephropathy
  • CKD
  • familial hypercholesterolaemia
84
Q

Statins names and administration time

A
  • atorvastatin, rosuvastatin = anytime
  • simvastatin, fluvastatin, pravastatin = at night
  • cholesterol produced at night
  • atorvastatin 80mg = strongest = 2ndary prevention
85
Q

Statins monitoring

A
  • rule out thyroid disorders - if hypo = manage before statin initiation
  • high risk of diabetes = FBG or HbA1c before statin initiation - repeat after 3 months
  • before initiation = LFTs, TFTs, renal, full lipid profile
  • LFTs before, 3 months, 12 months - stop if 3x UL
  • CK if muscle pain - 5xUL = remeasure in 7 days, if still 5xUL = don’t start, if raised but not 5xUL = statin at lower dose
86
Q

Statins interactions

A
  • CYP 450 inducers - reduce concentration of statins
  • CYP 450 inhibitors - increase conc of statins = rhabdomyolysis
  • macrolides = hold statin
  • grapefruit juice
  • oral fusidic acid = hold statin and restart 7 days after last dose
87
Q

CYP 450 enzyme inducers

A
  • Carbamazepine
  • Rifampicin
  • Alcohol
  • Phenytoin
  • Griseofulvin
  • Phenobarbital
  • St Johns Wort
88
Q

CYP 450 enzyme inhibitors

A
  • Sodium valproate
  • Isoniazid
  • Cimetidine
  • Ketoconazole
  • Fluconazole
  • Alcohol
  • Chloramphenicol
  • Eryhtro/clarithromycin
  • Sulfonamides
  • Ciprofloxacin
  • Omeprazole
  • Metronidazole
  • Grapefruit
  • Amiodarone
  • Verapamil
  • Itraconazole
  • Diltiazem
89
Q

Statins side effects

A
  • myopathy and rhabdomyolysis = muscle toxicity = medical advice
  • interstitial lung disease = med attention if dyspnoea, cough, weight loss
  • teratogenic = stop 3 months before conceiving
90
Q

Max doses of statins

A
  • amiodarone/amlodipine/RLCCBs + simvastatin = 20mg
  • ticagrelor + simvastatin = 40mg
  • ciclosporin + atorvastatin = 10mg
  • tipranavir + atorvastatin = 10mg
91
Q

Other lipid lowering agents

A
  • ezetimibe or fibrates (bezafibrate, ciprofibrate, fenofibrate, gemfibrozil)
  • dont give either with statin - risk of rhabdomyolysis
  • fibrates = myotoxicity in renal impairment
  • fibrates = LFTs every 3 months for first year
92
Q

What is myocardial ischaemia

A
  • build up of atherosclerotic plaques = restrict arteries = lowers blood and oxygen to the heart
  • stable angina
  • ACS (unstable angina, NSTEMI, STEMI)
93
Q

Stable angina initial treatment

A
  • predictable chest pain or pressure due to physical exertion or emotion
  • prophylactically or when symptoms arise
  • GTN dose at 5 minute intervals - 999 after 3rd dose
94
Q

Stable angina long term prevention

A
  1. b-blocker (RLCCBs if bb contraindicated - never together)
  2. b-blocker + CCB (‘pines’)
  3. long acting nitrate, nicorandil, ivabradine or ranolazine
    - nicorandil = GI and mucosal ulceration
    - implement healthy life style and introduce 75mg aspirin and low dose statin
95
Q

Nitrates key information

A
  • GTN sublingual tabs = discard 8 wks after opening bottle
  • nitrate free period to prevent tolerance
  • 2nd dose after 8 hours not 12
  • transdermal = leave off for 8-12 hours a day
  • side effects = dizziness, flushing, headaches, risk of falls
96
Q

ACS risk factors

A
  • family history
  • hypertension
  • hypercholesterolaemia
  • diabetes
  • smoking
97
Q

ACS initial Management

A
  • aspirin 300mg stat, pain relief - GTN +/- IV morphine, oxygen if needed
  • test result to determine type of ACS
  • PCI for STEMI within 2 hours - heparin if done through radial access
98
Q

What is unstable angina and NSTEMI

A
  • partial blockage of artery (myocardial necrosis in NSTEMI)
  • NSTEMI = ST not elevated
99
Q

What is STEMI

A
  • complete blockage of artery = myocardial necrosis
  • ST elevated
100
Q

Secondary prevention for all ACS

A
  • DAPT - lifelong aspirin, 12 months of either clopi, prasugrel, ticagrelor. Prasugrel preffered for STEMI
  • ACEi - ARB if contraindicated
  • Statin - atorvastatin 80mg
  • B-blocker - stopped after 12 months if reduced LV ejection fraction
  • if NSTEMI - consider PCI to prevent future MI
  • assess risk of HF
101
Q

Heart failure symptoms

A

SOB, persistent coughing, wheezing, ankle swelling, reduced exercise, fatigue, multiple pillows

102
Q

Heart failure treatment

A
  1. ACEi (ARB if CI) + b-blocker - titrate both up
    alt: hydralazine + nitrate if not tolerated
  2. & aldosterone antagonist - spiro/eplerenone
  3. & amiodarone, digoxin, sac+val, ivabradine or dapagliflozin (dapa = water loss)
    - digoxin if sinus rhythm worsening or severe HF
    - digoxin loading dose in HF = 62.5 - 125 mcg OD
    - loop diuretics to relieve SOB and oedema in fluid retention
103
Q

What is oedema

A

water retention in system = pulmonary (lungs) or peripheral (rest of body e.g. ankle) oedema

104
Q

Thiazide diuretics key information

A
  • bendroflumethiazide, indapamide
  • inhibits sodium reabsorption at beginning of distal convoluted tubule
  • long half life - give early to avoid sleep disturbance
105
Q

Loop diuretics key information

A
  • furosemide, bumetanide, toresamide
  • preferred over thiazide if prone to urinating through night
  • inhibits reabsorption from ascending limb of loop of henle
  • in pulmonary oedema due to left ventricular failure
  • last 6 hours so can be given BD w/o interfering sleep
106
Q

Potassium sparing diuretics key information

A
  • amiloride, triamterene (blue urine)
  • prevents sodium reabsorption in the distal convoluted tubule collecting duct
  • hyperkalaemia - dont take K+ supplements
  • aldosterone antagonists ( a type of K+ sparing diuretics) = spiro/eplerenone. Inhibit potassium secretion in distal tubule collecting duct. Stop if dehydrated due to vomit and/or diarrhoea
107
Q

All diuretics side effects

A
  • hyponatraemia
  • hypomagnesaemia
108
Q

Loop and thiazide diuretics side effects

A
  • hypokalaemia
  • exacerbate diabetes
  • loop only - exacerbates gout
  • hypotension
109
Q

Potassium sparing diuretics side effects

A
  • hyperkalaemia
  • change in libido
  • breast pain or tenderness
110
Q

Diuretics side effects

A
  • loop and thiazide = hypokalaemia inducing drugs
  • K+ sparing = hyperkalaemia inducing drugs
  • Loop and aminoglycosides = nephro and oto - toxicity
  • spiro/loop + lithium = reduced lithium secretion = lithium toxicity
111
Q

Occlusive peripheral vascular disease key information

A
  • normally caused by atherosclerosis
  • reduced risk with healthier lifestyle , statins and antiplatelets
112
Q

Vasospastic peripheral vascular disease (Raynaud’s) key information

A
  • bad circulation to extremities
  • avoid exposure to cold
  • smoking cessation
  • further tx = nifedipine
113
Q

Which beta-blocker has a long duration of action

A

nadolol

114
Q

What drug class is metolazone

A

thiazide-like diuretic

115
Q

Rivaroxaban administration post hip replacement

A

10mg OD for 35 days

116
Q

INR level if switching from warfarin to apixaban

A

<2

117
Q

Which drugs increase the risk of QT interval prolongation when given with sotalol

A
  • haloperidol
  • citalopram
118
Q

Perindopril administration directions

A

30 - 60 minutes before food

119
Q

Reye’s syndrome symptoms

A
  • vomiting
  • seizures
  • increased white cell count
  • increased LFTs
  • delirium
  • lack of energy
  • irritability
  • aggression
  • coma
120
Q

Lifestyle measure to reduce BP

A
  • restrict salt intake to 6g per day
  • 30 minutes exercise 5x week
  • healthy diet including 5 fruit or veg per day
121
Q

Max dose of ramipril when eGFR 30-60

A

5mg

122
Q

What is ticagrelor not licensed with

A
  • aspirin AND low dose rivaroxaban together
  • licensed with aspirin alone
123
Q

Which PPI is the least suitable with clopidogrel

A
  • omeprazole and esomeprazole
124
Q

How long should ramipril be taken before the response is determined

A

4 weeks

125
Q

Which drugs increase the risk of gout

A

diuretics

126
Q

Dipyridamole MR capsules key information

A
  • keep in original container
  • discard 6 weeks after opening
127
Q

Is warfarin okay to use whilst breastfeeding

A

yes

128
Q

Which diuretic can be given BD without risking interfering with sleep

A

furosemide

129
Q

Which drugs can cause secondary hypertension

A
  • ciclosporin
  • leflunomide
  • NSAIDs
130
Q

Which drug is not known to cause secondary hypertension

A

progesterone only pill

GPhC Exam (22 decks)

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