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The Patient - pharmacology (Y2-1) > Management of AF > Flashcards

Management of AF Flashcards

1
Q

What type of tachycardia is AF?

A

Supraventricular

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2
Q

What are the common causes of AF?

A

Excessive alcohol consumption
CHD
Thyrotoxicosis

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3
Q

50% of AF cases are asymptomatic. What are some of the symptoms that AF patients may present with?

A

Syncope
Dyspnoea
Half notice palpitations

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4
Q

Patients with AF are 5 times more likely to have a stroke. True or false?

A

True

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5
Q

What is meant by a lone AF?

A

Single episode
Structurally normal heart
Low risk of thromboembolic event

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6
Q

What is meant by paroxysmal AF?

A

Spontaneous termination within 7 days

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7
Q

What is meant by persistent AF?

A

Non-self terminating and is persistent for over 7 days

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8
Q

What is meant by permanent AF?

A

Non-terminated or terminated and relapsed

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9
Q

How long does acute AF last for?

A

Less than 48 hours

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10
Q

How is paroxysmal AF treated?

A

B-blocker or rate limiting CCB

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11
Q

What is the aim of treatment in paroxysmal AF?

A

Reduce frequency of self-limiting episodes
Prevent the occurrence
Control ventricular rate during episodes

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12
Q

What is the aim for treatment of persistent/permanent AF?

A

Heart rate control

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13
Q

What is first line treatment given for persistent/permanent AF?

A

B-blocker or rate limiting CCB

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14
Q

What is given for treatment of persistent/permanent AF if monotherapy doesn’t work?

A

Two of either beta blocker, digoxin, diltiazem

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15
Q

If dual therapy doesn’t work in treatment of persistent/permanent AF, aim of treatment should become controlling rate. True or false?

A

False - should move on from controlling rate to controlling rhythm

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16
Q

What is cardioversion?

A

Involves an electrical shock into chest wall to override conduction pathways and allow sinus nodes to control HR again

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17
Q

Cardioversion is used to control heart rate. True or false?

A

False - used for rhythm control

18
Q

All patients are successfully cardioverted on their first attempt. True or false?

A

False - 80%

19
Q

If patient re-lapses after cardioversion, what treatment is given?

A

Long-term B blocker

20
Q

Can digoxin cardiovert?

A

No, it controls heart rate not rhythm

21
Q

Photosensitivity and skin discolouration are common side effects of which drug?

A

Amiodarone

22
Q

Amiodarone converts the heart back to sinus rhythm. True or false?

A

True

23
Q

Amiodarone interacts with digoxin and which other drug?

A

Warfarin

24
Q

What is the CHA2DS2VASc risk assessment used for?

A

To assess risk for use of anti-coagulant in treatment of AF

25
Q

Should patients with a CHA2DS2VASc risk score of >2 be anticoagulated?

A

Yes

26
Q

Should anti-coagulation be considered for male patients with a CHA2DS2VASc risk score of 1?

A

Yes

27
Q

What is the HAS-BLED score used for?

A

Once CHA2DS2VASc risk has been established, risk assess bleeding risk for patient who need anti-coagulation

28
Q

What HAS-BLED score indicates a risk of bleeding and what does this mean?

A

> 3 - does not disqualify use of anticoagulants but use with caution

29
Q

What does INR stand for?

A

International normalised ratio - blood test to see how long blood takes to clot

30
Q

How long is the onset of warfarin?

A

2-3 days

31
Q

What is the normal INR value?

A

1

32
Q

What is the target INR is AF patient?

A

2.5

33
Q

How do laxatives interact with warfarin?

A

They reduce warfarin absorption

34
Q

What does a high INR mean?

A

Blood takes a long time to clot and so increased risk of haemorrhage

35
Q

What does a low INR mean?

A

Blood clots quickly and so increased risk of thromboembolic events

36
Q

What is the result of the interaction between warfarin and metronidazole?

A

Reduced warfarin metabolism and so enhanced effects of warfarin

37
Q

Vitamin K interferes with warfarin. True or false?

A

True

38
Q

Patients should be counselled if they take warfarin. What should they be told?

A

Tell all practitioners they are on warfarin
Reduce alcohol
Diet - Vit K
Bring yellow book to appointments

39
Q

What colour is a 1mg tablet of warfarin?

A

Brown

40
Q

What colour is a 3mg tablet of warfarin?

A

Blue

41
Q

What colour is a 5mg tablet of warfarin?

A

Pink

The Patient - pharmacology (Y2-1) (18 decks)

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