Cardiovascular Drugs 1

Question 1

what is the pathophysiology of AF?

Answer 1

chaotic atrial electrical activity

Question 2

what is the Fibrosis and loss of atrial muscle mass related to?

Answer 2

Ageing

     - Chamber dilatation
     - Inflammation
     - Genetic

Question 3

Risk factors of AF?

Answer 3

Hypertension
Valvular heart disease
Coronary artery disease
Cardiomyopathy
Congenital heart disease
Previous cardiac surgery
Pericarditis
Lung disease -  PE, Pneumonia, COPD
Hyperthyroidism
Alcohol

Question 4

how is AF classified?

Answer 4

Lone AF

Paroxysmal (<7 days)

Persistent (>7 days)

Permanent (>7 days ± Cardioversion)

Question 5

clinical features of AF

Answer 5

Asymptomatic
Palpitations
SOB
Chest pain 
Syncope
Pre-syncope
Heart failure

Question 6

what are the treatment options for AF?

Answer 6

rate control
rhythm control
anticoagulation

Question 7

if <48 hours recent onset AF, how would you manage?

Answer 7

rhythm control

Question 8

if >48 hours AF, mx?

Answer 8

rate control

Question 9

when is rhythm control preferred?

Answer 9

Symptom improvement

Younger patient

Heart failure related to AF

Adequacy of rate control

Question 10

what is 1st and 2nd line rate control for AF in those with no HF?

Answer 10

1. Beta blocker

2. CCB such as verapamil or diltiazem

Question 11

what is 1st and 2nd line rate control for AF in those with HF?

Answer 11

1. digoxin/ amiodarone

2. amiodarone

Question 12

what do you use for rhythm control?

Answer 12

1. fleicanide and sotalol.

if the heart is abnormal then amiodarone.

Question 13

give 2 examples of rate limiting CCB

Answer 13

verapamil

diltiazem

Question 14

cut off for chadsvasc ?

Answer 14

> /= 2

Question 15

cut off for hasbled ?

Answer 15

> /= 3

Question 16

who do we offer a statin to ?

Answer 16

To people who have a 10% or greater 10‑year risk of developing CVD.

Adults with type 1 diabetes

People with chronic kidney disease

Offer atorvastatin for the secondary prevention of CVD in any patient who has had a stroke or MI.

Question 17

what is ezetimibe used for?

Answer 17

Ezetimibe monotherapy is recommended as an option for treating primary (heterozygous‑familial or non‑familial) hypercholesterolaemia in adults in whom initial statin therapy is contraindicated or not tolerated

Question 18

which drugs dont reduce mortality in HF patients?

Answer 18

Diuretics

digoxin

Question 19

what is the treatment for CCF?

Answer 19

diuretics
ace inhibitors beta blockers
spirinolactone

Question 20

when is ivabradine used in HF pts?

Answer 20

Ivabradine – Used with or in place of beta blocker if heart rate too high (>75 bpm)

Question 21

what other forms of therapy can you use in HF?

Answer 21

Coronary revascularisation

Cardiac resynchronisation therapy

Cardiac transplantation