Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacy > Cardiovascular > Flashcards

Cardiovascular Flashcards

(97 cards)

Start Studying
1
Q

what are the symptoms of AF?

A

papitations
pounding/ fluttering
dizziness
SOB
tiredness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the three types of AF?

A

paroxysmal AF - episodes stop within 48 hours
persistent AF - episodes last > 7 days
permanent AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the treatment for life threatening haemodynamic instability in AF?

A

electrical cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what treatment should be offered to patients who present with acute AF within the first 48 hours?

A

rate (beta blocker or rate limiting CCB)

AND

rhythm control (flecanide or amiodarone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what treatment should be offered to patients who present with acute AF after 48 hours?

A

rate control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the treatment options for rate control?

A

beta-blocker (not sotalol)
rate limiting CCB (diltiazem or verapamil)
digoxin (non paroxysmal AF who are sedentary) (AF with congestive HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the treatment options for rhythm control?

A

beta blocker (not sotalol)
amiodarone, flecainide, propafenone, sotalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the pill in the pocket approach and when can it be used?

A

used for patients with symptomatic paroxysmal AF
flecainide or propafenone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the treatment step process to managing AF?

A

rate control - monotherapy
rate control - dual therapy
rhythm control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what two tools are used to guide stroke prevention in AF?

A

CHA2DS2-VASc
ORBIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what CHA2DS2-VASc score is required to offer stroke prevention?

A

All patients with a score of 2
Men with a score of 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what drugs can be offered to patients who need stroke prevention in AF?

A

DOAC - non-valvular AF
Warfarin - valvular or DOAC not appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the treatment options for paroxysmal supraventricular tachycardia?

A

1st spontaneous termination or reflex vagal nerve stimulation
2nd IV adenosine
3rd IV verapamil

Prevention: beta blockers or rate limiting CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you treat torsade de pointes?

A

IV magnesium sulfate
beta blocker (not sotalol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the causes of torsade de pointes?

A

sotalol and other drugs causing QT prolongation
hypokalaemia
bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the classes of anti-arrhythmics?

A

Class I: membrane stabilising (lidocaine, flecainide)
Class II: beta blockers (not sotalol)
Class III: Amiodarone, sotalol
Class IIII: CCBs (verapamil and diltiazem)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the loading dose for amiodarone?

A

200mg TDS for 7 days
200mg BD for 7 days
200mg OD thereafter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the side effects of amiodarone?

A

corneal microdeposits - night time glares when driving
optic neuropathy - STOP if vision impaired
phototoxicity - skin burns (use high SPF)
slate grey skin
peripheral neuropathy
pulmonary fibrosis
hepatotoxicity
thyroid (hyper and hypo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what monitoring is required for amiodarone?

A

eye tests annually
chest x ray before treatment
LFTs 6 monthly
TFTs before and 6 monthly
BP and ECG
Serum potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which of the following does not interact with amiodarone?
grapefruit juice
warfarin
morphine
simvastatin
clarithromycin

A

morphine

grapefruit juice - enzyme inhibitor
warfarin - amiodarone is enzyme inhibitor
simvastatin - risk of myopathy
clarithromycin - QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the therapeutic target level of digoxin?

A

1-2 mcg/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what digoxin level is associated with an increased risk of toxicity?

A

1.5-3 mcg/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the symptoms of digoxin toxicity?

A

hypokalaemia
hypercalcaemia
bradycardia/ heart block
nausea, vomiting, diarrhoea, abdo pain
blurred/ yellow vision
confusion
rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the treatment for digoxin toxicity?

A

digoxin specific antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what effect do enzyme inhibitors have on digoxin?
increase plasma concentration, leading to toxicity
26
what effect do enzyme inducers have on digoxin?
reduce plasma concentrations, leading to subtherapeutic doses
27
what test can be used to diagnose a thromboembolism?
D-dimer
28
what are the DOACs?
edoxaban, rivaroxaban, apixaban, dabigatran
29
what are the reversal agents for the DOACs?
andexanet alfa - for apixaban and rivaroxaban idarucizumab - for dabigatran edoxaban has no reversal agent
30
which of the DOACs require an initial loading dose of a LMWH before treatment for confirmed PE/DVT?
dabigatran and edoxaban
31
which DOAC must be taken with food?
rivaroxaban (15mg and 20mg)
32
how long does warfarin take to act?
48-72 hours
33
what is the monitoring requirements for warfarin?
INR every 3 months once stable
34
what is the MHRA alert for warfarin?
calciphylaxis - painful skin rash
35
what are the warfarin targets?
2-3 - AF, VTE, MI 3-4 - recurrent VTE, valvular AF
36
what should be done if a patient presents with an INR of 5-8 and no bleeding?
withhold 1-2 doses reduce maintenance dose measure INR after 2-3 days
37
what should be done if a patient presents with an INR > 8 and no bleeding?
omit warfarin oral phytomenadione repeat if INR still high after 24 hours restart warfarin when INR < 5
38
what should be done if a patient presents with an INR > 5 with bleeding?
omit warfarin IV phytomenadione repeat if INR still high after 24 hours restart warfarin when INR < 5
39
what treatment options are available for stable angina?
Acute angina attacks: Short acting nitrates - (1st GTN, 2nd isosorbide dinitrate) Long term prophylaxis: 1st beta-blockers (atenolol, bisoprolol, metoprolol, propranolol) 2nd BB + CCBs (verapamil, diltiazem) 3rd Ivabradine, Ranolazine, Nicorandil, MR isosorbide dinitrate, isosorbide mononitrate
40
what formulations does GTN come as?
sublingual spray and tablets (tablets must be discarded after 8 weeks)
41
how and when should you take GTN, and when should you escalate care?
when required OR before angina-inducing activities take sitting down as dizziness can occur, under tongue, 1 dose is 1 tablet or 1-2 sprays 1st dose and wait 5 MINS, 2nd dose and wait 5 MINS, 3rd dose and wait 5 MINS, if pain still present, CALL 999
42
what is the risk with nicorandil?
ulcers (mouth, skin, eyes, GI)
43
what is the risk with long acting nitrates which requires specific administration timings?
risk of tolerance leave patches off for 8-12 hours take second dose after 8 hours not 12 hours (MR isosorbide dinitrate and isosorbide mononitrate) MR isosorbide mononitrate is take OD
44
what is the side effects of nitrates?
flushing, throbbing headache, dizziness, postural hypotension, tachycardia, dyspepsia, heartburn
45
what three things come under ACS and how do you differentiate between them?
unstable angina - symptoms NSTEMI - increased troponin but no ST elevation STEMI - increased troponin and ST elevation
46
how should ACS be initially managed?
aspirin 300mg GTN with/ without morphine oxygen if needed
47
if a patient has a STEMI, what treatment should be offered?
PCI within 2 hours *PCI can be considered in NSTEMI
48
what secondary prevention medications would be appropriate following an NSTEMI/ STEMI?
DAPT - Aspirin lifelong with clopidogrel, prasugrel, ticagrelor for 12 months ACE/ ARB BB (12 months if reduced LVEF) Statin GTN
49
how should you manage a stroke?
alteplase within 4.5 hours aspirin 300mg daily for 14 days
50
how should you manage a TIA?
aspirin 300mg daily
51
what is the long term treatment of stroke?
1st clopidogrel 2nd MR dipyridamole + aspirin 3rd MR dipyridamole OR aspirin
52
patients presenting to clinic with a BP over what need to perform ABPM?
>140/90
53
what is stage 1 hypertension?
140/90 - 160/100 (clinic) 135/85 - 150/95 (ABPM)
54
what is stage 2 hypertension?
160/100 - 180/120 (clinic) > 150/95 (ABPM)
55
what is stage 3/ severe hypertension?
180/120
56
when would you treat patients with stage 1 hypertension?
if <80 with CKD, diabetes, CVD or 10% CVD risk in 10 years
57
what is the target BP for patients under 80?
140/90 (clinic) 135/85 (ABPM)
58
what is the target BP for patients over 80?
150/90 (clinic) 145/ 85 (ABPM)
59
what is the target BP if a patient is pregnant?
135/85
60
what is the target BP if a patient has a high risk of CVD or target organ damage?
135/85
61
what is the treatment step pathway for patients with hypertension who are < 55 years and/ or T2DM?
1st ACE/ARB 2nd + CCB/ TLD 3rd ACE/ARB + CCB + TLD 4th spironolactone (K<4.5) OR alpha/ beta blocker (K>4.5)
62
what is the treatment step pathway for patients with hypertension who are < 55 years and/ or afro-carribean?
1st CCB 2nd + ACE/ ARB OR TLD 3rd ACE/ARB + CCB + TLD 4th spironolactone (K<4.5) OR alpha/ beta blocker (K>4.5)
63
is an ACE or ARB preferred in afro-carribean patients?
ARB
64
If a CCB is not tolerated due to oedema, what should be offered instead?
TLD
65
If starting on a diuretic for hypertension, which is preferred?
thiazide like diuretic (indapamide) as opposed to a thiazide type diuretic
66
which conditions increase a woman's risk of pre-eclampsia during pregnancy?
diabetes hypertension CKD
67
what treatment should be offered to women who are at increased risk of developing pre-eclampsia?
aspirin from week 12
68
what treatment options are available for treating hypertension in pregnancy?
1st labetalol 2nd nifedipine
69
what time should you take your first dose of an ACE?
bedtime
70
which of the ACE is taken BD?
captopril
71
which of the ACE needs to be taken 30-60 minutes before food?
perindopril
72
what are the side effects of ACEs?
dry cough hyperkalaemia angioedema hepatic effect (cholestatic jaundice, hepatic failure) renal impairment
73
which of the beta blockers have intrinsic sympathomimetic activity, and what benefit does this have?
Acebutolol Pindolol Celiprolol these BBs cause less bradycardia and less coldness of extremities Acebutolol Prevents Coldness
74
which of the beta blockers are water soluble, and what benefit does this have?
Atenolol Celiprolol Sotalol Nadolol these BBs are less likely to cross the BBB and therefore less likely to cause nightmares and sleep disturbances these BB are renally cleared, and may need dose reductions in renal impairment Atenolol Can Stop Nightmares
75
which of the beta blockers are cardioselective, and what benefit does this have?
Bisoprolol Atenolol Metoprolol Acebutolol Nebivolol these BBs cause less bronchospasm and can be used in asthmatics if no other choice B A MAN
76
which of the beta blockers have intrinsically longer duration of action?
Bisoprolol Atenolol Celiprolol Nadolol these BBs have once daily dosing BACoN
77
which of the CCB requires the same brand prescribed?
nifedipine (modified release) diltiazem (doses > 60mg)
78
what are the side effects of CCBs?
gingival hyperplasia ankle swelling flushing headache
79
what treatments are available for hypotension and shock?
noradrenaline phenylephrine (longer acting)
80
which CCBs should be avoided in HF?
verapamil and ditiazem
81
which BBs are licensed for HF?
bisoprolol, carvedilol, nebivolol
82
which ARBS are licensed for HF?
candesartan, losartan, valsartan
83
which diuretics are first line for patients with HF who have breathlessness and/or oedema?
loop diuretics
84
what is the treatment pathway for HF?
ACE + BB (titrate low and slow) * aldosterone antagonist (spironolactone/ eplerenone) amiodarone, digoxin, entresto, ivabradine, dapagliflozin *ARB if ACE not tolerated *hydralazine + nitrate if ACE/ARB not tolerated
85
what is the monitoring requirements for HF patients?
initiating ACE/ARB/MRNA: potassium and sodium, renal function, and BP before, 1-2 weeks after starting and after each dose increase, monthly for 3 months, then 6 monthly thereafter initiating BB: HR and BP before and after dose increases
86
define hyperlipidaemia?
> 6 mmol/L total cholesterol
87
what are the lipid targets for hyperlipidaemia?
Total cholesterol < 5 Non - HDL < 4 LDL < 3 Triglycerides < 2 HLD > 1
88
which statins do not need to be taken at night?
atorvastatin rosuvastatin
89
which of the statins are high intensity statins?
Atorvastatin: 20mg, 40mg, 80mg Rosuvastatin: 10mg, 20mg, 40mg Simvastatin: 80mg
90
what is the MHRA alert for simvastatin?
high dose simvastatin (80mg) has increased risk of myopathy
91
what are the side effects of the statins?
myopathy, myositis, rhabdomyolysis, interstitial lung disease, diabetes
92
why should hypothyroidism be resolved prior to commencing a statin?
increased risk of muscle toxicity
93
what are the monitoring requirements of statin treatment?
baseline lipids renal function TFTs HbA1c
94
what is first line for hyperlipidaemia?
statins
95
what is second line for hyperlipidaemia?
ezetimibe
96
what other options are available for hyperlipidaemia?
fibrates (fenofibrate) bile acid sequestrants (colestyramine)
97
what are the two types of vascular disease?
occlusive peripheral - statins + antiplatelets vasospastic peripheral (raynauds) - nifedipine

Pharmacy (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions