Cardiovascular Drugs Flashcards
(19 cards)
What’s the 48 hour rule in AF
48 hour rule onset, need to think about the risk of thrombosis - focus should now be now on rate control, try to prevent any clots that have formed
Treatment of AF
Flecaindie - Na channel blocker, prolongs cardiac action potential. Slows conduction via the bundle of His (contraindicated in coronary artery disease)
AF in elderly patients - no other co-conditions
Rate control. Anti coagulation. Unlikely to have a structurally normal heart. First time beta-block or CCB (without heart failure)
What scoring system is used for anticoagulation
CHADSVaS score
How does warfarin work?
Warfarin inhibits vitamin K dependent factors in the coagulation cascade. By factors……. Side effect can cause bleeding
What factor does heparin effect?
Factors Xa
Elderly man that came in AF with heart failure. How do you treat?
Digoxin, Amiodarone
How does Digoxin work?
Inhibits membrane bound Na-K ATPase. Increases intracellular calcium. Increases force of myocardial contraction (positive ionotropic effect). Positive ionotropic effect (AV node effects + vagal stimulation + sympathetic inhibition)
AF, high pulse, low BP. Treatment?
DC Cardioversion
AF, pregnant, intermittent palpitations, pulse 142, BP 120/70. Treatment?
Rate control / Anticoagulation
What’s a caution of warfarin in pregnancy?
Warfarin is teratogenic in pregnancy
Old. Stroke. BP >180/110. Treatment?
CCB - Amlodipine
45, Caucasian, BP 158/99. Treatment
ACE inhibitor
54, BPH (benign prostatic hypertrophy), persistently elevated BP. Treatment?
Alpha blocker - all over in prostate, heart, blood vessel
Equation for BP
BP = CO x TPR (total peripheral resistance)
76, stroke, HTN, 3/7 of SOB on exertion. White frothy sputum. Treatment?
Presentation of Acute HF. Diuretic - Frusimide (loop diuretic- inhibits sodium, potassium co transporter from the ascending loop of henlè. This reduces preloads, reducing the pressure on the heart). Sit him up! Oxygen.
76, Amlodipine, Indapamide and Atorvastatin is treated for a chest infection recently. 5/7 after treatment starts he develops muscle aches and pains
Satin induced myopathy, caused by clarithromycin as it causes enzyme inhibition
Rhythm control in AF - treatment of Cardioversion or sinus rhythm
Flecanide, Sotalol
Rhythm control AF, Cardioversion or sinus rhythm in an ABNORMAL HEART
Amiodarone
