CV masterclass Flashcards
(23 cards)
Which beta blockers can cross BBB and cause nightmares
PM
Propanolol and metoprolol
Dietary restrictions with warfarin
-Vitamin K rich foods can reduce warfarin effectiveness
- Cranberry juice can enhance the anticoagulant effect
- Limit alcohol and avoid binge as INR can be affected
Key counselling points of amiodarone
SPF
Report SOB, Persistent cough, Jaundice, restlessness, weight loss, weight gain, tiredness
Avoid grapefruit juice
What CHADVASC score requires anticoagulation
Offer to people with a score of 2+, unless CI, taking bleeding into account
Consider anticoagulation for men with a score of 1 unless CI, taking bleeding risk into account
Loop diuretic side effects
Dehydration
Hypotension
dizziness
Low electrolyte (hyponatraemia, hypocalcaemia, hypokalaemia)
At high doses: Hearing loss and tinnitus
Which calcium channel block should be avoided in heart failure and why ?
AMLODIPINE SMOOTH ON HEART OTHERS TEAR
VERAPAMIL MAY PRECIPITATE HF
What is febuxostat used to treat
Chronic hyperuricaemia in gout. Can be first line or allopurinol
MHRA FEBUXOSTAT
SJS AND ANAPHYLACTIC SHOCK - HYPERSENSITIVITY
USE IN CAUTION WITH PRE-EXISTING MAJOR CV DISEASE
What vitamin is given to new born babies usually within the first 72hours of birth
Routinely given vitamin K injection shortly after birth to prevent vitamin k deficiency bleeding
Why is amlodipine CI in unstable angina
Its potent vasodilator effect can lead to reflex tachycardia which may worsen myocardial ischemia
Difference between stable and unstable angina
Stable - Chronic and manageable with predictable symptoms and lower short term risks of heart attack
Unstable- Acute emergency with unpredictable, severe symptoms and a higher risk of heart attack or death requiring urgent treatment
What can spironolactone and furosemide cause when taken together
Hyponatraemia
SE SPIRONOLACTONE
Gynaecomastia
Breast neoplasm benign
Breast pain
Nicorandil SE
Headache on starting (transient)
Can cause serious skin, mucosal and eye ulceration which may progress to perforation, haemorrhage etc - stop if ulceration occurs
Why should BB not be given with diltazem or verapamil
RISK OF SEVERE BRADYCARDIA, HEART BLOCK, PROFOUND HYPOTENSION
When should you stop methyldopa after birth
Stop 2 days after birth as it may increase the risk of depression
What should patients go home on following NSTEMI
SAABS
STATIN
ASPIRIN
ACE
BB
Second/dual antiplatelet
ACEI/ARB and lithium
Can increase lithium concentration, increasing the risk of toxicity
What does it mean if the trough levels of GENT come back high or the peak levels come back high in terms of dosing
If trough high= interval between dose should be increased
If peak high= dose should be decreased
Choice of anticoagulation in preg
LMWH (dalteparin or enoxaparin)
Does not cross the placenta
Key side effects of LMWH
Bleeding
Injection site reactions
Heparin induced thrombocytopenia (usually 5-10 days after)
Hyperkalaemia
Cautions with LMWH
Uncontrolled hypertension
Avoid in invasive procedures
Renal impairment (lower dose)
Avoid in severe hypertension
Caution in elderly
Caution in low body weight (increased risk of bleeding)
Cautions and CI of thiazides
Avoid in hypokalaemia and hyponatraemia
Reduce uric acid excretion - may precipitate gout
Diabetes - can increase glucose concentration
Elderly- Lower doses and adjust according to renal function
