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CVS Flashcards

1
Q

what are the 4 types of CVD?

A
  • coronary heart disease
  • strokes & transient ischaemic attacks
  • peripheral arterial disease
  • aortic disease
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2
Q

what is primary prevention?

A

strategies that identify & alter modifiable risks to reduce incidence in disease-free pop.

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3
Q

what is secondary prevention?

A

strategies that target individuals w/ established disease, usually have already had an event

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4
Q

what is risk stratification?

A

• strategies used in primary care to identify potential patients
• estimate regularly >40s
• full formal assessment when risk 10% or higher
• use Q-risk

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5
Q

what is coronary heart disease?

A

when arteries become narrowed by an atheroma

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6
Q

what is acute coronary heart syndrome?

A
  • when rupture/erosion of atherosclerotic plaque & subsequent thrombus formation
  • thrombus because of platelet aggregation under high stress
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7
Q

what is an ischaemic stroke/transient ischaemic attack?

A

when blockage because blood clot lodge in vessel narrowed by atheroma

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8
Q

what is peripheral arterial disease?

A
  • when build up of fatty deposits in arteries & restrict blood flow to leg muscles
  • cause intermittent tiredness = claudication
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9
Q

what treatments are required for arrhythmias?

A
  • to control heart rhythm & rate to prevent cardiac arrest
  • prophylactic to prevent stroke
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10
Q

what is different in treatment of AF compared to treating arrhythmias?

A
  • stagnation of blood in atria & incomplete ventricular emptying = clot formation
  • strokes affect larger part of the brain & more likely fatal/leave bed ridden
  • antiplatelets less effective = use anticoagulants
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11
Q

what are 3 examples of ACS?

A
  • unstable angina
  • NSTEMI
  • STEMI
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12
Q

what is unstable angina?

A
  • partial/transiently obstructive thrombus
  • ischaemia, no necrosis
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13
Q

what is an NSTEMI?

A
  • partial/transiently obstructive thrombus
  • ischaemia w/ necrosis
  • partial thickness damage
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14
Q

what is a STEMI?

A
  • complete obstruction by intracoronary thrombus
  • ischaemia w/ necrosis
  • full thickness damage
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15
Q

what are some symptoms of ACS?

A
  • chest pain & pain in other parts
  • sweating
  • SOB
  • lightheaded & dizzy
  • nausea & vomiting
  • anxiety & panic
  • coughing & wheezing
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16
Q

angina can be exacerbated and alleviated by?

A
  • worse after food, cold winds, exercise, stress
  • better after GTN, rest
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17
Q

what are some ACS symptoms only found in women?

A
  • heartburn
  • cold sweats
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18
Q

what are some ACS red flags?

A
  • chest pain >15-20 mins
  • recent onset unstable angina
  • unresponsive GTN, w/ nausea, vomiting & sweating
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19
Q

what are the differences between electrocardiograms taken for ACS conditions?

A

[ unstable angina & NSTEMI ]
- ECG can be normal
- may see ST depression/T-wave inversion
- no ST elevation

[ STEMI ]
- elevation ST

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20
Q

what is cardiac troponin & what levels are considered?

A
  • biological marker of cardiac muscle death
  • normal = <14 ng/L
  • if >14 ng/L = myocardial damage/necrosis
  • if elevate 1st sample, repeat >3hrs later & rise >7 ng/L is likely MI
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21
Q

what are some differential diagnosis for ACS?

A
  • acid reflux
  • pulmonary embolism
  • anaemia
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22
Q

what is treatment for angina for symptom relief?

A

[ 1st line ] - GTN spray
[ 2nd line ] - GTN sublingual spray

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23
Q

what is treatment for angina for symptom prevention?

A

[ 1st line ] - BB or CCB
- if persist - BB + CCB
- if CI BB & CCB = add 2nd agent
[2nd line ] - long-acting nitrate/ Ivabradine/ Nicorandil

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24
Q

what is treatment for angina for 2ndary prevention?

A
  • aspirin
  • statin
  • ACEi
  • hypertension treatment & lifestyle advice
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25
what is used as initial management to treat unstable angina & NSTEMI?
- aspirin - ticagrelor/ clopidogrel/ prasugrel - LMWH = enoxaparin/ fondaparinux [ to consider ] - O2 therapy, pain management, anti-sickness, hyperglycaemia
26
what is used as 2ndary prevention to treat unstable angina & NSTEMI?
- aspirin - ticagrelor/ clopidogrel/ prasugrel - ACEi - statin [ to consider ] - GTN spray for prophylaxis, hypertension treatment & lifestyle advice
27
what is the process of neural regulation?
via baroflex mechanisms - baroreceptors in aorta send signal CV centre in brain = control vagus nerve - brain send signal = change cardiac activity - change heart contraction, HR & CO
28
what is the process of hormonal regulation w/ low BP?
- release renin = angiotensinogen to angiotensin I - release ACE = angiotensin I to angiotensin II - angiotensin II = potent vasoconstrictor & stimulate release aldosterone from adrenal cortex
29
what factors are affected by hormonal regulation?
- Na+ reabsorption - osmotic pressure - H2O reabsorption - intravascular volume - venous return - CO
30
what is the process of hormonal regulation w/ high BP?
- stop release renin = block conversion angiotensinogen & no aldosterone release
31
what effect has erythropoietin w/ low BP?
- low O2 = trigger EPO release - stimulate red bone marrow to produce RBC = increase O2 transport - EPO is a vasoconstrictor = blood viscosity, resistance and pressure
32
what effect do catecholamines have w/ low BP?
- release by adrenal medulla - vasoconstriction = increase HR & force of contraction
33
what effect do ADH and AUP w/ low BP?
- ADH secreted by hypothalamus & transporter to posterior pituitary = store until nervous stimuli - ADH signal kidney reabsorb H2O & increase fluid level = constrict peripheral vessels & restore blood volume and pressure
34
what effect does ANP/ANH have w/ high BP?
- extreme stretching cardiac cells trigger ANP release; secreted atria cells - natriuretic hormones = angiotensin II antagonists & promote Na+/H2O loss from kidneys; suppress renin, aldosterone & ADH release - promote fluid loss = decrease blood volume & BP
35
what kind of information does the pulse give?
- heartbeat rhythm & heartbeat contraction; pulsatile volume and strength - regular; regular irregular; irregular irregular - weak, faint, strong and bounding
36
how is blood pressure measured?
- relaxed, temperate setting w/ person seated, arm outstretched and supported - use both arms if significant difference > 15mmHg & use higher side for readings - in-clinic > 140/90 = take other reading; if different again, take 3rd reading & record lower 2nd & 3rd - 140/90 to 180/20; offer ABPM/HBPM - BP > 180/20 = urgent treatment
37
what are some extra tests used for hypertension diagnosis?
assess for target organ damage - haematuria & HbA1C for diabetes - urine albumin:creatinine & examine fundi - electrolytes, creatinine & eGFR for chronic kidney disease - 12-lead ECG for left ventricular hypertrophic & assess CVD-risk w/ Q-risk
38
what should the patient be informed of when diagnosed for hypertension?
- absolute CVD risk & benefits/harms intervention in 10-year period - present absolute event risk numerically - use diagrams & text
39
what are the steps of full history taking?
- introduction - presenting complaint - history of presenting complaint - past medical/surgical history - family history - social history - drug history - systems review
40
what should be involved in social history?
- alcohol intake - tobacco use - recreational drug use - employment history - home situation - travel history
41
what is involved in drug history?
- confirm name & dose = prescribed, OTC, vitamins, supplements & herbal medicines - borrowed, recently started, stopped & changed - compliance - allergies
42
what are the different types of metabolisers?
- poor metabolisers - normal metabolisers - rapid metabolisers - ultra-rapid metabolisers
43
what are some BBs side effects?
- fatigue - cold extremities - low pulse
44
what are factors that affect ADME?
[ genetic polymorphisms ] - SNPs - tandem repeats - micro-satellites - insertions & deletions
45
what are some drugs to be avoided with ACEi?
[ Aliskiren ] - risk of renal impairment [ Allopurinol ] - risk hypersensitivity & haematological reactions [ Azathioprine ] - risk anaemia & leukopenia [ Everolimus ] - increased risk angioedema
46
what are some adverse effects of thiazide-like diuretics?
- postural hypotension - hyperglycaemia - hypokalaemia - cardiac arrhythmias - metabolic alkalosis - dehydration - hyponatremia
47
what are some contraindications of thiazide-like diuretics?
- refractory hypokalaemia - hyponatraemia - hypercalcaemia - Addison’s disease - pregnant women - severe liver & renal impairment
48
what are some contraindications of CCBs?
- uncontrolled HF - AV block - unstable angina/recent MI - hepatic & renal impairment - pregnant/breastfeeding - grapefruit
49
what are ACE inhibitors?
- target production angiotensin II = act on AT1 receptor; adrenergic innervations; release ADH - block vasoconstriction & aldosterone release
50
what are the effects of ACEi?
[ arterial & venous vasodilation ] - decrease arterial & venous pressure - decrease ventricular preload & after load [ decrease blood volume ] - natriuresis - diuresis - down regulation sympathetic activity & suppression hypertrophy
51
what are some rare adverse effects of ACEi?
- hyperkalaemia = aldosterone - taste disturbance = zinc in ACEi - hypotension - renal impairment - angioedema
52
what are some clinical considerations with ACEi?
- cough = class effect - hypotension = combine low-dose diuretics [ dehydration ] = suspend - diarrhoea & vomiting - postural hypotension - acute kidney disease
53
what are some renal risk assessments for ACEi?
- beneficial chronic kidney failure & hypertension - monitor serum creatinine, electrolytes & eGFR - periodically assess renal function - discontinue bilateral renal artery stenosis
54
when are ACEi avoided?
- 55 or less - caribbean/black african origin = decrease response renin-dependent BP regulation - pregnant & breastfeeding
55
what are some adverse effects of ARBs?
- hyperkalaemia = aldosterone - renal impairment
56
how do BBs work?
- block sympathetic effect - adrenaline bind B-1 receptor & increase heart activity = BB block receptor - prolong PR interval = decrease SA & AV nodes automaticity
57
what are the effects of BBs?
[ cardiac ] - contractility - relaxation rate - HR & conduction velocity [ vascular ] - mild smooth muscle contraction
58
what are some adverse effects of BBs?
- bradycardia - bronchoconstriction - cardiac depression - hypoglycaemia
59
what are some cautions w/ BBs?
- pre-existent bradycardia - conduction defect - HF - cardio-selective CCBs
60
how do CCBs work?
- block Ca2+ channels - reduce contraction force & smooth muscle contraction
61
what is the effect of dihydropyridines and non-dihydropyridines?
[ dihydropyridines ] = amlodipine - vascular effect - vascular smooth muscle relaxation [ non-dihydropyridines ] = verapamil & diltiazem - cardiac effect - reduce contraction force & HR - reduce conduction velocity
62
what are some side effects of dihydropyridines?
[ oedema ] - CCB dilate arteries but veins constricted - capillary overload forces fluid into surrounding tissue [ reflex tachycardia ] - baroreceptor reflex
63
what are some side effects of non-dihydropyridines?
- bradycardia - AV node block = impaired electrical conduction; Ca2+ channels located in electrical nodes - contractility = cardiac depression
64
what are some clinical considerations for thiazide-like diuretics?
- potassium supplements - potassium-sparing diuretics - avoid ACEi = hyperkalaemia
65
how do thiazide-like diuretics work?
- moderately powerful = indapamide - block Na+/Cl- symporter of early DCT = inhibit Na+ active reabsorption & Cl- transport = H2O reabsorption - promote natriuresis & diuresis
66
how do aldosterone receptor antagonists work?
- antagonise mineral corticoid receptors - prevent insertion Na+/K+ ATPase pumps & ENAC channels in late DCT & CD - spironolactone & eplerenone
67
how do Na+ channel blockers work?
- block apical ENAC in late DCT & CD - decrease influx Na+ - Na+ not retained at expense K+ - amiloride & triamterene
68
what are the 2 states of solid?
[ crystalline ] - polymorphous; solvates & hydrates; co-crystals - molecules packed in defined order - cool slowly to below melting point & between melt and freeze [ amorphous ] - unstructured ice - molecules packed in random order - rapid solidification/precipitation & glassy and rubbery - moisture sensitive
69
what is polymorphism?
- different molecular arrangements in crystal lattice - difference = molecule orientation/conformation in lattice sites
70
how is x-ray diffraction used to differentiate between crystals?
- characteristic pattern of diffraction angles & intensity diffracted beam = planes of crystal - crystalline = high intensity & narrow peaks - amorphous = low intensity & broad peaks - polymorphic = median intensity & narrow peaks
71
how does hydration occur in crystal lattices?
- small molecular size H2O - multi-directional H-bonding capability
72
how is the salt form better than other crystal forms?
- increase solubility - increase dissolution
73
what is a co-crystal?
- 2 or more molecules in same crystal lattice in definite stoichiometric ratio - not based ionic bonds = sildenafil & aspirin
74
what are some primary powder properties and their effects?
[ particle size ] & [ shape ] - content uniformity - flow & mixing [ surface area ] - dissolution rate
75
what are some secondary powder properties and their effects?
[ density ] - tablet/capsule size [ porosity ] - compressibility - permeability/H2O uptake [ flowability ] - content uniformity [ compressibility ]
76
how are small & irregular particles measured?
- 3D size impractical - only 1 dimension used
77
how is the surface area of irregular particles measured?
- Brunauer-Emmett-Teller theory (BET theory) - powder filled into vacuum-sealed chamber - small amounts N2 added & adsorb to powder surface until entire surface and pores covered - pressure transducers sense gas amount adsorbed = used calculate SA
78
what are 4 equivalent diameters for sedentary particles?
- projected perimeter diameter & projected area diameter - feret's diameter & martin's diameter - sieve diameter - diameter of equivalent volume/SA/mass sphere
79
what are 3 equivalent diameters for moving particles?
[ stoke's diameter ] - sphere w/ same density & settling velocity as particle [ aerodynamic diameter ] - sphere w/ same density & terminal velocity in air/any relevant fluid as particle [ hydrodynamic diameter ] - sphere w/ same density & settling velocity that diffuses at same rate in liquid as particle
80
what are the different dimensions and types of particle shapes?
- 1D = acicular & rod-shaped - 2D = flaky & dendritic - 3D = porous, angular/irregular; spherical & rounded
81
how good is the flowability of each type of particle shape?
- spherical & rounded = good & easy mix - acicular; rod-shaped & angular/irregular = tend interlock = increased mechanical strength - flaky = cohesive effect because greater SA
82
what drugs often cause interactions?
[ problematic ] - enzyme inducers & inhibitors - PGP protein inducers/inhibitors & chelating agents [ long half lives ] [ overdose/underdose ] - narrow therapeutic windows - therapeutic drug monitoring - critical medications
83
what are some resources used for drug interactions?
- BNF = paper, mobile & web app - drug SPC - Stockleys
84
what are some drugs that cause absorption issues?
- calcium-containing products = Adcal & Calchichew - aluminium-containing antacids = Gaviscon & Peptac - chelating agents = doxycycline, alendronic acid & levothyroxine
85
what are some drugs that affect distribution?
- sodium valproate - phenobarbital - phenytoin - carbamazepine - warfarin
86
what are the steps of phase 2 in metabolism?
- conjugation - acetylation - sulfation
87
what are some metabolism inducers?
- carbamazepine - rifampicin - phenobarbitone
88
what are some metabolism inhibitors?
- sodium valproate - ketoconazole - erythromycin/clarithromycin
89
how is excretion affected by drug interactions?
- via glomerular filtration & active tubular secretion - site competition = interactions when eliminated via same active transport mechanism in PT - elim. w/ low affinity to transport protein = drug accumulation - urine pH can also affect reabsorption
90
what are some PGP inducers/inhibitors?
- apixaban - colchicine - ciclosporin - dabigatran - digoxin - tacrolimus
91
what affects warfarin effect?
[ increase ] - grapefruit/pomegranate/cranberry - large acute alcohol [ decrease ] - green leafy vegetables/egg yolks/chickpeas - chronic heavy alcohol
92
what are MAOI?
- monoamine oxidase inhibitors - antidepressant w/ frequent interactions
93
what should be avoided w/ MAOI?
- tyramine-rich & dopa-rich foods = mature cheese; salami & alcohol - only fresh food products - continue 2-3 weeks after stopping = long half life
94
how does grapefruit juice affect ADME?
- inhibit CYP 3A4 isoenzyme - statins; CCBs & antibiotics
95
what are patients at higher risk of interactions?
- elderly = less renal & liver function - children = underdeveloped metabolising systems - w/ co-morbidities - polypharmacy
96
what is heart failure diagnosis based on?
- signs & symptoms - patient history - blood levels NT-proBNP - ECG - exercise tolerance test - transthoracic echocardiography
97
what are some other tests used to confirm HF?
- full bloods - thyroid function tests - chest x-ray - peak flow test
98
what is HF?
- increased pressure in heart & inadequate cardiac output - due to left ventricular & myocyte dysfunction from MI - progressive & no cure
99
what are the features of HF?
[ fatigue ] - low CO = low O2 [ oedema ] - pulmonary & peripheral - fluid retention; increase heart pressure affect pulmonary vessels & failing kidneys [ breathlessness ] - dyspnoea & orthopnea - lying down redistribute oedema on lungs - patient sleep w/ multiple pillows (3+)
100
what is NT-proBNP and its function?
- released response pressure changes in heart - less 400ng/L = less likely HF - more 2000ng/L = poor prognosis - used monitor progress HF
101
what may decrease levels of NT-proBNP?
- obesity - african-caribbean - current treatment ACEi/ARBs/mineral corticoid receptor antagonists
102
what may increase levels of NT-proBNP?
- age > 70 - LV hypertrophy - renal dysfunction - sepsis - COPD - diabetes - ischaemia
103
how is severity of HF graded?
- NYHA functional classification system - symptoms alone & show effect functional ability & QoL
104
what is preserved EF?
- preserved Ejection Fraction = more 40% - preserving EF = slow deterioration
105
how is HF with preserved EF treated?
- loop diuretic & titrate - relieve congestive symptoms & fluid retention - 1st line = ACEi & BB - add in = mineralcorticoid receptor antagonists
106
what is the future treatment for HF?
- SGLT2 inhibitors = dapaglifozin/empaglifozin - symptomatic HF w/ reduced EF [ only add optimised care by HF specialist ] - ACEi/ARB & BB & MRA - Entresto & BB & MRA
107
what is used to control symptoms in palliative care?
[ breathlessness ] - repeated small dose opioids - oramorph [ pain ] - opioids PO or SC - morphine/oxycodone [ anxiety ] - midazolam = help agitation [ N&V ] - depends trust & other meds = cyclizine [ secretions ] - prevent death rattle = hyoscine hydrobromide
108
what is palliative care?
- optimise QoL & reduce suffering in patients w/ life-threatening conditions - symptom control = make comfortable - honour patient wishes & family informed trajectory
109
how is acute/decomposed HF treated in 2ndary care?
- IV diuretics = bolus/infusions furosemide - risk ototoxicity & renal impairment - stable 48 hours = stop IV & re-start meds - monitor renal function, electrolytes, HR & BP
110
what is some lifestyle advice for HF patients?
- regular exercise & physically active - sleep & careful hidden salts - balanced diet & health weight - lower alcohol & smoking - eligible flu vaccine
111
what is a cardiac rehab programme for HF patients?
- personalised, exercise-based programme for stable HF - exercise training = increase tolerance & QoL - include psychological & education component
112
how is HF treatment monitored?
- assess functional capacity; fluid status; cardiac rhythms - cognitive & nutritive status - assess renal function & other Us and Es - monitor NT-proBNP - teach patient recognise symptoms change & alert HP
113
what if optimal drug management doesn't work for a HF patient?
- w/ severe refractory symptoms = cardiac transplant - if older & co-morbidities = unlikely consider - referral specialist centre & waiting list - complications = life-long immunosuppression; risk rejection & graft failure
114
what is the CVS disease continuum?
- endothelial dysfunction - atherosclerosis - ischaemia - coronary artery disease - thrombosis & lesion rupture - myocardial infarction - reduced contraction - ventricular dilation & remodelling - heart failure - death
115
what can affect endothelial dysfunction?
- hypertension - dyslipidemia - diabetes mellitus - smoking
116
how does ischaemia occur?
- thicken internal surface arteries & atherosclerotic lesions - block & affect O2 supply heart muscles
117
what are the troponin levels for angina, NSTEMI & STEMI?
stable & unstable = no change troponin NSTEMI = changes troponin STEMI = rise troponin
118
how does NO cause vasodilation?
- endothelial cells release NO - NO stim. cytoplasmic guanylyl cyclase - elevate intracellular cGMP - activate protein kinase G - smooth muscle relaxation = vasodilation - PDE isoform breaks down cGMP
119
what are the features of systemic circulation?
- venous dilation > arterial dilation - decreased venous pressure - decreased arterial pressure = small effect
120
what are the features of cardiac circulation?
- reduced preload and afterload = decreased wall stress - decreased O2 demand
121
what are the features of coronary circulation?
- prevent/reverse vasospasm - vasodilation epicardial vessels - improve subendocardial perfusion - increased O2 delivery
122
what are nitrates used for and what types are there?
- acute attacks/ preventative measures - direct = nitroglycerin & sodium nitroprusside - organic = isosorbide dinitrate & mononitrate
123
what are the 2nd line antianginal drugs?
- IF current inhibitors = ivabradine - Class ID sodium-channel blocker = ranolazine - Potassium channel activator = nicorandil
124
what are the 3 types of antithrombotic drugs and their functions?
- anticoagulants = prevent thrombus formation - antiplatelets = prevent platelet aggregation - fibrinolytics = clot retraction
125
what are the 2 types of oral anticoagulants?
- vitamin K antagonist = warfarin [ direct oral anticoagulant ] - reversible factor Xa inhibitor = apixaban; edoxaban & rivaroxaban - reversible thrombin inhibitor = dabigatran
126
what class is aspirin and its function?
- COX-inhibitor - low dose irreversibly inhibit thromboxane in platelets = decrease platelet aggregation - in endothelial cells, aspirin inhibit prostaglandins = increase platelet aggregation
127
what are glycoprotein IIb/IIIa inhibitors and 2 example types?
- prevent platelet aggregation by block binding fibrinogen to receptor on platelet - abciximab - eptifibatide & tirofiban - specialists only & administer i.v. hospital & high risk bleeding
128
what are the 2 example types of tissue plasminogen activators?
- streptokinase - alteplase; reteplase & tenectplase
129
what are the features of alteplase, reteplase & tenectplase?
- synthetic recombinant - highly-selective fibrin-bound plasminogen = clot selective - reteplase & tenectplase = longer half-life alteplase
130
which drugs does warfarin interact with?
- macrolide antibiotics; azole antifungals; H2 receptor antagonists = breakdown warfarin - NSAIDs; broad-spectrum antibiotics = kill gut flora and vitK synthesis = potentiate warfarin
131
what are some adverse effects of warfarin?
- bleeding - skin necrosis
132
what are the adverse effects of HUF & LMWH?
- haemorrhage - heparin-induced thrombocytopenia/ low platelet - hyperkalaemia
133
how is haemorrhage stopped for HUF & LMWH?
- withdraw HUF/ LMWH - if rapid reversal of heparin effects needed = protamine sulfate - spec. antidote = neutralise/inactivate heparin but only partially reverse effect LMWH
134
what are the 3 classes of drugs used to treat hyperlipidaemia?
- HMG-CoA reductase inhibitors = statins - cholesterol absorption inhibitors = ezetimibe - fibrates = fenofibrate & gemfibrozil - anion exchange resins = colestyramine
135
what are high number of small LDLs associated with?
- hypertriglyceridemia - low HDL levels - obesity - type 2 diabetes - infectious & inflammatory states
136
what are adverse reactions due to statins?
- GI disturbances - skeletal muscle myopathy - myalgia - myositis w/ rhabdomyolysis
137
how do K+ channel blockers work?
- block outflow K+ - prolong QT interval = prolong refractory period & AP duration
138
what are the 3 types of familial hyperlipidaemia?
- combined hyperlipidaemia - hypercholesterolaemia & polygenic hypercholesterolaemia = high chol. content - hyperapobetalipoproteinemia = high levels apolipoprotein B
139
what are the three arrhythmias that are treated with anti-arrhythmic drugs?
- supraventricular arrhythmias - both supraventricular & ventricular arrhythmias - ventricular arrhythmias
140
what does CHAD2DS2-VASC stand for?
- Congestive failure (1) - Hypertension (1) - Age (65-74 =1) (+75 = 2) - Diabetes (1) - Stroke/TIA (2) - Vascular disease (1) - Age (") - Sex (females = 1)
141
which DOAC to use if no renal impairment/active cancer/ antiphospholipid syndrome/haemodynamic instability
- apixaban/rivaroxaban - LMWH (5 days) then dabigatran/edoxaban
142
how to monitor for DOACs
Factor Xa
143
how to reverse heparin
protamine
144
how to reverse warfarin
vitamin K (phytomenadione)
145
how to reverse rivaroxaban
andexanet
146
how to reverse dabigatran
idarucisumab
147
drugs that cause hyperkalaemia
- co-trimoxazole - trimethoprim - ACEi - ARB - K+ sparing diuretics - Heparin
148
side effects of warfarin
- calciphylaxis = painful skin rash - abnormal hepatic function
149
drugs that cause hypokalaemia
- theophylline - nebulised salbutamol
150
what is the CYP enzyme involved in warfarin metabolism
CYP2C9
151
what are the water-soluble BBs
- atenolol - sotalol
152
which BBS are given once daily and are cardio-selective
- atenolol - bisoprolol

Pharmacy 201 (10 decks)

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