Pharmaceutical Care of CV patients I (Role of Pharmacist in Commmunity) Flashcards
(53 cards)
List 5 red flag symptoms for CV conditions
Chest pain Breathlessness Oedema Fast heart rate Dizziness/collapse
How can you differentiate that pain is cardiac pain?
Central or band-like
Radiation to jaws/arms/back
Fast pulse
May be relieved by GTN/rest
How can you differentiate that pain is respiratory?
Fast respiratory rate
Persistent localised pain
Pain worsens on breathing deeply or coughing
“Knife-like”
How can you differentiate that pain is gastro-intestinal?
Sub-sternal "burning" pain Often after food or at night Relieved by antacid Difficulty swallowing Tenderness
How can you differentiate that pain is due to infection?
High temperature
Previous viral illness
Fast pulse
Infected sputum
List 5 types of drug to avoid in patients with CV disease?
Drugs that: Have a high sodium content Increase BP Increase risk of falls Cause fluid retention (e.g. NSAIDs) Increase heart rate
Why should NSAIDs be avoided in patients with CVD?
NSAIDs cause fluid retention, renal impairment and interfere with platelet effect of low dose aspirin
Why should triptans be avoided with patients in CVD?
Triptans cause vasoconstriction
Treatment of migraines and cluster headaches
What could be the cause of general pain in patients with CVD?
Statins - possible side effect = myopathy
What type of pain should paracetamol be taken for in CVD patients?
For more severe pain
Take regularly for best control
What two drugs can CVD patients take for pain
Paracetamol
Low dose opioids
Why should low dose opioids be avoided if possible in CVD patients?
Can increase the risk of falls in the elderly (can cause drowsiness)
What should CVD patients use to treat a fever in colds/flu?
Paracetamol
What should CVD patients use to treat blocked sinuses in colds/flu?
Steam inhalation Avoid decongestants (increase workload of heart)
What should CVD patients use to treat a cough in colds/flu?
Steam inhalation
Simple linctus
Pholcodine linctus - if insistent
What should CVD patients use to treat headaches/migraines?
Paracetamol - however often tried already
Codeine - good for headaches, watch with the elderly (increases risk of falls)
Migraleve - contains codeine ^^
What should CVD patients NOT USE to treat headaches/migraines and why?
Triptans - cause vasoconstriction
NSAIDs - increase fluid retention
Midrid - contains sympathomimetic = may increase heart rate and BP
Why should some CVD patients restrict their fluid consumption?
Help prevent symptoms e.g:
Swelling
Weight gain
Shortness of breath
How should CV patients with no fluid restriction treat constipation?
Bulk forming laxatives
Lactulose
Encourage fluid intake
Encourage fresh fruit and vegetables, high fibre
How should CV patients with fluid restriction treat constipation?
Use stimulant laxatives short term - e.g. senna, docusate sodium
Encourage fresh fruit and vegetables, high fibre
What treatments should not be recommended for patients on warfarin?
Miconazole gel (antifungal) Glucosamine (nutritional supplement) NSAIDs St John's Wort Omeprazole (PPI inhibitor) Many cold and flu preparations
Why should antihistamines be avoided in patients with CVD?
Prolong QT interval and may lead to arrhythmias
Why should miconazole gel be avoided by patients on warfarin?
Causes increase in INR
Antifungal, often prescribed for oral candidiasis
Why should glucosamine be avoided by patients on warfarin?
It delays the breakdown of and repairs damaged cartilage
Nutritional supplement
