Cardiovascular BNF chapter TWO

Question 1

Define the following terms

Positive ionotrope, negative ionotrope, arrythmia, supraventricular tachycardia and atrial fibrillation

Answer 1

1. Positive ionotrope - drug that stimulate heart muscle contraction
2. Negative ionotrope - drug that reduces heart contractions
3. arrythmia - deviation from normal rhythm
4. Atrial fibrillation - Rapid heart rate cause by disorganised electrical acitivity.

Question 2

Name two cardiac glycosides and answer the following questions about them

1. The common side effects
2. What is an important factor that determines dose
3. what predisposes toxicity and a cure for toxicity
4. Sign and symptoms of toxicity

Answer 2

1. Digoxin and Digitoxin
2. Have a long half (usually ONE daily) and renal function is important in determining dose
3. Hypokalaemia predisposes toxicity, can be given potassium-sparing diuretics or supplements
4. Toxicity is suspected using the mnemonic SLOW SICK - the patient will be nauseous and vomit, confusion and blurred vision - digibind in the antidote

Question 3

Name two thiazide diuretics and explain the difference in their indication

Answer 3

Bendroflumethiazide is can be used for hypertension and oedema wheres indapamide is used only for essential hypertension.

Question 4

List the side effects of thiazide diuretics and note any counselling points that differ between the two thiazed diuretics

Answer 4

Side effects include - GI disturbances, postural hypotention, hypokalaemia + natraemia. Low ion levels like magnesium, calcium. Can exacerbate gout.

2. Patient counselling points - they act within one or TWO hours and can last for 12 to 24 hours
3. Cause hypokalaemia (not for cardiac glycosides)
4. Indapamide is less likely to cause diabetes than bendroflumethiazide