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CV Qs Flashcards

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1
Q

CCB + bisoprolol

A

peripheral oedema

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2
Q

Ticagrelor + inhibitor (clari)

A

increased exposure of ticagrelor

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3
Q

Secondary prevention: Stroke and CV events

A

ASAP BB
Antiplatelet
Statin
ACEi/ARB
PPI
Beta blocker

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4
Q

INR 9.5 and no bleeding

A

PO phyto 2.5mg

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5
Q

Which ONE of the following is LEAST likely to occur as a result of hypersensitivity to aspirin?
- Angioedema
- Bronchospasms
- Haemorrhagic stroke
- Rhinitis
- Urticaria

A

Haemorrhagic stroke

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6
Q

Aspirin hypersensitivity

A
  • Angiodema
  • Bronchospasms
  • Urticaria, rhinitis
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7
Q

Ischaemic stroke: which antiplatelet should be prescribed?

A

Aspirin or clopidogrel
- Prasugrel and ticragelor CI fot ischaemic stroke

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8
Q

Dipyrimadole SE

A

Headache

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9
Q

GTN patch counselling

A
  • apply the patch to the lateral chest every 24hrs
  • does not need to be removed for showering/bathing
  • not prn, regular use
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10
Q

Which antihypertensive causes constipation?

A

CCB

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11
Q

If pt has heart failure with preserved ejection fraction
AF
Pulmonary oedema
What drug do we offer?

A

Furosemide

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12
Q

Amiodarone MOA

A

Inhibits myocardial ATPase activity via Na K channel inactivation

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13
Q

Treatment for Delayed cerebral ischaemia

A
  1. Nimodipine 60mg PO ever 4 hrs for 21 days
    - CCB reduces incidence and severity of neurological defecits following subarachnoid haemmorrhage
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14
Q

Heparin induced thrombocytopenia (HIT)

A
  • Severe drug reaction to heparin
  • Switch to danaparoid
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15
Q

Acute ischaemic stroke initial treatment

A
  • Alteplase IV
  • Administered within 4.5hrs
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16
Q

Initial treatment for acute DVT: rivaroxaban

A
  • 15mg BD for 21 days, then 20mg OD
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17
Q

ACEi counselling

A

empty, morning, 30-60 mins before food

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18
Q

Pt with non V AF INR target

A

2-3

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19
Q

Tranexamic acid: ADR

A
  • Colour vision changes due to toxicity to retina
  • Rare but serious
  • STOP + opthalm
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20
Q

Which DOAC is least likely to be chosen with renal impairment?

A

Dabigatran

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21
Q

Abx which decrease anticoagulant effect of warfarin

A

Rifampicin

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22
Q

Abx which increase anticoagulant effect of warfarin

A

Clarithromycin
Doxycyline
Erythromycin
Metronidazole

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23
Q

What is the dose for rivaroxaban in patients with DVT/PE?

A

15mg BD (twice daily) for 21 DAYS then 20mg OD (once daily)

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24
Q

Eplenerone and amiodarone dose adjustment

A

max 25mg
- Eplerenone is primarily metabolized by CYP3A4
- amiodarone is a potent CYP3A4 inhibitor
- increase eplerenone levels, necessitating a dose adjustment.

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25
What calcium channel blocker is commonly prescribed for prophylaxis of cluster headache?
Verapamil
26
Nitrates can lead to tolerance and reduced therapeutic effects if long-acting preps used/transdermal preps used - what can be done to overcome this
reduce blood nitrate conc for 4-12 hours each day to avoid tolerance
27
What antifungals must the patient temporarily withhold their atorvastatin treatment for?
keto/intraconazole - azole antifungals
28
What are the specifics of dispensing dipyridamole?
1) modified-release capsules should be dispensed in original packs 2) capsules should be discarded after 6 weeks after opening
29
How many days prior to elective surgery should ticagrelor be stopped?
5 days
30
is ACEi or ARB preferred in afro
ARB
31
Ischaemic stroke initial treatment
Aspirin 300mg OD for 14 days Clopidogrel 75mg OD long term
32
When is apixaban 2.5mg bd indicated?
Creatinine clearance is 15-29mL/min or the following TWO apply from: 1) 80 + 2) 60kg or less 3) serum creatinine 133 micromol/L or over.
33
what is the maximum daily dose of simvastatin that can be taken with bempedoic acid?
20mg
34
35
What drug should be avoided for short-term whilst on atorvastatin?
oral fusidic acid - avoid during and 7 days after treatment
36
What is the max daily dose of atorvastatin that a patient can take whilst on tipranavir?
10mg OD
37
Statins SE | Remember STATIN
- Sugars raised (hyperglycaemia) - Transanimase (raised LFT) - Aches and pain (rhabdo) - Tendon disorder - Interstitial lung disease - Nausea report coughing, dyspnoea, weight loss, muscle aches
38
Which antiplatelet can cause a throbbing headache as a SE
Dypirimadole
39
Levothyroxine counselling: initial dosing
- If metabolism increases too rapidly (causing diarrhoea, nervousness, rapid pulse, insomnia, tremors and sometimes anginal pain where there is latent myocardial ischaemia), - reduce dose or withhold for 1–2 days and start again at a lower dose.
40
How many days should you STOP clopidogrel prior to elective surgery?
7
41
What calcium channel blocker is commonly prescribed for raynaud's syndrome?
Nifedipine
42
What effect does drinking grapefruit juice have on plasma levels fo CCBs?
may increase levels of calcium channel blockers (dihydropyridine CCBs - cardioselective ones)
43
In diarrhoea and vomiting which medication should be stopped?
stop ACEi for 1-2 days until they recover
44
Dyspepsia and gatro oesophageal reflux in 56 y o for the first time
calcium carbonate and refer to the pt ASAP for referral for non-urgent endoscopy
45
Ibandronic acid counselling
Remain upright for at least 1 hr Report ear discharge Report signs of groin pain OD
46
Carbamazepine + apixaban
decreases exposure to apixaban
47
HF with REF beta blocker preferred
carvedilol
48
GRACE score is ≤3%
* predicted 6month mortality is low * elderly pt = angiography is not recommended
49
Anticoagulation for SPAF
* Antiplatelet is NOT effective. * The anticoagulant of choice for SPAF = DOAC * Warfarin is no longer recommended as first line.
50
Which pharmacological option is preferred in pregnant patients with a history of deep vein thrombosis
LMWH
51
What pharmacological parenteral anticoagulant option is preferred for patients with renal impairment
Unfractionated Heparin
52
What is the reversal agent of LMWHs→
Protamine Sulfate
53
For elderly patients (80+) what is the target BP?
Under 150/90 mmHG
54
55
Switching warfarin to dabigatran
o Yes in diabetes o No in GI ulcer, prosthetic heart valve, recent surgery, malignant neoplasm
56
What eGFR should TLD be avoided
Less than 30 ml/min
57
If a loop diuretic (e.g., bumetanide, furosemide, co-amilofruse) is needed twice daily, when should the doses be taken
ONE in the morning and ONE before 4pm - no later than this as nocturia
58
Paroxysmal AF treatment
PILL POCKET with fleicanide
59
Which juice increases INR?
Pomegranate
60
Chronic HF 1st line
1. BB 2. ACEi 3. Loop diuretic If symptoms persist = ENTRESTO
61
When is ivabradine CI
HR less than 75bpm
62
Pharmacological cardiocersion for patients with normal cardiac function and no structural heart disease
Fleicanide Amiodarone | Amiodarone preferred in heart disease
63
Simvastatin + amiodarone
Amiodarone inhibits metabolism of simvastatin = increased plasma levels and risk of myopathy
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