QuestionSBA
QuestionChoice
The initial medical management of peripheral vascular disease generally involves a single antiplatelet with preference for clopidogrel over aspirin as supported by the best available evidence. In addition, a high-dose statin should be prescribed
33980
a
Clopidogrel 75mg PO OD and atorvastatin 80mg PO OD
QuestionChoice
Dual antiplatelet therapy may be eventually indicated in the medical management of peripheral vascular disease but is no longer recommended as an initial treatment option. In addition, a high-dose statin should be prescribed
33982
c
Aspirin 75mg PO OD and clopidogrel 75mg PO OD
QuestionChoice
While antiplatelet therapy is recommended for the medical management of peripheral vascular disease, the current evidence supports the use of clopidogrel over aspirin. Aspirin may still be prescribed if clopidogrel is not tolerated
33981
b
Aspirin 75mg PO OD and atorvastatin 80mg PO O
QuestionChoice
This patient should be prescribed lipid-lowering therapy on account of likely peripheral vascular disease. However a statin should be the first line agent of choice rather than a fibrate, which are prescribed as adjuncts to statins or if statins are not appropriate
33983
d
Clopidogrel 75mg PO OD and fenofibrate 200mg PO OD
QuestionChoice
This patient is presenting with symptoms of intermittent claudication and risk factors suggesting he has peripheral vascular disease. As such he should be prescribed an antiplatelet drug such as clopidogrel and a high-dose statin. In this option the dosages are incorrect – the dose of clopidogrel is too high and the dose of atorvastatin is too low
33984
e
Clopidogrel 300mg PO OD and atorvastatin 20mg PO OD
QuestionComment
Where can you find this in the BNF?
8299
QuestionComment
https://cks.nice.org.uk/topics/peripheral-arterial-disease/management/intermittent-claudication/#managing-cardiovascular-risk
https://cks.nice.org.uk/topics/antiplatelet-treatment/
https://bnf.nice.org.uk/drug/clopidogrel.html
8472
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subscriber
Tuberculosis222
QuestionComment
we cant use CKS in the exam...where can we find this info via medicine's complete?
17485
User
subscriber
Gas Haemophilus
User
subscriber
Cystic Prognosis
QuestionComment
BMJ Best practice states "Antiplatelet therapy with aspirin is recommended.[2] Clopidogrel is an effective alternative to aspirin." Would the option with aspirin and the statin not also be correct?
15685
User
subscriber
Dermis Supine
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2740
Medical management of peripheral vascular disease
Topic
13
Neurosurgery
6807
Case Presentation: A 68-year-old man has been having pain in his legs for six months. The pain typically comes on when he is climbing stairs or has been walking for longer than 30 minutes, and is concentrated in the backs of his calves. **PH** hypertension. **DH** amlodipine 10mg PO OD. **SH** current smoker 10-20 per day, total 45 pack year history. NKDA


**O/E**

HR 74 regular, RR 14, BP 134/85. No pain at rest. Lower limbs pale and cool to knee level. Weak dorsalis pedis and posterior tibial pulses bilaterally. Normal power and tone, reflexes and sensation preserved. Capillary refill at toes 3s.

**Investigations**

ABPI: 0.7 bilaterally

Question: Select the most appropriate management at this stage.
a