Cardiovascular System 2
Terms
undefined, object
copy deck
- angina pectoris
- pain and pressure in the chest caused by a lack of proper blood flow and oxygenation to the heart muscle
- Arrhythmia
- Irregular heartbeats resulting from a malfunction in the conduction system
- Arteriosclerosis
- A disease of the arterial vessels resulting from thickening, hardening, and loss of elasticity in the arterial walss
- artherosclerosis
- a form of artheriosclerosis resulting from cholsterol-lipid calcium deposits in the walls of the arteries
- Conjestive heart failure (CHF)
- a condition in whic the heart is unable to pum the amounts of blood needed to meet the requirements of the body
- Coronory artery disease (CAD)
- A term used to describe blood vessels disorders that affect the coronary arteries:
- Hyperlipidemia
- high or excessive amounts of lipid (fat) in the blood that leads to arteriosclerosis and atherosclerosis
- Hypertension
- high blood pressure: considered to be >140/90 mm Hg over several readings
- myocardial infarction
- an even in which part of the heart muscle dies because of an interuption or cessation of blood flow
- prehypertensive state
- BP in the range of 120/80 to 140/90
- thrombosis
- the formation of a blood clot within the vascular system
- name conditions that can lead to hypertension?
-
heart condition
hyperthyroidism
kidney conditions - name risk factors that can lead to hypertension?
-
primary: genetic, age, gender, race
secondary: lifestyle, diet, anxiety, alcohol consumption, sodium intake - what is drug action of bile acid sequestrants?
- bile acid sequestrants increase the loss of LDL through increased defacation.
-
bile acid sequestrant
cholstryamine -
Questran
route: po (powder)
dose: 4g qd or bid
action: bile acid sequestrants increase the loss of LDL through increased defacation.
>>constipation, flatulence
do not chew or crush tablets
Tk ac -
bile acid sequestrant
colestipol -
Colestid
route: po
dose: 5-30 q qd (may be given in divided doses)
action: bile acid sequestrants increase the loss of LDL through increased defacation.
>>constipation, flatulence
do not chew or crush tablets
Tk ac - What are HMG-COA reductase inhibitors referred to as?
- the HMG-COA reductase inhibitors are referred to as statins.
- Name drug action of statins or HMG-CoA reductase inhibitors?
- HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
- what is the overall effect of statins or HMG-CoA reductase inhibitors?
- statins or HMG-CoA reductase inhibitors raise the rate of HDL and lower the LDL and VLDL cholesterol levels.
-
HMG-CoA reductase inhibitor
lovastatin -
Mevacor
ind: antihyperlipidemic
route: po
dose: 10-80 mg qd in single or divided doses
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
>>photosensitivity, GI upset
Tk c meals -
HGA-CoA reductase inhibitors
simvastatin -
Zocor
ind: antihyperlipidemic
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
route: po
dose: 5-40 mg qd -
HGA-CoA reductase inhibitor
pravastatin -
Pravachol
ind: antihyperlipidemic
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
route: po
dose: 10-40 mg qhs
>>photosensitivity -
HGA-CoA reductase inhibitor
atrovastatin -
Lipitor
ind: antihyperlipidemic
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
route: po
dose: 10-80 mg qd
>>photosensitivity - Name drug action of fibric acid antihyperlipidemics?
- fibric acid antihyperlipidemics work by inhibiting the extraction of free fatty acids, which reduces the liver's ability to produce triglicerides. this agent also increases HDL.
-
fibric acid antihyperlipidemic
gemfibrozil -
Lopid
route: po
dose: 600 mg po bid before morning and evening meals
action: fibric acid antihyperlipidemics work by inhibiting the extraction of free fatty acids, which reduces the liver's ability to produce triglicerides. this agent also increases HDL.
>>dizziness, blurred vision -
miscellaneous antihyperlipidemic
nicotinic acid -
Niaspan (legend)
Niacin (OTC) [read package insert for dose]
route: po
dose: 1-2g tid c meals or pc
>>photosensitivity - name drug action of antiarrhythmic agents
- all antiarrhythmic agents work on the conduction system in the heart to produce regular heartbeats.
-
antiarrhythmic agent
quinidine sulfate,
quinidine gluconate -
Quinidex (po)
Quinalan (IV)
ind: tacycardia and other arryhthmias
route: po, IV
dose: 200-300 mg tid to qid
action: all antiarrhythmic agents work on the conduction system in the heart to produce regular heartbeats.
>>GI upset
do not crush or chew sustained-release tablets
Tk c food
Tk utd - ATTENTION: explain the difference between quinine and quinidine
-
quinine: antimalarial agent
quinidine: cardiac aget -
antiarrhythmic agent
procainamide -
Pronestyl
route: po, IM, IV
action: slow down the speed of heart conduction
ind: tachycardia and other arrhythmias
inj form used in life threatening tachycardia events.
dose: tbd by dr. based on weight and age of patient
Tk utd -
antiarrhythmic agent
diospyramide -
Norplace
route: po, inj
action: slows down the heart, inj form used in life-threatening tachycardias
dose: 100-200mg q6h or 300-SR q12h
>>dry mouth, dizziness, difficulty urinating, constipation, blurred vision
Do not break or chew tablet
Tk utd -
antiarrhythmic agent
lidocaine -
Xylocaine
ind: acute mgmt of ventricular arrhythmias
route: inj, IV
dose: for IV, 50-100 mg at a rate of 25 to 50 mg/minute
kept in ER crash carts. used in code blue situations. - name common treatment options available to Americans suffering from CHF?
-
digoxin and diuretics.
diuretics releive edema often associated with CHF - explain the 4 steps of controlling HBP?
-
step 1: weight reduction
ACE inhibitors
Beta-blockers
Calcium channel blockers
Diuretics
step 2: adrenergic blockers
step 3: vasodilators -
Angiotensin converting enzyme agent (ACE Inhibitor)
enalapril -
Vasotec
ind: mild to severe HTN
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po, IV
dose: 10-40 mg qd or bid prf HTN
Tk utd
>>HA, hypotension, nausea, vomiting -
Angiotensin converting enzyme agent
ACE inhibitors
lisinopril -
Prinivil, Zestril
ind: hypertension
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po
dose: 20-40 mg qd or bid
>>HA, hypotension, nausea, vomiting -
Angiotensin converting enzyme agents
ACE inhibitors
benazepril -
Lotensin
ind: hypertension
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po
dose: 20-40 mg qd or bid
>>HA, hypotension, nausea, vomiting -
angiotensin converting enzyme agents
ACE inhibitors
captopril -
Capoten
ind: HTN
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po
dose: 25 mg bid or tid
Tk ac
>>HA, hypotension, nausea, vomiting -
angiotension converting enzyme agents
ACE inhibitors
fosinopril -
Monopril
ind: hypertension
route: po
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
dose: 20-40 mg qd
Tk ac
>>HA, hypotension, nausea, vomiting -
angiotensin II receptor antagonist
losartan -
Cozaar
ind: HBP
action: inhibit the affects of angiotensin II receptors located in vascular muscle which reduces BP via antagonistic effects on vasoconstriction
route: po
dose: 50mg qd
Tk utd -
Angiotensin II Receptor Antagonist
valsartan -
Diovan
ind: HBP
action: inhibit the affects of angiotensin II receptors located in vascular muscle which reduces BP via antagonistic effects on vasoconstriction
route: po
dose: 80-320mg qd
Tk utd -
beta-blocking agents
atenolol -
Tenormin
ind: HTN, angina pectoris, after MI
action: block various enzymes that can cause HBP, including epinephrine
route: po, IV
dose: 50 mg qd
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea -
beta-blocking agents
propranolol -
Inderal
ind: HTN, angina, arrhythmias and migraines
action: block various enzymes that can cause HBP, including epinephrine
route: po, IV
dose: for hypertension 40mg bid
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea -
beta-blocking agents
metoprolol -
Lopressor
ind: hypertension, angina pectoris, arrhythmias
route: po, IV
action: block various enzymes that can cause HBP, including epinephrine
dose: po 100-450 mg bid or tid
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea -
beta-blocking agent
pindolol -
Visken
ind: hypertension
route: po
action: block various enzymes that can cause HBP, including epinephrine
dose: max. of 60 mg qd
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea -
beta-blocking agent
acebutolol -
Sectral
ind: hypertension, ventricular arrhythmias
route: po
action: block various enzymes that can cause HBP, including epinephrine
dose: 400-800mg qd
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea -
calcium channel blockers
diltaziem -
Carziem CD
ind: angina pectoris, chronic stable angina, essential hypertension
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po, IV
dose: po for HTN, 180-360 mg qd in divided doses tid or qid
Tk utd
do not crush or chew extended release tablets
>>dizzy, drowsy, blurred vision -
calcium channel blockers
nifedipine -
Procardia, Adalat
ind: chronic stable angina, HTN
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po
dose: for HTN 30 or 60 mg qd
Tk utd
do not chew or break extended release tablets
>>dizzy, drowsy, blurred vision -
calcium channel blockers
verapamil -
Calan, Isoptin
ind: angina, chronic atrial flutter, or fibrillation, essential hypertension
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
dose: po for HTN 80mg tid; for SR formulation 120mg or 240mg qd
Tk c food
Tk utd
>>dizzy, drowsy, blurred vision -
calcium channel blockers
amlodipine -
Norvasc
ind: HTN, chronic stable angina, variant angina
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po
dose: for HTN, 5-10 mg qd
Tk utd
>>dizzy, drowsy, blurred vision -
calcium channel blocker
felodipine -
Plendil
ind: HTN
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po
dose: 2.5 to 10 mg qd
Tk utd
do not crush or chew tablet
>>dizzy, drowsy, blurred vision - name agents commonly used to treat anginal attacks?
- nitrates, calcium channel blockers, beta-blockers
-
anticoagulant
heparin -
Liquaemin
ind: decrease clotting factor in blood
route: IV, SC (only inj forms)
>>possible hemmorhage (prethrombin time (PT) tests must be done to monitor how long it takes the blood to form clots when on this medication
antidote: phtonadione inj (vit K) -
anticogulant
warfarin -
Coumadin
ind: reduce clotting factor of blood
route: po, IV
>>possible hemmorhage; prethrombin time (PT) tests must be done to monitor how long it takes the blood to form clots when on this medication
antidote: phtonadione inj (vit K) -
antiplatelet agent
aspirin -
aspirin
ind: reduce the arterial thrombi of blood
route: po
dose: 81 to 325 mg qd
action: work mainly on arterial thrombi which are made of platelet aggregates -
antiplatlet agent
dipyridamole -
Persantine
ind: reduce the arterial thrombi of blood
action:work mainly on arterial thrombi which are made of platelet aggregates
dose: 75 to 100 mg qid
route: po -
antiplatelet agent
ticlopidine -
Ticlid
ind: reduce the arterial thrombi of blood
action: work mainly on arterial thrombi which are made of platelet aggregates
route: po
dose: 250 mg bid with food -
antiplatelet agent
clopidogrel -
Plavix
ind: reduce the arterial thrombi of blood
action: work mainly on arterial thrombi which are made of platelet aggregates
route: po
dose 75 mg qd -
thrombolytic
streptokinase -
Streptase
ind: thrombolism
action: enzyme extracted from bacteria destroys clots after they are formed
used in ER dept ASAP after MI to break up clot -
thrombolytic
urokinase -
Abbokinase
ind: thrombolism
action: lytic agent retrieved from a human protein that reduces thrombolism -
thrombolytic
alteplase -
Activase, tPA
ind: thrombolism
action: natural enzyme that is normally produced by body to dissolve blood clots
>$1000/dose