CAD/HF worksheet Flashcards
Angina
3 types stable-predictable chest pain transient myocardial ischemia unstable-unpredictable chest pain unstable p;aque with rupture ***1st sign ischemic heart disease IHD/MI Prinzmetal (vasospastic) variant spasm of coronary artery, no plaque
Angina Goal of TX
Increased Bloof Flow to cardiac muscle by
1.< preload–bloodflow–>O2 to heart muscle
Prevention of Acute Coronary Syndrome ACS
Prevention of death
Alleviate acute s/s of MI
Prevent recurrent s/s myocardial ischemia
Avoid/minimize adverse tx effects
Medication Treatment of Chronic Angina
Beta-Blockers
CCB
Long acting Nitrates
Medication Treatment of Chronic Angina
Beta blockers
Beta Blockers
< BP–<ventricular wall tension
Medication Treatment of Chronic Angina
CCB
Calcium Channel Blockers
bloodflow– >O2 supply.
Medication Treatment of Chronic Angina
Long acting Nitrates
Long acting Nitrates
NO Nitrous oxide–vasodilates–>bloodflow–<O2 demand
Medication Treatment of Chronic Angina
Long acting Nitrates
**
Avoid rebound sympathetic response by a break in therapy during the nighttime.
Used as an adjunct not alone Contraindicated hypertrophic obstructive cardiomyopathy common SE Flushing, orthostatic hypotension
HF and choice of Beta blocker
Non selective Beta blocker with Alpha 1
Vasospastic Angina
Different tx
CCB
Dyhypherines
WHy?
Vasospastic Angina
Avoid Beta blockers
Blockade of beta receptors leaves alpha receptors unopposed.
Heart Failure
The inability of the heart to pump enough blood to meet the bloodflow and metabolic demands of the body
Etiology and heart failure
CAD HTN Dilated Cardiomyopathy
HF goal of therapy class B/C/D
Class B HF-Medication to prevent onset clinical s/s Class C HF- Medication to control s/s <morbidity Class D- Quality of life Measures
Chronic HF treatment
ACE inhibitors
Beta Blockers
ACE–vasodilation–<hr><contractility
Carvedilol vs Metoprolol
Carvediol Betablocker + alpha
Diruetic
K+ wasting
K+ sparing
???????????
Both are Inotropes
Chronic HF and Digoxin TX
Digoxin causes the heart to beat stronger and pump more blood
Digoxin toxicity
Drug to drug interactions
quinidine, verapamil, amiodarone
Increased risk of toxicity with dehydration and renal insufficciency
Increased risk of toxicity with <K+—-monitor closely with diuretics
Drug to drug interactions
HF and vasodilation
vasodilation decreases workload on heart
Hydrazaline
combined with nitrate= effect of ACE
