Cardiac Diagnostic Tests and Intro to Cardiac Pharm Flashcards
What are some cardiac biomarkers that may be tested ?
- troponin
- creatine kinase
- c-reactive protein
- b-type natriuretic peptide markers (BNP)
What is troponin ?
myocardial muscle protein
What is creatine kinase (CKMB) ?
enzyme present in myocardium
What is c-reactive protein ?
produced by liver during inflammation
What is B-type natriuretic peptide markers (BNP) ?
hormone secreted from cardiac cells
- high levels indicate heart failure
What is a chest x-ray used for ?
can show cardiac size/shape
- fluid around heart and lungs can be detected
- change in aorta can be seen
What is a 12 lead ECG ?
leads placed to analyze the electrical impulses in the heart
- PQRST waves interpreted
- changes can occur during stress tests and with angina and ACS
- placement can be done by trained tech
What is a Holter monitor ?
records EKG events over time for diagnostics
- data stored then analyzed
- worn over time and read for arrythmia events
What is a echo-cardiogram ?
uses ultrasound to see the structures of the heart
- can assess ejection fraction of blood pumping from heart (EF)
- color flow or duplex to detect blood flow direction
What is a trans-esophageal echo cardiogram (TEE) ?
transducer is placed in the esophagus and sends images of the heart
- frequently used for assessment of valves and endocarditis
- must be NPO/monitor O2 Sat
- can detect clots in heart
What is a cardiac stress test ?
evaluates cardiac stress and reserve
- cardiac symptoms frequently occur with activity due to increase in demand
- test will get HR and RR up in pt and evaluate cardiac response
- can be exercise or chemical
- EKG is monitored for changes indicated CAD
What is nuclear cardiology ?
injection of radioactive isotopes and uptake observed in cardiac muscle
- MUGA: used to establish cardio toxicity of drugs
- (PET) establishes viable vs nonviable heart tissue
- may be used with exercise and stress
What is a cardiac catheterization and coronary CT angiography ?
- insertion of a catheter into the coronary arteries via femoral or alternate site
- angiography is an injection of dye or contrast medium to visualize the arteries
What do the alpha 1 receptors affect ?
vasoconstriction & increase BP
- agonists: constriction
- antagonists: dilation
What do the beta 1 receptors affect ?
increase heart contractility and HR (heart and kidneys)
- agonists: increase HR and renin
- antagonists: decrease HR and renin
What do the beta 2 receptors affect ?
bronchodilation (bronchi and arterioles of the heart and lungs)
- agonists: dilation
- antagonists: constriction
- may have respiratory SE
What are some characteristics of the Non-selective beta blockers ?
- Ex.) propanolol
- blocks beta 1 and 2 receptors
- watch for bronchoconstriction
- can’t be given if pt has respiratory illness
- will decrease BP and HR
What are some characteristics of the Cardio-selective beta blockers ?
- Ex.) metoprolol and atenolol
- blocks beta 1 receptors
- will decrease BP and HR
What are some characteristics of the alpha-beta blockers ?
Ex.) carvedilol
- results in peripheral vasodilation (decreased BP) and decreases HR
How do the calcium channel blockers work ?
inhibit the movement of calcium ions across cardiac muscle and the smooth muscle lining blood vessel walls
What are some characteristics of calcium channel blockers ?
Ex.) Amlodipine & Nifedipine
- arterial dilation leads to decreased BP and dilated coronary arteries
- often prescribed for pts with both HTN and CAD/chronic stable angina
- never give in pt’s with HF
What is the function of angiotensin II ?
helps balance BP by narrowing blood vessels (especially in the kidneys)
- when BP gets too low, the body makes AT2 to help bring it back up
- too much can cause HTN or kidney damage
- can also worsen HF and other types of CVD worse
What are some characteristics of ACE inhibitors ?
Ex.) Lisinopril & Captopril
- prevents the conversion of angiotensin 1 and 2 by slowing down how much our body makes
- relaxes the blood vessels and lowers BP
- can lead to renal impairment, hyperkalemia, and dry cough
What are some characteristics of ARBs ?
Ex.) Losartan & Valsartan
- block the angiotensin II receptors used to narrow the blood vessels
- often used when pt is unable to take ACE inhibitors due to SE
- less likely to cause hyperkalemia
How do loop diuretics work ?
Ex.) Furosemide
- inhibit NaCl reabsorption in the ascending loop of Henle
- most potent, potassium wasting (decreased K+)
- Monitor: weight, BP, electrolytes, and kidney function
How do thiazide diuretics work ?
Ex.) hydrochlorothiazide
- inhibits NaCl reabsorption in distal convoluted tubule
- potassium wasting
- Monitor: weight, BP, electrolytes, and kidney function
How do Potassium-sparing diuretics work ?
Ex.) Spironolactone
- reduces the exchange of potassium and sodium in the distal tubules
- potassium sparing
- Monitor: weight, BP, electrolytes, and kidney function
What are some characteristics of Nitroglycerin ?
a vasodilators
- relaxes veins, arteries, and coronary arteries by relaxing vascular smooth muscle
- reduces preload and afterload
- SE: works fast, flushing, HA, dizziness
- fall precautions
What are some characteristics of Hydralazine ?
a vasodilator
- direct arterial vasodilation leads to reduced BP
- reduces afterload
- commonly given for hypertensive crisis
- IV, watch BP and HR
- fall precautions
