cardiac meds Flashcards
Ischemic HD -anti ischemic drugs
goals
physio- heart is O2 dependent
patho: myocardium can only func w/o adequte O2 for short period
Pharm: restore balance
drugs that decrease myocardial O2 demand
Beta blockers
CCBs
Nitrates
Angina (vasodilators)
Nitroglycerin tablets (1-3mins)(first pass effect- bypass liver)
nitro ointmeny (30mins)
patch (30mins)
infusion(immediate)
oral isorbide tablets (60mins)
chewable isorbide tablets (2-5mins)
AEs: HA, dizzy, hypotention -esp w/ sublingual
Drugs that increase myocardial O2 supply
-thrombolytic agents
-antiplatelet agents
-anticoags
-CCBs
Anti-clotting drugs
-antithrombotics (anti-platelet activity): aspirin, plavix, ticlid
-anticoags(inhibit blood clotting process): IM:Heparin, SQ:Lovenox, PO:Warfarin(INR monitoring)
-thrombolytics(dissolve clot and reopen vessels): need to be admined within 3hrs from occlusion: streptase, eminase, alteplase
AEs: bruising. bleeding
HF
physio: positive ionotropes(drugs that increase contractility), negative ionotropes(drugs that decrease contractility)
pharm: diuretics, B blockers, ACE inhibitors, vasodilators, CCBs,
digitalis glycosides-increase Na in heart(TOXIC-monitor pt carefully)
phosphodiesterase-increases Ca in heart
*drugs can only improve QOL
Cardiac arrhythmias
types
warning
AEs
Na channel blockers
CCBs
B blockers
drugs that prolong repolarization
warning: monitor when exercising
AEs: triggers different forms of arrhythmia
HTN
Diuretics
drugs acting on SNS
vasodilators
drugs acting on RAS
centrally acting drugs
Diuretics
-thiazide diuretics (HCTZ)
-loop (furosemide, torsemide)
-K sparing diuretics (amiloride, spirolactones)
Vasodilators
-peripheral alpha 1-blockers- ZOSIN
-ACE inhibs -PRIL
-ARBS -AN
-CCBs
-K channel openers
-renin inhibs
Cardioinhibitory drugs
BBs -OLOL
CCBs -DIPINE
AEs anti-hypertensive drugs
can cause drop BP- results in OH, dizziness, fainting, falls
AEs BBs
fatigue, weakness, decreased libido. Respond different during exercise
AEs CCBs
swollen ankles, arrhythmias, MI
ACE inhibs AEs
persistent dry cough (this is due to them having an allergic reaction to it)
Diuretics AEs
electrolyte imbalance -confusion, dizziness, unreasonably fatigue and dehydration
OH
more fx in older HTN pts with DM, taking diuretics, vasodilators, and some psychotropic drugs
HTN women
oral contras- increase BP, HRT does not raise BP
pregnant women- a lot of meds cannot be given if ACEI or ARBs
Lipid disorders
-elevated cholesterol levels- esp LDL are associated w/ premature coronary disease
TLC
drugs for this disorder- many AEs
Statins*, bile sequestrants
Statins
mechan: inhibit LDL synthesis, increase LDL catabolism
AEs: constip, diarrhea, heartburn, stomach pain, dizzy, HA, hapetotox, myopathy/renal dysfunc, neuropathy, liver failure
Lower cholesterol natural products
fish oils
flaxseed
garlic
oat bran
psyllium
red yeast (very effective)
soy
DM mx
safe exercise program (avoid hypoglycemia)
knowledge of insulin
remind not to inject insulin into muscle related to exercise
SQ, PO
AEs: hypoglycemia, coma, death
DM sxs, classification
sxs: polyuria, polydipsia, polyphagia
class: 1,2, gestational
