Cardio Flashcards
What produces rapid control of blood pressure?
Baroreceptor reflex
peripheral chemoreceptors
adrenergic system
What produces long term control of BP?
Renin-angiotensin-aldosterone
BP can be decreased by
decreasing HR and SV
reducing peripheral resistance.
explain RAS
kidney sense low profusion and release renin(also inc. BP) -> turns angiotensin-angiotensin1-> ACE turns it to Angiotensin 2->cause BP rise. because ang2 is most powerful vasoconstrictor.
Whats target tissue of antihypertensive drugs?
- sympathetic nerves releasing NE (adrenergic inhibitors)
- kidney
- heart
- arterioles
- CNS
loop diuretics are ____ anti-hypertensives yet _____ diuretics.
thiazides ?
mod/ powerful
powerful/moderate
MOA of Diuretics?
inhibit sodium pumps
induce renal PG synthesis
used for HTN
ADR of diuretics?
fluid depletion hyponatremia hypokalemia orthostatic Hypotension hyperglycemia increase LDL
What makes Diuretics less effective?
when should prescriber be notified?
NSAIDS
BP=<100 HR=<60
Potassium sparing diuretics work at ?
MOA?
collecting duct
block aldosterone receptors
inhibition Na Flux through ion channels
ADR of K+ sparing diuretics?
dehydration hyperkalemia gynecomastia impotence acute Renal failure kidney stones.
Clinical signs to watch for diuretics?
hypotension dizzy orthostatic hypotension dehydration cramping irregular pulse incontinent elevated K+ and BUN
Rehab implications for diuretics?
- ankle pumps
- monitor pulse
- inspect skin
- prolonged exercise contraindicated
- geriatrics increased risk/fall prevention
- bp<100 hr<60
MOA of beta blockers?
-olol
slow HR and CO
inhibit sympathetic activity
inhibit renin release
reduce mortality after MI
ADR for beta blockers?
fatigue
excessively lower BP
bradycardia
excessive sweating.
Delay recovery of hypoglycemia
Clinical signs of beta blockers?
hypotension decreased BP with exercise weak pulse dizzy orthostatic hypotension lower extremity edema monitor pulmonary symptoms weight gain with heart failure.
beta blockers
myocardial ischemia?
uncomplicated hypertension?
increase performance
decrease performance.
MOA of calcium channel blockers?
interfere with calcium uptake in arteriole smooth muscle in cardiac muscle.
ADR of calcium channel blockers?
low BP
Headache
Papitation
Orthostatic hypotension
Clinical signs of calcium channel blockers?
rehab implications?
hypotension
Orthostatic hypotension
dizzy
LE edema.**
less effect on performance.
MOA of ACE 1
inhibit Angiotensin converting enzyme ACE
CO and HR don’t change. but lowers BP
ADR of ACE 1
affect RAS
chronic cough hyperkalemia Impaired by NSAIDS Orthostatic hypotension increase risk of angioedema Low BP
MOA of ARB?
prevent angiotensin 2 from binding to receptor on blood vessel.
lowers BP
ADR of ARB?
affect RAS
low bp hyperkalemia dizzy Orthostatic hypotension impaired by NSAID NO COUGH
MOA of direct renin inhibitor
block renin release
ADR of direct renin inhibitor
peripheral edema
increased serum creatinine
increase risk of stroke/renal complications after 18-24 mo
what is more important cardiovascular risk factor SBP or DBP?
SBP
