Cardiology Flashcards by vanessa Prusia

BP equals

heart rate x SV x PVR

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cardiac output equals

heart rate x stroke volume

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as one ages what is a risk with blood pressure

systolic hypertension

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What is hypertension?

a complex disease with core defet of vascular dysfx that leads to select target organ damage

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What does Tx of HTN do?

minimizes risk for target organ damage

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Organs affected by HTN

brain
cardiovascular system
kidney
eye (optic disk)

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Affect of HTN on brain

stroke

vascular dementia

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Affect of HTN on cardiovascular system

atherosclerosis
MI
left ventricular hypertrophy
heart failure

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Affect of HTN on kidney

hypertensive nephropathy

renal failure

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Affect of HTN on eyes

hypertensive retinopathy

risk of blindness

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How is hypertensive retinopathy graded

1-4

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grade 1 retinopathy

narrowing of terminal branches

no visual changes

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grade 2 retinopathy

local constriction of vessels

no vision changes

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grade 3 retinopathy

striate hemorrhages and soft yellow exudate

visual changes

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grade 4 retinopathy

papilledema

visual changes

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What are the lifestyle changes to encourage for HTN

weight reduction
DASH diet
Na restriction
exercise
limit alcohol consumption

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Diuretics for HTN

HCTZ
chlorthalidone
it is used to lower sodium depletion that leads to PVR reduction

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Caution of diuretics

can have a neg impact on dyslipidemia and glucose control if dose is over 25mg

monitor for Na, K and Mg depletion

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Beta- adrenergic antagonists for HTN

“lol” medications: atenolol

works to block andrenergic beta receptor sites, blunt catecholamine response and are non cardioseletive

you have B2 in your 2 lungs and periphery

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Caution of Beta adrenergic antagonists

in heart block
lower dose for COPD, asthma
taper to discontinue

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Alpha adrenergic antagonists for HTN

carvedilol
labetalol

works on all BP componets (alpha and beta)

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when is it good to use alpha adrenergic

less insulin resistance

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ACE inhibitors for HTN

“prils”

take time to work no instant

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ARBS for HTN

“sartan”

direct renin inhibitor for HTN

aliskiren

Caution with ACE ARBS and DRI's

not in bilateral renal artery stenosis risk for hyperkalemia angioedema risk Cate D in pregnancy

Calcium channel blockers for HTN

amlodipine diltiazem verapamil cause vasodilation and decrease HR work quicker

Caution with calcium channel blockers

ankle edema | heart failure, renal or hepatic impairment

Aldosterone antagonists for HTN

spironolactone eplerenone blocks effects of aldosterone better regulator of Na and water homeotostasis

Caution with aldosterone antagonists

hyperkalemia risk esp with ACE and ARB used in heart failure tx gynecomastia risk

Centrally acting agents for HTN

clonidine methyldopa works on brain BP control center

Caution with centrally acting agents

sedation | can have rebound htn if you stop

BP goal age 60 and >

<150/90

BP goal age <60

<140/90

BP goal in someone with DM

<140/90

BP goal in someone with kidney disease

< 140/90

beginning med tx for non black person with htn

diuretic ACE ARB CCB if needed

beginning med tx for black person with htn

diuretic CCB *need higher doses of ACES*

When starting someone on spironolactone have them back to check

Potassium

What can be a herbal remedy for HTN

cumin and coriander

What does a person need to do before having lipid panel drawn

fast for 12 hours

Lifestyle changes for dislipidemia

reduce sat fats increase omega 3s weight management physical activity

HMG CoA reductase inhibitors for tx of dislipidemia are

"the statins"

Use of statins for dislipidemia

power house medication lowers LDL by 18-55% hepatic enzymes prior to start caution with grapefruit juice rhabdomyolysis and myositis are adverse effects so don't use in dose over 80mg

Bile acid resins in dislipidemia

cholestyramine colestipol could increase TG no hepatic monitoring required take 2 hours apart from other meds can have GI s/e

use of cholesterol absorption inhibitor with dislipidemia

ezetimibe most often used in combo with a statin for LDL lowering no need to adjust with decreased hepatic fx

use of niacin with dislipidemia

vasodilator used to decrease TG minimal effect on LDL can cause flushing, hyperglycemia, hyperuricemia not in liver disease, gout or ulcers

Use of fibric acid derivatives in dislipidemia

fenofibrate gemfibrozil for lowering TG and increasing HDL LDLs can increase if takin with a statin can increase risk of dyspepsia, gallstones and myopathy

Fish oil with dislipidemia

omega 3 decrease TG by 20-30% increased risk of bleeding GI upset

How often should you do ASCVD risk factor for someone 40-75 with no co morbidities

every 4-6 years

low intensity statin therapy examples

LDL reduction < 30% pravastatin 10-20mg lovastatin 20mg

moderate intensity statin therapy

LDL reduction 30-49% lovastatin 40mg pravastatin 40-80mg

High intensity statin therapy

LDL reduction >50% atorvastatin 40-80mg rosuvastatin 20-40mg

LDL goal in someone with very high risk

someone with early MI and genetic lipid disorder <70

LDL goal in someone with CHD, or DM

< 100***

LDL goal with someone with > 2 risk factors

<130

LDL goal with someone with 0-1 risk factors

<160

What is the lipid goal for a man with DM and HTN

HDL >45 | LDL<150

What are 3 potential causes of hypertriglyceridemia

untreated hypothyroid poorly controlled DM excess alcohol use