Cardiopulmonary Pharmacology Flashcards
Alpha adrenergic antagonist agents
action: reduce peripheral vascular tone, this action causes dilation of arterioles and veins and decreases blood pressure
indications: hypertension, benign prostatic hyperplasia
side effects: dizziness, palpitations, orthostatic hypotension, drowsiness
implications for PT: use caution when rising from a sitting or lying position due to risk of dizziness and orthostatic hypotension
examples: doxazosin, prazosin, terazosin
ACE inhibitors
action: decrease blood pressure and afterload by suppressing the enzyme that converts angiotensin 1 to angiotensin 2
indications: hypertension, congestive heart failure
side effects: hypotension, dizziness, dry cough, hyperkalemia, hyperponatremia
implications for PT: avoid sudden changes in posture due to the risk of dizziness and fainting from hypotension. Patients with heart failure should avoid rapid increases in physical activity
examples: captopril, enalapril, lisinopril, ramipril
angiotensin 2 receptor antagonist agents
action: block angiotensin 2 receptors which limit vasoconstriction and stimulation of vascular tissue
indications: hypertension, congestive heart failure
side effects: dizziness, back and leg pain, angina pectoralis
implications for PT: minimal
examples: losartan, candesartan, valsartan
antiarrhythmic agents
indications: cardiac arrhythmias
side effects: unique to the specific antiarrhythmic agent, exacerbation of cardiac arrhythmias, dizziness, hypotension
implications for PT: encourage patients to adhere to the prescribed dosing schedule and immediately report any adverse reactions to a healthcare professional
anticoagulant agents
action: inhibit platelet aggregation and thrombus formation
indications: post percutaneous transluminal coronary angioplasty and CABG, prevention of venous thromboembolism and cardioembolic events in patients with atrial fibrillation and prosthetic heart valves
side effects: hemorrage, increased risk of bleeding, gi distress with oral medicaiton
implications for PT: a therapist must be careful to avoid injury secondary to the risk of excessive bleeding or bruising
examples: warfarin, heparin, enoxaparin
antihyperlipidemia agents
actions: inhibit enzyme action in cholesterol synthesis, break down low density lipoproteins, decrease triglyceride levels, increase HDL
indications: hyperlipidemia, atherosclerosis, prevent coronary events in patients with existing coronary disease, diabetes, or PVD
side effects: headache, GI distress, myalgia, rash
implications for PT: aerobic exercise can increase high density lipoproteins and maximize the effects of drug therapy
examples: atorvastatin, simvastatin, fenofibrate
antithrombotic agents
action: antithrombotic agents inhibit platelet aggregation and clot formation
indications: post MI, atrial fibrillation, prevent arterial thrombus formation
side effects: hemorrhage, thrombocytopenia, potential liver toxicity with the use of aspirin, gi distress
implications for PT: a therapist must be careful to avoid injury secondary to the risk of excessive bleeding
examples: aspirin, clopidogrel, dipyridamole
beta blocker agents
action: decrease myocardial oxygen demand by decreasing heart rate and contractility by blocking b adrengic receptors
indications: hypertension, angina, arrhythmias, heart failure, migraines, essential tremor
side effects: bradycardia, cardiac arrhythmias, fatigue, depression, dizziness, weakness, blurred vision
implications for PT: heart rate and blood pressure response to exercise will be diminished
examples: atenolol, metoprolol, propanolol
calcium channel blocker agents
action: decrease entry of calcium into vascular smooth muscle cells resulting in diminished myocardial contraction, vasodilation, and decreased oxygen demand for the heart
indications: hypertension, angina pectoris, arrhythmias, congestive heart failure
side effects: dizziness, headache, hypotension, peripheral edema
implications for PT: heart rate and blood pressure response will be diminished. Observe for signs of worsening heart failure such as peripheral edema, dyspnea, weight gain
examples: amlodipine, nifedipine, verapamil, diltiazem
diuretic agents
action: diuretic agents increase with excretion of sodium and urine. This causes reduction in plasma volume which decreases blood pressure
indications: hypertension, edema associated with heart failure, pulmonary edema, glaucoma
side effects: dehydration, hypotension, electrolyte imbalance, polyuria, increased LDL, arrhythmias
implications for PT: positional changes can increase the risk of dizziness and falls due to decreased blood pressure
examples: chlorothiazide, furosemide, triamterene
nitrate agents
action: nitrate agents decrease ischemia through smooth muscle relaxation and dilation of peripheral vessels
indications: angina pectoris
side effects: headache, dizziness, orthostatic hypotension, reflex tachycardia, nausea, vomiting
implications for PT: patients must be educated to come to standing slowly. Sublingual administration of nitroglycerin is the preferred method to treat acute angina attack
positive inotropic agents
action: increase the force and velocity of myocardial contraction, slow the heart rate, decrease conduction velocity through the AV node, and decrease the degree of activation of the sympathetic nervous system
indications: heart failure, atrial fibrillation
side effects: cardiac arrhythmias, GI distress, dizziness, blurred vision
implications for PT: should monitor heart rate
examples: digoxin
thrombolytic agents
actions: facilitate clot dissolution through conversion of plasminogen to plasmin. Plasmin breaks down clots and allows occluded vessels to reopen to maintain blood flow
indications: acute myocardial infarction, pulmonary embolism, ischemic stroke, arterial or venous thrombosis
side effects: hemorrhage, allergic reactions, cardiac arrhythmia
implications for PT: must be careful to avoid situations that may cause trauma due to altered clotting activity
examples: urokinase, alteplase
antihistamine agents
action: block the effects of histamine resulting in a decrease of nasal congestion, mucosal irritation, and symptoms of the common cold, sinustis, conjunctivitis, and allergies
indications: respiratory seasonal allergies, rhinitis and sneezing from the common cold, allergic conjunctivitis, motion sickness, and parkinsons
side effects: arrhythmias, postural hypotension, GI distress, dizziness, drowsiness, headache, blurred vision, fatigue, nausea, thickening of bronchial secretions
implications for PT: increase guarding when rising from a sitting or lying position de to risk of hypotension
examples: diphenhydramine, fexofenadine, centrizine HCL, loratadine
anti inflammatory agents
action: help prevent inflammatory mediated bronchoconstriction by inhibiting production of inflammatory cells
indications: bronchospasm, asthma
side effects: systemic side effects are decreased with inhaled for o corticosteriods but may include damage of supporting tissues. Nasal irritation, dryness, sneezing, bloody mucus
implications for PT: instruct patient in use of inhaler
examples: beclomethasone dipropionate, budesonide, flunisolide, zileuton, cromolyn sodium
