Cardiovascular Drugs Flashcards
What are the determinants of Cardiac Output?
Heart Rate - controlled by the ANS
Stroke Volume - Determined by 1) myocardial contractility (force with which the ventricles contract),2) cardiac afterload, 3) cardiac preload
Preload - Amount of tension (stretch) applied to a muscle before contraction = force of venous return
Afterload - Load against which a muscle exerts its force = arterial pressure that the left ventricle overcomes to eject blood
What is Blood Pressure?
- Determined by the product of cardiac output and systemic vascular resistance
Cardiac Output - amount of blood ejected from the left ventricle and measured in Lpm
SVR - resistance to blood flow that is determined by the diameter of the blood vessels and vascular musculature
What is the goal of Antihypertensive Therapy?
- Reduction of cardiovascular and renal morbidity and mortality
JNC 7 – achieve a blood pressure of less than 140/90mmHg and for patients with hypertension and diabetes, less than 130/90mmHg
- Individualized considering co-morbidities and impact of patient’s quality of life
What is Diuretics?
Drugs that accelerate the rate of urine formation that results to the removal of sodium and water from the body
What are the Nursing Process in assessing on Anti-Hypertensives: Direct Vasodilators?
- Obtain health history, physical assessment and V/S
- Monitor labs: Na, K, Cl, Mg, Ca, Troponin, BUN and Creatinine, ALT, AST.
- Adrenergic drugs –watch out for edema, BP and HR, first-dose syncope (2-6hrs).
- ACEI –assess BP, Apical pulse, respiratory status (dry cough) and CBC.
- ARBs –assess renal function of elderly clients.
- Vasodilators –assess neurological status, use with extreme caution to elderly.
What are the Patient Health Teaching for Anti-Hypertensives: Direct Vasodilators?
- Medications are taken exactly as prescribed.
- Hypertension mgt includes dietary restrictions (low-salt, low fat), monitoring stress levels and exercise and avoidance of smoking and alcohol.
- Emphasize recording of blood pressure readings and daily weights.
What are the Angina Types?
Chronic Stable Angina – intense but subsides within 15 mins of rest or medication and caused mainly by atherosclerosis and can be triggered by exertion or stress (cold, emotions) and exacerbated by smoking, alcohol, coffee and some drugs.
Unstable Angina – early stage of progressive artery disease characterized by pain increasing in severity and frequency and may even occur at rest.
Vasospastic Angina – from spasms of the smooth muscle that surrounds the coronary arteries and occurs at rest without any triggers but usually occurring at the same time of day.
What is Heart Failure?
- Occurs due to a reduced ratio of ejection fraction to left-ventricular end-diastolic volume.
Ejection fraction – amount of blood ejected with each contraction (65% of total ventricle volume).
LV End-diastolic volume –total amount of blood in the ventricle before contraction.
What are the classifications of AHA’S HF?
Class 1 - No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpation, dyspnea (shortness of breath).
Class 2 - Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpation, dyspnea (shortness of breath).
Class 3 - Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpation, or dyspnea.
Class 4 - Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.
What are the Coagulation Modifiers?
Anti-coagulants - inhibit the action or formation of clotting factors and prevents clots from forming.
Antiplatelet – prevent platelet plugs from forming by inhibiting platelet aggregation.
Hemorrheologic – alter platelet function without preventing the platelets from working.
Thrombolytic – breaks down clots and thrombi that have already formed.
Anti-fibrinolytic – hemostatic drugs, promote blood coagulation.
