Chapter 41 - Vascular Dis - Exam 2 Flashcards
adequate blood flow depends on
- efficiency of heart as a pump
- patency of the blood vessels
- quality and quantity of blood
what is peripheral arterial disease (PAD)
it is a thickening of artery walls, result of atherosclerosis
PAD is characterized by
lower extremity:
upper extremity:
lower extremity: intermittent claudication
upper extremity:
arm fatigue and pain with exercise ( forearm claudication)
might have trouble gripping, have dizziness, visual changes, or syncope
what is aortoiliac occlusive disease
a form of PAD involving the blockage of the abdominal aorta as it transitions into he common iliac arteries
aortoiliac occlusive disease is characterized by
pt may c/o butt or low back pain associated with walking. men may have impotence
manifestations of peripheral artery disease
dec/absent peripheral pulse. no LE edema, loss of hair, skin is shiny and taut, dependent rubor and or muscle atrophy, extremity is cold and gray/blue or darkened, pallor may occur with extreme elevation
manifestation of peripherial venous disease
peripheral pulse is present, but diff d/t edema, LE edema, edema that progresses through out the day, may have hair, skin is think, warm
what do statins do
Statins are a class of medications primarily used to lower cholesterol levels in the blood. They work by inhibiting an enzyme called HMG-CoA reductase, which plays a key role in the production of cholesterol in the liver. By blocking this enzyme, statins reduce the liver’s ability to produce cholesterol, leading to lower levels of LDL (low-density lipoprotein) cholesterol, often referred to as “bad” cholester
what does niacin do?
Lipid modification: Niacin is known to decrease levels of LDL (low-density lipoprotein) cholesterol, commonly referred to as “bad” cholesterol, and triglycerides while simultaneously increasing levels of HDL (high-density lipoprotein) cholesterol, often referred to as “good” cholesterol. This makes it a valuable tool in managing dyslipidemia (abnormal lipid levels).
Atherosclerosis prevention: By improving lipid profiles, niacin can help reduce the risk of atherosclerosis, a condition characterized by the buildup of plaque in the arteries. Lowering LDL cholesterol and raising HDL cholesterol levels can slow the progression of atherosclerosis and reduce the risk of cardiovascular events such as heart attacks and strokes.
Antioxidant properties: Niacin has antioxidant properties, meaning it can help neutralize harmful free radicals in the body, which are molecules that can cause cellular damage and contribute to various diseases, including cardiovascular disease.
Vasodilation: In higher doses, niacin can cause vasodilation, or widening of blood vessels. This effect may contribute to its ability to lower blood pressure and improve blood flow, which can be beneficial for individuals with hypertension or peripheral vascular disease.
Due to its lipid-modifying effects, niacin has been used as a therapeutic agent in the management of dyslipidemia and cardiovascular risk. However, it’s important to note that niacin supplementation should be used under the supervision of a healthcare professional, as high doses can cause side effects such as flushing, itching, and liver abnormalities. Additionally, recent research has questioned the overall benefit of niacin therapy, particularly in combination with other lipid-lowering medications, so its use is now more selective and based on individual patient characteristics and risk factors.
what is a fibric acid
Fibric acids, also known as fibrates, are a class of medications used primarily to lower levels of triglycerides (a type of fat) in the blood. They work by activating a receptor called PPAR-alpha (peroxisome proliferator-activated receptor alpha), which regulates the expression of genes involved in lipid metabolism.
Fibric acid derivatives primarily act by increasing the activity of enzymes that break down triglycerides, leading to their clearance from the bloodstream. Additionally, fibrates can also increase levels of HDL (high-density lipoprotein) cholesterol, often referred to as “good” cholesterol.
Overall, fibric acids are used to treat hypertriglyceridemia (high triglyceride levels) and may be prescribed alone or in combination with other lipid-lowering medications, such as statins, to help reduce the risk of cardiovascular events such as heart attacks and strokes.
Common examples of fibric acid medications include fenofibrate and gemfibrozil. Like all medications, fibric acids can have side effects and interactions with other drugs, so they should be used under the guidance of a healthcare professional. Common side effects may include gastrointestinal upset, muscle pain, and liver
how can we teach a patient to manage PVD
-antiplatelet drugs
vasodilators
- exercise to the point of pain then rest and try to increase indurance
- foot care is important to avoid foot ulcers
- never use heating pad
