Chapter 5-Cardiovascular Drugs Flashcards
What happens in right sided heart failure?
Blood is backed up within the body
What happens in left sided heart failure?
Blood backs up in the lungs
What is preload?
Pressure from volume of blood in ventricles at the end of diastole
What is preload increased?
- Hypervolemia
- Regurgitation of cardiac valves
- Heart failure
What is afterload?
Resistance left ventricle must overcome to circulate blood
When is afterload increased?
- Hypertension
- Vasoconstriction
Increased workload ALWAYS does what?
increases afterload
What are some characteristics of left sided heart failure?
- Cough (crackles/wheezes)
- Blood-tinged sputum
- Orthopenea-can breath better leaning over-pressure off of lungs
- Cyanosis on extremities
What are some characteristics of right sided heart failure?
- Dependent Edema-ankles
- Chronic nausea, no appetite, weight gain
- Ascites-enlarged abdominal cavity with fluid
- Enlarged liver & spleen
- Distended jugular veins
What lab test is done for HF?
Brain natriuretic peptide (BNP)
normal values less 100 pg/mL
What are nonpharmacologic treatments we could tell our patient to utilize?
- Limit salt intake
- Limit or avoid alcohol intake
- Stop smoking
- Decrease saturated fat intake
- Perform mild exercise
What is the acronym for treating CHF?
U-upright position N-nitrates L-lasix O-oxygen A-ACE inhibitors D-digoxin
F-fluids (decrease)
A-afterload (decrease)
S-sodium restriction
T-test (dig level, ABG’s, potassium level)
What time of the day would we most likely want to give our patients their Lasix?
Morning because it makes them pee all day
Which are the first line of CHF drugs?
Inotropics- dopamine, dobutamine
What do inotropics do?
increase the force of heart contractions
What do inotropics treat?
Heart failure
SVT
A-fib or flutter
These drugs are used with patients with chronic HF because they REDUCE heart contractility (are not use with class IV CHF)
Beta blockers
These drugs dilate venules and arterioles to improve renal blood flow (promote fluid loss) and decrease blood fluid volume but have a LOT OF SIDE EFFECTS
ACE inhibitors
These drugs are used if ACE inhibitors are not tolerated but are more expensive and not available in generic form
Angiotension-receptor blockers (ARB’s)
These drugs reduce conduction of the heart (less contraction)
Calcium channel blockers
These drugs decrease cardiac afterload (left)/cardiac output, improve renal perfusion and increase fluid loss, and improve circulation to skeletal muscle
arteriolar dilators
These drugs reduce oxygen demand on the heart
vasodilators
These drugs reduce vascular fluid volume
Diuretics
Cardiac glycosides do what?
Act on the CNS to slow the heart rate
They do this by boosting intracellular calcium at the cell membrane, enabling stronger heart contractions - inhibits sodium-potassium pump
