Chpt 2: Cardiovascular system Flashcards
What is the most common cardiovascular disease?
Hypertension (HTN)
What are the two mechanisms that cause HTN?
-increased fluids and vasoconstriction
Both cause an increase of pressure in the arteries
What can a person do to control HTN?
lifestyle modification and medication
Diuretics
work by increasing sodium and water excretion from kidney, thereby reducing blood volume (only one that helps with increased fluid)
Types of diuretics
Thiazide: hydrochlorothiazide- HCTS
Loop: Lasix (furosemide)–> lose potassium
Potassium sparing
Adverse reactions of diuretics
hypotension and electrolyte imbalances
what are beta blockers?
work by blocking vasoconstriction, decreasing heart rate and BP, and increase blood flow to the kidneys
what are the beta blocker actions?
B1- blocker affect (1 heart)
B2- blocker affect (2 lungs)
ACE inhibitors (angiotensin converting enzyme)
preventions conversion of angiotensin I to angiotensin II (a vasoconstrictor) thereby causing vasodilation
Calcium Channel blockers
blocks calcium moving into the muscle cells
what do adrenergic blockers (alpha 1 blockers) do?
-Inhibited alpha 1 receptors and cause vasodilation
-Also block alpha 2 receptors which increase
-Common A1 blocker: Flomax (tamsulosin)
Common CCBs
Narvasc (amlodipine)
Cardizem (diltiazem)
Adverse reactions: hypotension
Vasodilators
produce smooth muscle relaxation of blood vessels (most important)
Common vasodilators
-Apresoline (hydralazine)
-Imdur (isosorbide mononitrate)
-Antihypertensive: breakdown by the liver and excreted by the kidneys
Adverse reactions: hypotension
Antihyperlipidemic
drugs that treat high lipids in the body
Total Cholesterol=
HDL cholesterol + LDL cholesterol+ 20% of Triglycerides
HMG-COA reductase–>
statin drugs
Statin drugs info
-Adverse reactions:GI disturbance, HA (headache)
-Contraindication: liver failure and patients with hx of alcoholism
***Cannot eat or drink a lot of grapefruit/ grapefruit juice, also with beta blockers because it can cause the drug to become toxic in the body
Fibric Acid Derivatives
-Tricor (fenofibrate)
-Adverse reaction: GI disturbance
-Contraindications: patients w/ impaired renal or hepatic function
Miscellaneous Fibric Acid Derivatives
Niacin- OTC: herbal medication
-Adverse reaction: GI disturbance, generalized flushing, severe itching/tingling (aspirin can help w/ the flushing)
-Precautions: patients w/ renal impairment, high alcohol
Lipid lowering herbal medicine: Fish oil and garlic
Antianginal (decreased blood flow)
Nitrates: cause a relaxation of the smooth muscle layer in blood vessels–> allows more blood into vascular structures –> allows more oxygen to get to tissues
Common nitrate drug
Nitro-Bid (nitroglycerine) as sublingual pill, buccal, transdermal patch, or topical ointment
-Must be kept in a dark container as it degrades with light
-Can be taken up to 3 times in a 15-minute period
Adverse reactions: hypotension
Contraindications: renal or hepatic impairment
Anticoagulant (reduces bloods ability to clot) and Thrombolytic (stationary blood clot)
Antiplatelets: decrease responsiveness of platelets to aggregate which create a platelet plug when aggregating in an area
Common Antiplatelet
Aspirin (acetylsalicylic acid-ASA)
-Plavix (clopidogrel)
Adverse reactions: increased bleeding
Contraindications: pregnancy and lactation
Precautions: bleeding disorders
Anticoagulant-coumadin (warfarin)
works by depleting prothrombin in the clotting cascade
Anticoagulant-coumadin (warfarin) extra info
-Adverse reaction: bleeding
-Overdoses: bleeding from the gums, excessive menstrual bleeding
-Contraindication: patient w/ hemorrhagic disease
**Education: limiting intake of greens (high in vitamin K-which is the antidote for warfarin)
Anticoagulant-HeparinInhibits
Inhibits conversion of fibrinogen to fibrin as well as lowering other clotting factors
Anticoagulant-Heparin extra info
-Adverse reaction: thrombocytopenia (low level of platelets) and bleeding
-Contraindications: bleeding disorders
Thrombolytic
convert plasminogen to fibrinolysin to break down clots in emergencies
Thrombolytic extra info
Common drugs: suffix -ase
-Activase (alteplase)
-Retavase (reteplase recombinant)
-TNKase (Tenecteplase)
Adverse reaction: bleeding
Precautions: patients w/ recent major surgery
Antianemia (Iron deficiency anemia)
-ferrous sulfate or ferrous gluconate (OJ increases absorption-ascorbic acid)
-Adverse reaction: GI upset, dark stool, NVD
-Contraindications: patients w/ other types of anemia
-Absorption is decreased when taking coffee and tea
Pernicious anemia
lack of vitamin B12; vitamin B12 (alcohol decreases absorption
Whats the normal level for cholesterol (lipid panel)
Below 200
Normal range of Hemoglobin in men and women
men: 14-18 g/dl
women: 12-16 g/dl
What is hematocrit?
% of red blood cells in the blood
What is the normal level of hematocrit in men and women?
Men: 42%-52%
Women: 37%-47%
What is Coumadin
prothrombin/time (PT) (if # is off either bleeding isn’t good enough or too much)
Heparin and Coumadin
PTT- Partial Thromboplastin Time (Coumadin)
APTT- Activated Partial Thromboplastin Time (Heparin)
Heart Labs
-BNP(brain natriuretic peptide): related to congestive heart failure
-CK(creatine kinase): dx ANY muscle breakdown, not just heart
MI specific markers
- will see elevation of CK
- creatine kinase muscle/brain (CK-MB)
- troponin
EKG
Assesses the heart’s electrical activity
1st = P wave: atrial depolarization (atria are contracting) (AD)
2nd = QRS wave: ventricular depolarization (VD)
3rd = T wave: ventricle repolarization (VR)
Everything is in alphabetical order
What waves of the EKG happen at the same time?
atria repolarization happens at the same time as ventricular depolarization; the QRS wave hides it because its so big so we cannot see it (AR)
Holter Monitor
-another form of continuous EKG monitoring
-can stay on as long as the doctor needs the patient to (longest is usually 3 days
Stress Test
used to measure heart efficiency during dynamic exercise
Echocardiogram
-takes sound waves to get a picture of the heart
-uses ultrasound
Transesophageal Echocardiogram (TEE)
-placing the transducer down the esophagus to get a picture of the heart (w/ sound waves)
-NPO will always be before a diagnostic test with anything passed down the throat: 4-8 hours
-NPO after test until gag reflex comes back
Angiogram
-picture of a vascular structure
-pass camera thru arteries to assess the heart
-if you want to look at the left side of heart, with use vein
-if you want to look at the right side of heart, with use an artery
Angiogram Pretest and Postest
Pretest care: NPO 6-8 hours and contrast may cause hot flashes and heart palpitations which are normal side effects (contrast will not be given to ppl with kidney failure)
Posttest care: bed rest and dressing covering entrance is monitored
