CV 2 Flashcards
renin in olders adults
older adults tend to produce less renin - ACE-Is are effective HTN first line meds in pts who produce a lot of renin, so maybe go with CCB first in older adults
common early finding in pts who have chronic AR is
hypertrophied left ventricle
BP in patients with AR
elevated SBP and decreased DBP - termed wide pulse pressure
most common adult murmur
MVP
measure what while on warfarin
INR
how long to hold warfarin when high
generally one or two doses may be omitted before rechecking INR and resuming warfarin or decreasing the dose
ED is associated with what BP med
thiazide diuretics - specifically chlorthalidone
metoprolol is a ___ beta blocker
cardioselective
natural course of AR
long asymptomatic period with slowing of activities but remains essentially asymptomatic then SOB with activity and finally SOB at rest
an immune response to group A strep infection involving the heart is
rheumatic fever
preferred initial HTN med for non-black pt
ace
which HTN med is not preferred in DM patients and why
BB as they may mask the s/sx of hypoyglycemia
NSAIDs and HF
NSAIDs cause sodium retention and thus water retention - one dose may not cause issues but repeated doses are likely to produce water retention
after a myocardial event what meds should be started daily
4
ASA
ACE I
BB
statin
cough from an ACE usually occurs when
within two weeks of starting therapy
if a patient’s lipids are elevated, what should be performed and why
TSH is evaluated - if the TSH is elevated, it may be secondary cause of hyperlipidemia. It is considered safe practice to NOT treat elevated lipids until the TSH level has decreased to at least 10 mU/L. If lipids are still elevated then you treat them.
two groups of people that have adverse effects of Na consumption > 2G day
African Americans
Older adults
BP meds that can cause urinary incontinence and why
CCB - CCBs block the up-take of calcium into cells which is needed for muscle contraction. This can decrease muscle contraction of urinary muscles leading to urinary incontinence. If this is occurring, you can lower the CCB dose, try a different class of medication, or use incontinence products
most common ailments in older adults
2
HTN
arthritis
BP should be screened how often
annually
two meds recommended for starting tx in patients with ISH
long-acting CCB, specifically those that end in -pine and thiazide diuretics
thiazide-type diuretics produce an average decrease of how many points in SBP
2-8
when to check K after starting ACE I
1 month
classic symptoms of DVT
3
swelling
pain
discoloration in lower leg
