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DPT Semester 1 > deck_8853870 > Flashcards

deck_8853870 Flashcards

1
Q

how do Beta-blockers impact the heart during rest and exercise?

A

decrease HR, CO, and BP

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2
Q

Beta-blockers impact on thermoregulation

A

increase sweating by 10% during exercise

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3
Q

Beta-blockers +exercise consideration

A

beware of premature fatigue – espeically around 90 min after meds are taken

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4
Q

how should you gauge exercise tolerance in a patient on beta-blockers?

A

BORG RPE

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5
Q

Calcium channel blockers suffix

A

-dipine

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6
Q

Calcium channel blockers drugs

A
  1. Dihydropyridines
  2. Benzothiazepines
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7
Q

impact of Dihydrpyridines (amlodipine) on cardiac function?

A
  1. increased HR at rest and during exercise
  2. can leadto angina due to increased myocardial O2 consumption
  3. coronary steal phenomenon
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8
Q

what is coronary steal phenomenon?

A

shunting of blood from ischemic to normally perfused areas of myocardium

all the vessels are dilated reducing any gradient that would drive blood towards ischemic regions

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9
Q

Benzothiazepine (diltiazem) cardiac effects

A
  1. reduce HR at rest and during exercise
  2. more effective for treating exertional angina
  3. less likely to cause reflex tachycardia
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10
Q

if a patient is on CCB or beta-blockers medication should be readily available to them?

A

nitroglycerin (Nitrates) if they were prescribed to them, make sure it is available during PT

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11
Q

general guidelines for CCBs and Beta-Blockers and exercise prescription

A
  1. 3-5 days/week, 20-60 min duration
  2. limit HR increases to 20 bpm above RHR when pt. misses dose or has a dose adjustment
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12
Q

all antithromotics have a risk of _______

A

causing bleeding –> so monitor/prevent for falls!

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13
Q

antithrombotics we covered

A
  1. Heparin
  2. Warfarin
  3. LMWH
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14
Q

how does Heparin work?

A

prevents conversion of fibrinogen to fibrin

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15
Q

Heparin risks/notes

A
  1. increased risk for HIT
  2. increased risk for osteoporosis
  3. requires monotoring of aPTT
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16
Q

how does Warfarin work?

A

decreaes Vitamin K stores which stops production of coagulation factors

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17
Q

Warfarin Notes

A
  1. monitor INR (increased INR = less clotting factors = increased risk of bleeding)
  2. many drug & food inreactions
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18
Q

how does LMWH work?

A

increases inhibition of FXa (more specific than Heparin)

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19
Q

LMWH notes

A
  1. simpler dosing than Heparin and requires no lab monitoring
  2. decreased risk of HIT and osteoporosis
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20
Q

PT notes for Antithrombotics

A
  1. avoid soft tissue mobilization
  2. avoid pressure
  3. avoid cutting ot tissue (sharp debridement)
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21
Q

what are Nitrates used to treat?

A

Angina (exertional, variant, and unstable)

*may be used in conjunction with CCB and BB

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22
Q

how do Nitrates work?

A
  1. decrease intracellular Ca to work directly on heart smooth muscle
  2. this decresaes preload/afterload and decreases O2 demand
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23
Q

how are Nitrates administered?

A

IV

sublingual (used for acute attacks, tingle means its working)

topical (transderm patches)

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24
Q

Nitrates dosing/storage info

A

up to 3 doses in 15 minutes

store in dark, brown glass bottle

good for 6 months unopened and only 3 months once opened

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25
Goal of Antiarrhythmic Drugs
restore normal rhythm or control abnormal
26
how are antiarrhythmic drugs classified?
1. origin = ventricular/atrial (supraventricular) 2. pattern/rhythm = fibrillation or flutter 3. speed/rate = brady or tachycardia
27
Classes of Antiarrhythmic drugs
Class II Class III Class IV
28
Antiarrhythmic Drug Class II
beta-blocker try to control rate
29
Antiarrhythmic Drug Class III
Amiodarone controls rhythm (works by blocking K+ channles to lengthening AP) \*\*remember blue man
30
what would Amidoarone be used to treat?
recurrent V-tachycardia
31
Antiarrhythmic Drugs Class IV
verapril and diltiazem (CCBs) - used for atria \*used to control origin NOT for pts w/HFrEF
32
what are 2 types of non-pharmacological trxs that increase survival from COPD?
1. smoking cessation 2. long-term O2 therapy
33
main pharmacology trx for COPD
Bronchodilators
34
how are bronchodilators helpful in pts with COPD?
increased exercise capacity which can improve QOL
35
Types of Bronchodilators
1. beta 2 agonists 2. muscarinic antagonists
36
Beta 2 Agonists types
SABA LABA
37
SABA info
drug = albuterol used for acute exacerbations onset 5 min duration 4-6 hrs
38
LABA info
drug = salmeterol used to maintenance, daily use duration = 12-24 hrs
39
what do both SABAs and LABAs treat?
bronchospasms
40
Common AE for Beta 2 agonists?
1. tremor 2. tachycardia 3. hypokalemia (when taken w/thiazide)
41
types of muscarinic antagonists (antimuscarinics)
SAMA LAMA
42
SAMA info
drug = ipratropium used w/nebulizer onset = 15-20 min duration = 6-8 hrs
43
LAMA info
drug = tiotropium used for maintenance, daily use duration = 12-24 hrs
44
Common muscarinic antagonists AE
ABCDs \*specifically dry mouth
45
what is used to treat severe COPD?
PDE-4 Inhibitors
46
how do PDE-4 inhibitors work?
decrease cyclic AMP breakdown = decreased inflammation
47
PDE-4 Inhibitors AE
1. nausea 2. diarrrhea 3. weight loss
48
Treatments for Cystic Fibrosis
1. CFTR Modulators 2. Bronchodilators 3. Mucolytics
49
how do CFTR Modulators work?
increase chloride transport = increased regulation of Na+ and water = mucous thinning
50
CFTR Modulators AE
1. GI 2. HA 3. \*Orkambi = hypotension
51
which mucolytics are primarily used in treating CF?
hypertonic saline dornase alfa
52
Hypertonic Saline notes
2-4x daily almost all pts use them work by increases salt which increases water in airway = water down mucus = increased function of mucociliary elevator
53
Dornase alfa notes
1-2x daily amost all pts work by cleveing DNA = decreased viscosity of mucus AE: chest pain
54
Pulmonary medications Exercise Consideration
1. time PT w/meds 2. watch for paradoxial breathing 3. B-agonists and methylxanthines = Increase RHR 4. watch for R vent failure 5. pts should always carrier rescue inhaler (especially during PT sessions)
55
what is the most serious complication that can occur from Diabetes?
Diabetic Autonomic Neuropathy
56
what are the signs of Diabetic Autonomic Neuropathy?
1. exercise intolerance (BP and HR response blunted) 2. orthostatic hypotension 3. Silent MI 4. hypoglycemima unawareness
57
what is silent MI?
delay in recognizing angina unexplained fatigue, condusion, dyspnes, N/V, hemoptysis, diaphoresis, dysrrhthmias, edema
58
T1DM Exercise Considerations
exercise does not increase glucose uptake, possibly due to increased free fatty acids
59
T1DM + insulin Exercise Consideration
1. monitor blood glucose with exercise * before * during * after (2 hrs after, possibly middle of night) 2. make changes in insulin and carb consumption
60
Overall Diabetes Exercise Considerations
1. Proper footwear is essential 2. avoid high impact activitees for older adults 3. keep fast acting CHO nearby 4. no exercise if glucose \>300 mg/dL 5. injest CHO if glucose \<70 mg/dL prior to activity 6. avoid insuling injection sites 7. illness can increase glucose levels

DPT Semester 1 (12 decks)

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