Exam 1 Flashcards
B-1 agonists do what to the heart?
increase cardiac contractility
Positive inotropic agents do what to the heart?
increase force of contraction of myocytes that leads to increased CO
- increase contractility and CO
What type of patients would be on ionotropic agents (dopamine and dobutamine)?
severe heart failure
- probably on the heart transplant list
What does digitalis do to the heart?
increases cardiac contractility
- directly affects movement of calcium in the cells
- direct inotropic effects
What patients would be using digitalis?
atrial fibrillation, atrial tachycardia HF
beta blockers (B-1 antagonists) do what to the heart?
reducing the work of the heart
adverse effects of beta blockers (B-1 antagonists)
- bronchoconstriction
- excessive depression of cardiac function - reduced peak HR
- OH (vasodilation)
- depression, lethargy, and sleep disorders
What do calcium channel blockers do to the heart?
decrease contractility and decrease energy demands of the heart
- also decrease CO
What is double product?
HR x static pressure (systolic BP)
- index of myocardial oxygen consumption
How do you reduce double product? What does this cause?
- increase the radius of vessels which decreases afterload
- reducing radius of vessels reduces the workload on the heart
alpha-1 receptor blockers result in what?
peripheral vasodilation
- smooth muscle relaxation
- decreases blood flow resistance
adverse effects of alpha 1 receptor blockers
reflex tachycardia secondary to hypotension
- too much dilation
- can also cause OH
What do centrally acting agents do to HR?
decrease HR and contractility
adverse effects of centrally acting agents
-dry mouth
- dizziness
- drowsiness
- hypotension
diuretics effect on blood volume
decrease blood volume which decreases preload
adverse effects of diuretics
- dehydration
- electrolyte imbalance
- OH/falls precaution
Risk factors for CHD
- increasing age
- family history of CVD
- male
- uncontrolled HTN
- elevated total cholesterol
- uncontrolled diabetes
- smoking/components of cigarette smoke
- physical inactivity
- obesity
BMI cutoffs
Normal - 18.5-24.9
overweight - 25-30
Obese - > 30-40
morbidly obese > 40
total cholesterol numbers
normal - < 200 mg/dl
borderline high - 200-239 mg/dl
high - > 240 mg/dl
men normal and at risk ranges for HDL
normal - > 60
at risk - < 40 mg/dl
women normal and at risk ranges for HDL
normal - > 60
at risk - < 50 mg/dl
What can increase HDL concentrations?
aerobic exercise
What forms atherosclerotic plaque?
LDL
normal fasting ranges of LDL
100 mg/dl or less
- less is better
What should the cholesterol ratio be?
total cholesterol/HDL
- 4:1
- lower the ratio, the lower your risk of heart disease
- the higher to ratio, the higher the risk of heart disease
normal and abnormal triglycerides normal
normal < 150
anything above 150 will catch MD eye
diabetes is a disease of ______________
hyperglycemia
What type of heart dysfunction do diabetes patient exhibit?
LV diastolic dysfunction