Exam 4 Flashcards
How does the heart receive blood (for itself)?
It feeds itself first
through the coronary arteries which provide blood supply to the heart muscle
What is myocardial infarction? Where does the most common blockage occur?
blockage of a coronary artery
left ascending artery
What kind of muscle controls vasoconstriction and vasodilation? What system controls it?
smooth muscle
ANS
What is a adrenergic receptor that causes vasoconstriction? Alpha 2?
alpha 1
vasodilation
How often should a person exercise to reduc risk of heart disease?
3-4 times per week, 30 minutes, 150 minutes per week
What type of prevention is talking to a pt about modifiable risk factors? What is secondary? Tertiary?
primary = preventative
secondary = screening
tertiary = treatment
What are target cholesterol levels? Total, HDL, LDL anf triglycerides
Female
Total: under 200 mg/dL
HDL: 35-80 mg/dL (women) 35-65 (men)
LDL: less than 130
Triglycerides: less than 150
What are the most common antilipemics? other names? What is HMG-CoA?
the statins
HMG-CoA reductase inhibitor
an enzyme
What is myopathy? what contraindication with the statin meds can cause it?
muscle pain
rhabdomyolysis (muscle breakdown)
Do cholesterol drugs cause hypotension?
no, they do not lower blood pressure
What are 8 causes of HTN?
hyperlipidemia
Fluid volume overload
high salt intake
smoking
stress
atherosclerosis
pheochromocytoma (tumor on the pituitary)
Chshing’s disease
What 3 catergories will blood pressure medication fall under?
altering blood volume
reduces peripheral resistance
alter the heart function–contractility and CO
What are some s/s of hypertensive crisis? What are they at risk for?
HA
blurry vision
agitation
tachycardia
stroke
What is the lowest blood pressure reading where you would still take your antihypertensives? HR? Why?
90/60 or above (general rule)
60 or above
risk of rebound hypertension
What are the 5 cardiac rules?
change positions slowly
BP less than 90/60 hold the med, call HCP
HR less than 60 or greater than 100, hold med call HCP
Never abruptly stop med
Daily weight: gain for loss of more that 2lbs/day or
5lbs/week call HCP
What is inotrope? Chronotrope? Dromotrope?
inotrope: contractility
chronotrope: heart rate (how fast beating)
dromotrope: electrical conduction
What drugs are usually first-line with HTN?
hydrochlorothiazide
ACE inhibitors
What are the medications that affect the heart itself (inotropic/chronotropic)
beta blockers
What is the difference between cardio selective and non-selective beta blockers? Who cannot use a non-selective beta blocker?
cardio selective affect only the heart
non-selective affects heart and lungs
asthma, COPD
What issues can beta blocker mask? Use carefully with who?
hypoglycemia–low blood sugar because it turns off SNS
Diabetics
Sepsis (masks low blood pressure)
What can beta blockers be used for besides HTN? What should you not use it for?
stable heart failure
stable Afib (combined with blood thinner)
CAD
heart block, AV block
What is the difference between reflex tachycardia and 1st dose phenomenon? What med is used with reflex tachycardia
1st dose: BP drops lower than 90/60
Reflex: normal BP, increased HR
beta blocker
What is a normal troponin level?
0.04 or less
ONAM. What is the initial treatment for MI?
Oxygen
nitroglycerin (widen the artery around the blockage)
aspirin (platelet aggregation)
morphine (slows HR, pain)
Why must we prevent anginas from occurring even with stable angina?
any time there is angina there is ischemia. Causes scarring in time and permanent damage
What does the U wave indicate? elevated T wave?
hypokalemia
hyperkalemia
How do meds treat dysrythmias?
negative dromotrope
What do you try first before giving adenosine?
valsalva maneuver
What are the 3 generations of beta blockers? What do the affect? prototypes?
1st gen: non-selective beta2
affects heart and lungs
propranolol, nadolol
2nd gen: cardioselective beta1
heart
metropolol, atenolol, esmolol
3rd gen: alpha and beta blockers
carvedilol, labetalol
Do dihydropyridine CCBs affect the heart? How do nondihydropyradine affect the heart?
No
decreases contractility
What meds cause coughing
ACE inhibitors
What causes hyperkalemia?
ACEs, ARBs
What does digoxin toxicity look like? What is the antidote?
dizzy, seeing halos, weird vision
digiband ??
