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Chemistry Drugs > Heart Disease > Flashcards

Heart Disease Flashcards

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1
Q

William Harvey 1578-1657

A

Figured out how the heart worked and is known as the “father of the circulatory system”

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2
Q

Egypitans

A

Believed that the heart was the center of emotions and intellect

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3
Q

Romans

A

thought that the heart manufactured blood

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4
Q

William harvey discovered that…

A

the heart’s main action is in systole –> pump out blood to the rest of the body

  • blood goes out of the heart in the arteries and comes back via the veins
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5
Q

How does the heart work?

A

used blood comes back from the vena cava and goes through the right atrium

blood goes down through the tricuspid valve and into the right ventricle

it is pumped into the lungs and as it circulates through the lungs, it picks up oxygen and is delivered back to the left atrium

goes down to the left ventricle and through the aortic valve and delivers oxygen to every cell in the body

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6
Q

Vena Cava

A

large vein where used blood comes back to the heart

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7
Q

Blood that is deoxygenated =

A

blue colour

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8
Q

Blue that is oxygenated =

A

red colour

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9
Q

Used blood comes back from the Vena Cava …

A

and comes back through the Right atrium

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10
Q

arteries …

A

go away from the heart

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11
Q

Veins…

A

return to the heart

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12
Q

All arteries carry oxygenated blood except…

A

pulmonary artery

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13
Q

all veins carry deoxygenated blood except…

A

pulmonary vein

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14
Q

the heart pumps…

A

5-6 L/min

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15
Q

Capilalries

A

red blood cells go one by one through the capillaries

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16
Q

capillaries merge to become…

A

veins

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17
Q

veins merge together and become…

A

vena cava

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18
Q

problems with the heart ?

A
  • failure to pump enough blood
  • impairment of electrical activity
  • reduced flow of blood through coronary arteries
  • improper functioning of heart valves
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19
Q

Risk factors for heart disease

A
  • family history
  • ear lobe crease can be a marker for risk of heart disease
  • Baldness: hormonal connections?
  • Sex
  • Smoking! Most common to heart disease
  • obesity
  • Diabetes
  • Hypercholesterolemia
  • Homocysteine
  • Inflammation
  • Bacteria?
  • Hypertension
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20
Q

Diabetes

A
  • too much glucose
  • detect CVD by measuring blood glucose
  • often asymptomatic
  • if you have fasting blood glucose >7mM, they will do an oral glucose tolerance test
  • first signs of diabetes can be double vision, excessive thirst, or excessive urination
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21
Q

Cholesterol

A
  • blood levels of cholesterol are linked to heart disease
  • 1/3 of all heart attacks and strokes can be avoided in people at high risk by using a statin drug to lower cholesterol
  • not all cholesteroal is bad!
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22
Q

Gender? Male vs. Female

A
  • males have higher risk : 10x greater than permenopausal women
  • women have atypical symptoms which are often missed –> higher mortality
  • people thought the cause of this was due to estrogen decrease after menopause but estrogen was given and they still couldn’t reduce Cardiovascular disease risk
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23
Q

Lipitor

A
  • statin drug
  • brings down bad cholesterol levels when taken regularly
  • atorvastain
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24
Q

LDL

A

bad cholesterol

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25
Q

HbA1C

A
  • see how much glucose is bound to RBC surface - every 3 months ish
  • Allow us to follow the progress
  • want
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26
Q

Diabetes - Fasting/premeal

IDEAL

A

4-6

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27
Q

Diabetes - Fasting/premeal

OPTIMAL

A

4-7

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28
Q

Diabetes - Fasting/premeal

SUBOPTIMAL/DIABETIC

A

7.1-10

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29
Q

Diabetes - Fasting/premeal

INADEQUATE (SERIOUSLY ILL)

A

> 10

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30
Q

1-2hrs post-meal

IDEAL

A

5-8

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31
Q

1-2hrs post-meal

OPTIMAL

A

5-10

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32
Q

1-2hrs post-meal

SUBOPTIMAL (DIABETIC)

A

10.1-14

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33
Q

1-2hrs post-meal

INADEQUATE (SERIOUSLY ILL)

A

> 14

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34
Q

what percentage of pre-diabetics will develop diabetes in 5-10 years?

A

50%

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35
Q

Zocor (Hypercholesterolemia drug)

A

simvastatin

- intervenes with the formation of cholesterol

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36
Q

Side effects of lipitor and zocor

A

muscle aches and can impact liver

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37
Q

Homocysteine

A
  • High levels = more likely to come down with heart disease
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38
Q

Homocysteine Level is controlled by…

A

Vitamin B

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39
Q

Homocysteine is formed by …

A

nutrients from the thionine

  • metabolizes the homocysteine
  • when B vitamins are present homocysteine breaks down and is eliminated
  • without adequate B vitamins homocysteine reach toxic levels
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40
Q

Is homocysteine a marker or a cause of heart disease?

A

marker

- whatever causes heart disease also causes high levels of homocysteine

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41
Q

Inflammation

A
  • C-Reactive protein
  • body’s reaction to an injury
  • associated with redness
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42
Q

Redness

A

blood cells rush to the site of the problem and they dilate the blood vessels on the way there

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43
Q

Risk factor for heart disease

A

swelling in the arteries

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44
Q

Measured by which protein?

A

c-reactive protein CRP

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45
Q

high levels =???

A

CPR > 100 mg/L

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46
Q

CRP levels are of some use in…

A

differentiating between bacterial and viral infections

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47
Q

high CRP levels =

A

bacterial infections

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48
Q

Intermediate CRP levels (10-50 mg/L)

A

= both bacterial and viral conditions

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49
Q

Hypertension

A
  • high blood pressure
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50
Q

Systolic

A
  • blood pressure when heart is pumping out blood
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51
Q

diastolic

A

blood pressure is resting between beats

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52
Q

normal

A

120/80 mmg

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53
Q

blood pressure

A

systolic/diastolic

d= denominator = diastolic

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54
Q

Caused by…

A

increased stress, diet

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55
Q

How to reduce high blood pressure?

A

Exercise

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56
Q

How to reduce high blood pressure?

A

Dietary approach to stop hypertension

  • a diet high in whole grains, fruits, vegetables, and low fat-dairy and restricted in fat
  • vegetarians have lower risk of hypertension
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57
Q

How to reduce high blood pressure?

A

Bacteria!

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58
Q

Does C section or vaginal delivery affect later health status?

A

C-section babies are more likely to be autistic or have gastric intestinal diseases

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59
Q

Why do C-section babies are more likely to be autistic or have gastric intestinal diseases?

A

when you are in the womb, you are in a sterile environment

  • the first encounter with the world is delivery
  • you encounter your mom’s bacteria, which strengthens your immune system
  • if there is no birth canal the bacteria that the baby is exposed to is the skin bacteria of the mom which is very different to the bacteria in the birth canal
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60
Q

Bacteria part 2

A

many kids get antibiotics at a young age which knocks out all kinds of bacteria –> bacteria imbalance

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61
Q

How to reduce high blood pressure?

A

potassium lowers blood pressure

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62
Q

what increases blood pressure?

A

sodium

- processed food

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63
Q

How to reduce high blood pressure?

A

Medications

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64
Q

High blood pressure medications

A

diuretics

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65
Q

High blood pressure medications

A

ace inhibitors

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66
Q

High blood pressure medications

A

beta blockers

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67
Q

High blood pressure medications

A

calcium channel blockers

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68
Q

High blood pressure medications

A

angiotension receptor antagonists

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69
Q

DASH

A

Dietary Approach to Stop Hypertension

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70
Q

DASH

A

diet rich in whole grains, fruits, veggies, and low-fat dairy and restricted in fat
- control of salt intake

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71
Q

Diuretics

A
  • make you pee more
  • lowers volume of blood –> lows blood pressure
  • generally safe drugs
  • Cheap
  • Generically available
  • first drug
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72
Q

How do diuretics work?

A
  • make it difficult for the kidneys to retain water and salt, which are then filtered out into the urine
  • increase the amount of urine = reduces the amount of fluid in the blood stream and reduces PRESSURE ON ARTERY walls
  • sometimes: potassium supplements + diuretics
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73
Q

Angiotension Converting Enzyme Inhibitors

A
  • Vasotec
  • not recommended during pregnancy
  • take if diuretics don’t work
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74
Q

Angiotension Converting Enzyme Inhibitors blocks the formation of…

A

angiotension II which increases the blood pressure

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75
Q

Angiotension Converting Enzyme Inhibitors: fight or flight

A

you need to circulate the blood more –> you need higher pressure

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76
Q

how does Angiotension Converting Enzyme Inhibitors work?

A

ace inhibitors block the production of angiotension II (which raises blood pressure)

  • angiotension’s normal role is to maintai equilibrium when blood pressure drops
  • it acts directly on the arteries, and tightens them to raise the pressure
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77
Q

ace inhibitors can bring blood pressure down quickly but alos in rare cases…

A

can cause kidney damage or a reduction in the number of white blood cells - leading to an increased susceptibility to infection

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78
Q

Beta blockers

A
  • block adrenaline (stress hormone)
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79
Q

Beta blockers reduce high blood pressure by…

A

throttling back the force and speed of the heart

  • decrease heart workload and vasoconstriction
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80
Q

BB can also reduce blood pressure by…

A

a direct effect on the body’s master controls - the central nervous system

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81
Q

Calcium Channel Blockers

A
  • act by dilating the arteries and reducing resistance to the flow of blood
  • block Ca2+ entry into cells –> smooth muscle relaxation –> blood vessel dilation
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82
Q

CCB have proved to be beneficial not only for high blood pressure but also for…

A

angina and other problems of a weakened heart

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83
Q

Newest Drugs

A

Angiotensin II receptor antagonist

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84
Q

Newest Drugs

A

Valsertan

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85
Q

Newest Drugs

A

used when everything else has failed

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86
Q

Angiotension II receptor antagonists

A

a new class of drogs that lower blood pressure by blocking the angiotension from binding to “receptor sites” in the smooth muscles of the blood vessels

  • this blocking action stops the angiotension from tightening the arteries and raising the blood pressure
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87
Q

Angina

A

squeezing of the chest

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88
Q

angina is when the blood doesn’t flow through which artery properly?

A

coronary arteries

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89
Q

the heart muscle needs..

A

oxygen

90
Q

coronary arteries surround the ______ like a crown and feed the _______

A

HEART

91
Q

Angina is usually due to the lack of …

A

blood flow and the lack of O2 supply

92
Q

Coronary artery occlusion due to …

A

atherosclerotic plaque buildup

93
Q

Coronary arteries …

A

left anterior descending

94
Q

Coronary arteries …

A

right coronary artery

95
Q

Coronary arteries …

A

left circumflex

96
Q

Stable angion - angina pectoris

A

angina induced by exertion - relieved by the removal of exertion

97
Q

Unstable angina

A

angina at rest - requires treatment

- vasopastic

98
Q

ballooning out of the artery

A

body recognizes this as an injury and tries to stop the flow of liquid by forming a blood clot

  • blood clot blocks the floow of blood too much!
99
Q

Angina tests

A

stress tests: look at the heart’s activity at rest and response to stress –> determine if b.v. have been occluded

100
Q

Angina tests

A

monitoring the heart

101
Q

Angina tests

A

injecting radioactive thalium

102
Q

Angina treatment

A

nitroglycerin - explosive!

- can be used as a pill

103
Q

Nitroglycerin dilates…

A

the blood vessel so the blood can flow through

104
Q

Nitroglycerin comes as a …

A
  • tablet

- ointment - nitro-bid

105
Q

Side effects of ointment

A
  • someone used the ointment

- had a heart attack, abumlance came and when they started his heart a little spark was created

106
Q

Nitroglycerin comes as a …

A

patch : nitro-dur 0.2

107
Q

Nitroglycerin comes as a …

A

nitro-bid capsules

108
Q

Side effects of nitroglycerin

A

headaches

109
Q

Special case

A

some man put a Nitroglycerin patch on his private part and then did it with his wife and then she got a really bad headache …

110
Q

Angina treatment

A

BETA BLOCKERS

111
Q

beta blockers block

A

adrenalin = stress hormone

112
Q

Adrenalin causes

A

quick increase in blood pressure and increase in glucose

113
Q

where is the extra glucose in body stored?

A

liver

114
Q

release of glucose is a response to

A

adrenalin

115
Q

Angina treatment

A

CALCIUM ANTAGONISTS

116
Q

CALCIUM ANTAGONISTS

A

reduce the work of the heart

117
Q

Angina: heart has to work harder or less to get blood flowing?

A

harder

118
Q

Angina treatment

A

DIETARY SUPPLEMENTS

119
Q

DIETARY SUPPLEMENTS

A

L-Arginine

120
Q

L-Arginine

A
  • amino acid
  • releases nitroxyl = causes angina
  • viagra releases nitroxyl and dilates the blood vessel
121
Q

Arginine

A
  • combines with hydrogen peroxide in body to form nitric oxide
122
Q

Arginine stops ___ from forming and widens blood vessels

A

plaque

123
Q

Arginine prevents ___ from forming clots

A

platelets

124
Q

Angina tests

A

cath lab : inject dyes to get coronary angiogram

125
Q

Arginine

A

taken as a dietary supplement - unregulated and effectiveness is unknown

126
Q

CHF

A

Congestive Heart Failure

127
Q

CHF

A

heart is unable to properly fill or empty or a combination of both

128
Q

CHF the heart is not pumping efficiently due to …

A

weakened muscle - usually in the left ventricle

129
Q

CHF causes

A

constant fatigue

130
Q

CHF causes

A

short of breath

131
Q

CHF causes

A

congestion of fluid –> edema

132
Q

CHF can be caused by

A

coronary artery disease

133
Q

CHF can be caused by

A

high blood pressure

134
Q

CHF can be caused by

A

heart valve problems

135
Q

CHF can be caused by

A

abnormal heart rythms

136
Q

CHF can be caused by

A

thyroid problems

137
Q

CHF treatment

A

pumping deficiency has to be increased or workload of heart has to be decreased

138
Q

CHF treatment

A

left ventricle - most important - squeezes the blood out of the aorta and into the rest of the body

139
Q

CHF used to be known as …

A

DROPSY in the 1800s

140
Q

CHF can be caused by

A

Digitals

141
Q

CHF treatment

A

Ace inhibitors

142
Q

Ace inhibitors

A

relax constricted blood vessles

143
Q

CHF treatment

A

beta blockers

144
Q

beta blockers

A

improve pumping function

145
Q

CHF treatment

A

diuretics

146
Q

diuretics

A

reduce fluid build up

147
Q

William withering

A

first treatment for congestive heart failure

148
Q

William withering

A

foxglove plant

149
Q

william withering

A

digitalis

150
Q

Digitalis

A

extract of the plant

151
Q

active chemical of digitalis

A

digoxin

152
Q

digoxin is used in

A

lanoxin tablets

153
Q

CHF treatment

A

CoQ10

154
Q

Coenzyme Q10

A

levels are reduce in hearts of congestive heart failure patients

155
Q

Coenzyme Q10 are necessary for

A

energy production

156
Q

Coenzyme Q10 effectiveness is…

A

not certain yet

157
Q

Coenzyme Q10

A

natural substance in muscles and is involved in formation of ATP

158
Q

Cardiac Arrythmias

A

irregular heart rhythms due to problems with the electrical circuit of heart

159
Q

Cardiac Arrythmias can originate from

A

pacemakers or myocardium

160
Q

Cardiac Arrythmias treatment

A

amiodarone - most common

161
Q

Cardiac Arrythmias treatment

A

pacemaker - implanted in the chest cavity and produces a signal to produce a regular heart beat

162
Q

Heart Attack

A
  • myocardial infraction
  • chest pain
  • blood clot in corneal artery
  • heart becomes deprived of oxygen
163
Q

Blood clots

A

platelets caused the blood clots

- produce proteins that form a mesh with embedded red blood cells

164
Q

how many people suffer from heart attacks/year in North America?

A

1.5 million

165
Q

how many die immediately?

A

25%

166
Q

how many are unaware they are having a heart attack?

A

25%

167
Q

can degenerate into

A

ventricular fibrillation

168
Q

ventricular fibrillation

A

deprivation of oxygen in heart

- heart vibrates irregularly

169
Q

ventricular fibrillation treatment

A

automatic defbrillator

170
Q

Treatment for Heart attack

A

MONA

171
Q

MONA

A

Morphine
Oxygen
Nitro
Aspirin

172
Q

Morphine treats

A

pain

173
Q

Oxygen

A

increase oxygen levels in blood

174
Q

Nitro

A

dilate blood vessles

175
Q

Aspirin

A

prevent future blood clots

176
Q

Treatment for Heart attack

A

adrenaline / atropine

177
Q

adrenaline

A

if heart has stop inject to start it again

178
Q

Treatment for Heart attack

A

Electrocardiogram

179
Q

Electrocardiogram

A

determines if there is a heart attack

180
Q

Treatment for Heart attack

A

tropoin/creatine kinase

181
Q

tropoin - creatine kinase

A

both released by cells when they die - test for these levels

182
Q

Treatment for Heart attack

A

aspirin (ASA)

183
Q

aspirin

A

stops from forming meshes - bloot clots

184
Q

Treatment for Heart attack

A

Plavix

185
Q

Treatment for Heart attack

A

Heparin Lock Flush

186
Q

Heparin Lock flush

A

naturally occuring in the body

187
Q

Heparin Lock flush risk

A

increases chances of bleeding –> hemorrhage

188
Q

Treatment for Heart attack

A

thrombolytics

189
Q

thrombolytics

A

dissolve a blood clot

190
Q

thrombolytics

A

aspirin is very weak- thrombolytics is better at preventing future blood clots

191
Q

(thrombolytics) Activase

A

tissue plasminogen activator

192
Q

(thrombolytics) plasminogen

A

naturally occurring protein has to be activated to release a chemical plasmin to dissolve the blood clot

193
Q

Treatment for Heart attack

A

Ace inhibitors

194
Q

Ace inhibitors

A

regulate the blood pressure

195
Q

Treatment for Heart attack

A

Cath Lab

196
Q

Cath lab

A

insert a tube and snake it up to the heart while looking through an x-ray machine

197
Q

Cath lab will show where the

A

blockage is

198
Q

(cath lab) angioplasty

A

widening of the blood vessel with a balloon

  • cahteter
  • inflate it and open the blood vessel
199
Q

Placing stents in arteries during angioplasty is very effective at

A

keeping heart blood vessels open

200
Q

what percentage of people do the arteries narrow again in even after the stents are implanted?

A

15-25%

201
Q

the renarrowing is called??/

A

in-stent restenosis

202
Q

what forms in response to the injury created when the stent was implanted, which then leads to restenosis

A

scar tissue

203
Q

risk of in-stent restenosis, so instead you can use

A

drug-elucidating stents

204
Q

Drug eluting stent

A
  • sirolimus - reduces inflammation

- body sees stent as a foreign substance and will want to try and get rid of it - drug reduces this

205
Q

Treatment for Heart attack

A

bypass surgery

206
Q

bypass surgery

A
  • invasive procedure
  • resolves the probelm!
  • nypassing the blocked artery
  • open the chest and get at the heart
207
Q

in bypass surgery you build a path where..

A

the blood can flow around the blockage

208
Q

Bypass surgery aka

A

artery or vein graft

209
Q

bypass surgery is often used for severe or diffuse

A

occlusion

210
Q

bypass surgery can give

A

anticoagulants for prophylaxis

211
Q

Treatment for Heart attack

A

heart-lunch machine

212
Q

heart-lunch machine

A

oxygenate the blood

213
Q

heart-lunch machine mimics the

A

pumping pulses of the heart for a short period of time

214
Q

heart-lunch machine connect it so it pumps the blood

A

back into the heart

215
Q

heart-lunch machine stimulates with

A

electricity to get the heart stating again

216
Q

heart-lunch machine - persantine - dipyridamole - medication

A

reduces the chance of blood clots

217
Q

heart-lunch machine side effects

A

mental illness- depression

- mental functions don’t go back to normal

218
Q

Artificial valves

A

if valves aren’t opening and closing properly

219
Q

Heart attack treatment

A

Artificial hearts

220
Q

Artifical hearts problem…

A

how do you power it?

  • you need a source of energy to pump5-6L of blood
  • it needs to be plugged into some sort of external energy supply
  • short term
221
Q

Dr. chris barnard in 1967 survived for…

A

only 3 weeks because body rejected the heart

- heart-lunch machine

222
Q

Herat trasplants problem

A

lack of hearts

Chemistry Drugs (4 decks)

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