Heart & Vascular Disease Phamarcology Flashcards
Alpha Adrenergic Antagonist Agents: Action and Side Effects
A: reduce peripheral vascular tone by blocking alpha1-adrenergic receptors
S/E: dizziness, palpitations, orthostatic hypotension, drowsiness
Alpha Adrenergic Antagonist Agents: Indications
hypertension, benign prostatic hyperplasia (noncancerous enlargement of the prostate gland)
Alpha Adrenergic Antagonist Agents: PT Implications
use caution during prone-sit/ sit-stand due to risk of dizziness/ orthostatic hypotension
closely monitor pt during ther ex
Alpha Adrenergic Antagonist Agents: Examples
cardura, minipress
Antiotensin-Converting Enzyme (ACE) Inhibitor Agents: Action & Side Effects
A: decrease BP and afterload by suppressing enxyme that converts angiotensin I into angiotensin II
S/E: hypotension, dizziness, cry cough, hyperkalemia (abnormally high levels of potassium in the blood), hyponatremia (low sodium concentration in the blood)
ACE Inhibitor Agents: Indications
hypertension, congestive heart failure
ACE Inhibitor Agents: PT implications
avoid sudden changes in posture due to dizzinees/fainting from hypotension
pts w/ heart failure should avoid rapid increases in physical activity
ACE Inhibitor Agents: Examples
Capoten, Vasotec
Anticoagulant Agents: Action and Side Effects
A: inhibit platelet aggregation & thrombus formation
S/E: hemorrhage, increased risk of bleeding, gastrointestinal distress w/ oral meds
Anticoagulant Agents: Indications
post percutaneous transluminal coronary angioplasty & coronary artery bypass graft surgery
prevention of venous thromboembolism/ cardioembolic events in pts w/ atrial fib & prosthetic heart valves
Anticoagulant Agents: PT implications
therapist must be careful to avoid injury 2nd to risk of excessive bleeding/bruising
pt education regarding common S/E
Anticoagulant Agents: Examples
Heparin, Coumadin
Antihyperlipidemia Agents: Actions and Side Effects
A: 5 categories- most common = statins inhibit cholesteral synthesis, breakdown low-density lipoprotiens (LDL), decrease triglyceride levels, increase HDL levels
S/E: headaches, gastrointestinal distress, myalgia (pain in a muscle/ group of muscles), rash
Antihyperlipidemia Agents: Indications
hyperlipidemia, atherosclerosis, prevent coronary events in pts w/ existing coronary artery disease/ diabetes/ PVD
Antihyperlipidemia Agents: PT implications
aerobic exercise can increase HDL and maximize effects of drug therapy
Antihyperlipidemia Agents: Examples
Lipitor, Zocor
Antithrombotic (aka Antiplatelet) Agents: Action & Side Effects
A: inhibit platelet aggregation & clot formation
S/E: hemorrhage, thrombocytopenia (deficiency of platelets in the blood), potential liver toxicity w/ aspirin use, gastrointestinal distress
Antithrombotic (aka Antiplatelet) Agents: Indications
post MI, atrial fib, prevent arterial thrombus formation
Antithrombotic (aka Antiplatelet) Agents: PT implications
be careful to avoid injury 2nd to risk of excessive bleeding
pt education about common side effects
Antithrombotic (aka Antiplatelet) Agents: Examples
Aspirin, Plavix
Beta Blocker (Beta-Adrenergic Blocking) Agents: Actions & Side Effects
A: decrease myocardial O2 demand by decreasing heart rate & contractility via ß-adrenergic receptors
S/E: bradycardia, cardiac arrhythmia, fatigue, depression, dizziness, weakness, blurred vision
Beta Blocker Agents: Indications
hypertension, angina, arrhythmia, heart failure, migraines, essential tremor (benign rhythmic shaking)
Beta Blocker Agents: PT Implications
HR and BP response to exercise will be diminished
Rate of perceived exertion may be used to monitor intensity
Monitor pts closely during position changes due to increased risk for orthostatic hypotension
Beta Blocker Agents: Examples
Tenormin, Lopressor, Inderal
Calcium Channel Blocker Agents: Actions & Side Effects
A: decrease entry of calcium into vascular smooth muscle cells = diminished myocardial contraction, vasodilation, decreased O2 demand from heart
S/E: dizziness, headache, hypotension, peripheral edema
Calcium Channel Blocker Agents: Indications
hypertension, angina pectoris, arrhythmia, congestive heart failure
Calcium Channel Blocker Agents: PT implications
Diminished HR and BP response to exercise
Monitor pt when moving to upright position 2nd to dizziness/ orthostatic hypotension
Observe pt for signs of congestive heart failure (worsening peripheral edema, dyspnea, weight gain)
Calcium Channel Blocker Agents: Examples
Procardia, Cardizem
Diuretic Agents: Actions and Side Effects
A: increase excretion if sodium & urine = reduction in amount of plasma & BP
Classifications: thiazide, loop, potassium sparing
S/E: dehydration, hypotension, electrolyte imbalance, polyuria, increased LDL, arrhythmia
Diuretic Agents: Indications
hypertension, edema associated w/ heart failure, pulmonary edema, glaucoma
Diuretic Agents: PT Implications
position changes can increase risk of dizziness/ falls due to decreased BP
Monitor pts closely for signs of electrolyte imbalance/ muscle weakness/ cramping
Diuretic Agents: Examples
Diuril, Lasix
Nitrate Agents: Actions and Side Effects
A: deceased ischemia through smooth mouscle relaxation and dilation of peripheral vessels
S/E: headache, dizziness, orthostatic hypotension, reflex tachycardia, nausea, vomiting
Nitrate Agents: Indications
angina pectoris
Nitrate Agents: PT Implications
pts must be educated to sit-stand SLOWLY to minimize risk of orthostatic hypotension
Sublingual administration of nitroglycerin is preferred method to treat acute angina attack
Nitrate Agents: Examples
Nitrostat, Nitorglycerin
Positive Inotropic Agents: Actions & Side Effects
A: increase force/ velocity of moycardial contraction, slow HR, decrease conduction velocity through AV node, decrease degree of activation through Sympathetic Nervous System
S/E: cardiac arrhythmias, gastrointestinal distress, dizziness, blurred vision
Positive Inotropic Agents: Indications
heart failure, atrial fib
Positive Inotropic Agents: PT Implications
Therapist should monitor HR during activity, teach pt & family to take pulse, seek doctor’s advice for HR 100 bpm
Positive Inotropic Agents: Examples
Digoxin
Thrombolytic Agents: Action & Side Effects
A: facilitate clot dissolution (converts plasminogen to plasmin)
S/E: hemorrhage (specifically intracranial in certain populations), allergic reaction, cardiac arrhythmia
Thrombolytic Agents: Indications
acute myocardial infarction, pulmonary embolism, ischemic stroke, arterial/ venous thrombosis
Thrombolytic Agents: PT Implications
be careful to avoid situations that may cause trauma due to altered clotting activity
Thrombolytic Agents: Examples
Urokinase, Activase
