Hemodynamics Flashcards
When thinking about preload you should think about:
-Stretch
-Volume
Inotropic is related to:
contraction
When thinking about afterload you should think about:
-resistance
-vasoconstriction
if someone has COPD what side would they develop heart failure?
right
-preload
-periphreal edema
what are some s/sX for right sided heart failure?
JVD
peripheral edema
weight gain
what are some s/sx of left sided heart failure
SOB
cough, pink frothy sputum
nocturnal dyspnea
orothopnea
tachypnea
crackles in the lungs
If someone has HTN what side would they develop heart failure?
left
-afterload
-systemic edema
-pulmonary
stenosis of the mitral valve leads to a problem of what?
the afterload of the left atrium
regurgitation of the pulmonic valve leads to a problem of what?
the preload of the right ventricle
s1 represents what?
systole
-mitral and tricuspid
s2 represents what?
diastole
-pulmonic and aortic
-ventricles fill
how does preload increase as an compensatory mechanisms?
aldosterone (increase water and na)
ADH
how does afterload increase as an compensatory mechanisms?
RASS system
angiotensin II
Alpha-1 receptors
(vasoconstriction or dilation)
Alpha-1 does what sympathetically?
vasoconstrictor
how can the body decrease help preload?
natriuretic peptides
what would you give to treat A fib with rapid ventricular response and what are some drug names?
ca channel blockers
-verapamil
-diltiazem
what do natriuretic peptides do?
decrease the preload
-inhibits aldosterone and ADH
-released from the brain
chronotropic
is related to heart rate
an example of negative chronotropic medication is?
digoxin (lowers HR)
an example of negative chronotropic and negatiive inotropic medication is?
ca channel blockers
-decrease HR
-decrease contraction
Ca does what 3 things?
- increase HR
- increase contractility
- causes vasoconstriction
CCB’s do what 3 things?
- decrease HR
- decrease contractility
- causes vasodilation
non-dihydropyridine causes what best?
decrease AV node conduction (decrease HR)
dihydropyridines causes what best?
vasodilation
when taking dihydropyridines you should watch for what?
decreased HR
decreased contracility (decrease bp)
when taking non-dihydropyridines you should watch for what?
decreased contractility (low bp)
vasodilation
medications that end in -pine cause what and are what class
dihydropyridines
-vasodilation
CCB
what two meds decrease the HR? what class are they?
non-dihydropyridines
-verapamil
-diltiazem
what would prevent you from giving a CCB?
-heart block
-low bp less than 90
-hr less than 60
nimodopine is only used for what?
This drug is used only for cerebral arterial aneurysms
-prevent vasospasms
na nitroprusside what is the positive and negative?
-negative: expensive, cyanide poising
-pos: Extremely potent/effective vasodilator. Fastest acting antihypertensive agent.
what is the onset for na nitroprusside? what is it used for?
The drug of choice for hypertensive emergencies.
Onset 30-60 seconds, immediate
hydralazine can cause what symptom?
systemic lupus response (DC this med)
-can take 6 months for s/sx to go away
what is the fastest acting ccb?
Clevidipine
-dihydropyridine
aldosterone effects:
preload
angiotensin effects:
-afterload (vasoconstriction)
ACE inhibitors all end in what?
-pril
potential problems with ACE inhibitors?
-hyperkalemia
-cough
-first dose hypotension
-angioedema
what should you check before administering an ARB and ACE inhibitor?
-potassium
-bp
ARB’s all end in what?
-rtan
b1, b2, A1, A2, receptors relate to what?
b1-heart
b2-lungs
a1-vasoconstrictor
a2-vasodilator
beta blockers all end in what?
-olol
