HTN and HF Flashcards
what should be check before administering a diuretic?
potassium
what should you check before administering a beta blocker?
pulse and heart rate
angiotensin receptor blockers all end in _____?
-tan (losartan)
nitroglycerin does what?
decreases preload and afterload (decrease workload of the heart)
ACE inhibitors do what?
prolong life in those with HF
what do beta blockers end in?
-olol
beta blockers are good for treating _____?
early HF
HTN
Used in combo with CCB for reflex tachycardia
what are the side effects of beta blockers?
Anadonia (loss of pleasure in doing things they like)
Insomnia, bizarre dreams
Bradycardia
Exercise intolerance
when not to give beta blockers?
o HR less than 60
o BP less than 90
o Heart block
o Bronchoconstriction, not so great in asthma
o Can mask symptoms of hypoglycemia
Ca channel blockers end in?
-pine
nimodipine is only used for ____?
subanoractoid hemorrhage
when do you not give a ca channel blocker?
do not give in HF (neg inotropic effect)
how do thiazide diuretics effect K?
they are K wasting
-too low do not give
when o you not give a thiazide diuretic?
Check potassium levels (too low does not give)
Dehydration = do not give
If BP is too low, do not give
thiazide diuretics should be used cautiously in those with _____?
o Gout
o Diabetes
all ace inhibitors end in?
-pril
contraindications with ace inhibitors?
o Renal artery stenosis
o Pregnancy
o Dehydration
when should you give dig?
give for HF and atrial dysrhythmia
why do we give dig for HF?
its pos. inotropic
why do we give dig for atrial dysrhythmia?
its neg. chronotropic
-increase HR
when should be not give dig?
o HR less than 60
o Dig level over 2 (narrow therapeutic index)
o Heart block
o Have a low potassium (inverse relationship with k and dig)
what are the s/sx of dig toxicity?
o Greenish-yellow halo vision from lights
o Nausea/vomiting
o Bradycardia
what meds decrease preload?
- Diuretics
- Aldosterone inhibitors
- Nitroglycerin
- ACE inhibitors
- ARB’s
- Nesiritide
what meds decrease afterload?
- ACE inhibitors
- ARB’s
- Nitroglycerin
- Alpha-1-blocker
what meds decrease contracility?
- Digoxin
- Phosphodiesterase inhibitors
why are beta blockers only appropriate in the beginning of HF?
*This allows the left ventricle to fill more completely
*Decrease in catecholamines
*Overall, decreases left ventricular work-load
what are some late-stage HF meds that are combined?
- Loop diuretics
- ACE inhibitors
- Digoxin
how does dobutamine work?
Works on beta 1 (increase HR, and contractility) pos. inotropic, pos. Chronotropic
how is dobutamine administered?
IV
what is dobutamine given for?
someone who is in cardiogenic shock
norepi does what?
- Will increase the blood pressure
- Vasoconstrictor
how do we treat high LDL’s?
-HMG-CoA reductase inhibitor
-niacin
-fibrates
HMG-CoA reductase inhibitors end in what?
-statin
what are side effects of HMG-CoA reductase inhibitors
o Hepatotoxic
o Can cause muscle aches
what is a side effect of niacin?
can cause flushign
what should not be taken with a -statin? why?
-fibrates
-pt. can get muscle break down, kidneys have to filter many proteins. Pt could end up dialysis. (Rhabdomyolysis)
