Hypertension and Arrhythmia Flashcards
What is the American Heart Association BP categories?
Should be review
What are non-pharmacological treatments for blood pressure?
- dietary salt restriction
- potassium supplementation (but big emphasis on diet change)
- weight loss
- DASH diet
- aerobic exercise
What is tachycardia?
Fast HR
> 100 bpm
What is bradycardia?
Slower HR
< 60 bpm
What is depolarization?
Process where the electrical current to the heart is changing each cell from:
resting -> depolarized state
What is repolarization?
Heart muscle goes back to rest after contraction
What are the anti-hypertensive drugs?
Chart for all the drugs
What is the use of thiazide diuretics?
for mild-moderate hypertension
What is the use for loop diuretics?
effective in reducing edema but NOT a good hypertensive med
What is the use of potassium sparing diuretic?
a very weak anti-hyperensive agent
What are the effects of renin angiotensin?
- vasoconstriction
- release of aldosterone
- release of ADH
- induces thrist = more fluid intake
- chronic activation of renin-angiotensin system
Cardiac Action Potential
What is phase 0?
opening of fast Na channels and rapid depolarization
- Na+ into the cell
- changing membrane potential
Cardiac Action Potential
What is phase 1?
Initial rapid repolarization
- closing of fast Na+ channels
Cardiac Action Potential
What is phase 2?
The plateu phase
- balance between Ca+ coming in = K+ coming out
Cardiac Action Potential
What is phase 3?
Repolarization
- K+ channels stay open
- lets K+ to build up outside the cell
- cell repolarization
Cardiac Action Potential
What is phase 4?
Resting phase
What is the role of diuretics?
Acting on the kidney to increase excretion of sodium and water
What is the role of the renin angiotensin system?
BP regulation by:
- controlling fluid volume
- vascular tone by angiotensin II production
What is the roll of Ace inhibitors?
Lowering the BP
- prevents blood vessel and heart remodeling
What is the role Angiotensin receptor blockers?
lowering BP
- preventing blood vessel and heart remodeling
What is the role of calcium channel blockers?
lowers BP and preventing Ca+ from going into the cells of the heart and arteries:
- lowers BP
- treates angina
- controlling arrthymias
- treat migraines
What is the role of beta blockers?
decreases HR and force of contraction = decreased CO
What is the role of alpha blockers?
causes:
- reflex tachycardia
- but can also cause orthostatic hypotension
What is the role of alpha-2 agonist?
decrease in:
- HR
- CO
- vascular resistance
What is the role of vasodilators?
used to treat moderate-severe hypertension that is difficult to control
What are some of the anti-arrhythmic drugs?
Picture 1 of 2 - with MOA and common side effects
What are some of the anti-arrhythmic drugs?
Picture 2 of 2 - with MOA and common side effects
Class 1
What is the purpose of class 1 antiarrhythmics drug?
Blocks fast Na+ channels
Class 1
What is the purpose of subclass 1A?
causes mod phase 0 depression
longer repolarization
increased duration of action potential
Class 1
What are some of the drugs and its effects of class 1a?
Class 1
What is the purpose of subclass 1B?
weak phase 0 depresion
shorter repolarization
decreased action potential duration
Class 1
What are some of the drugs and effects of class 1b?
Best to treat ventricular arrhythmias
Class 1
What is the purpose of subclass 1c?
Strong phase 0 depression
little effect of repolarization
Class 1
What are the drugs and its effects of subclass 1C?
Best to treat ventricular arrhythmias
Class II
What is the two major actions of class II?
- blockage of myocardial B-adrenergic receptors
- Direct membrane-stabilizing effects related to Na+ channel blockage
Class II
What are some of the drugs and effects of class II?
Effective in treating atrial tachycardias and ventricular arrhythmias
Class III
What is the purpose of class III drugs?
K+ channel blockers
= causes delay in repolarization
Class III
What are some drugs and effects of class III drugs?
Class IV
What is the purpose of class IV drugs?
Ca2+ channel blockers
= slows rate of AV conduction in patients with atrial fibrillation
Class IV
What are some drugs and its effects for class IV?
What is the function of adenosine drug?
inhibits AV conduction (short effect) = IV injection for supraventricular tachycardia
What is the function of digoxin?
reduces conduction throught the AV node
= helpful to control atrial flutter and fib
What is the function of atropine?
blocks the vagal effects on the SA node
= treats sinus bradycardia
What is the PT considerations for class I: sodium channel blockers?
Consideration: risk of proarrhythmias
Intervention:
- monitor HR and rhythm closely
- adapt exercise intensity and duration to tolerance
What is the PT consideration for class II: beta-blockers?
Consideration: reduced HR and exercise tolerance
Intervention:
- use RPE sclaes to monitor intensity (because of HR is blunted)
What is the PT consideration for class III: potassium channel blockers?
Consideration: risk of torsades de pointes and other arrhythmias
Intervention:
- always monitor ECG during exercise if possible
- be ready for any acute changes
What is the PT considerations for class IV: calcium channel blockers?
Considerations: potential for hypotension and bradycardia
Intervention:
- monitor vitals
- avoid sudden positional changes to prevent orthostatic hypotension
