Lesson 4 Cardiovascular Flashcards
Hypertension
Risk of?
How much is hypertension
Hypertension increase risk of stroke and myocardial infarction, renal failure
>100/160 consider as hypertension
Angiotensin converting enzyme inhibitor
Angiotensin is a powerful circulating vasoconstrictor
Mode: lower blood pressure
Use: hypertension
Side: dry throat
Perindopril, Captopril, Enalapril, Lisinopril, Ramipril
ACE inhibitor
Mode: inhibit ACE, prevent coverting from angiotenisn 1 to 2
Use: hypertension
Side: hypotension, dry cough, renal failure
Implementation: monitor BP and renal function
Angiotensin 2 receptor blocker
Similar to angiotensin converting enzyme inhibitor, but no dry cough
Angiotensin2 receptor blocker ARB
Valsartan, Losartan, Candesartan, Telmisartan
Mode: block vasoconstrictor effect of ACE
Use: Hypertension
Side: hypotension, renal failure
Implementation: monitor BP, mind for orthostatic hypotension
Calcium channel blocker
Cardiovascular drug
Mode: block calcium entering cell to relax arteriolar smooth muscle
Use: hypertension
Side: dizziness, hypotension, flushing, ankle edema
Better from elderly with only hypertension
Dilitiazem, verapamil
Calcium channel blocker
Mostly used as angina prevention
Mode: inhibit calcium ion influx inti cell membrane
Use angina pectoris
Side: edema, nausea, constipation
Implementation: monitor vital sign (bp)
Amlodipine, felodipine, Nifedipine, Nifedipine
Calcium channel blocker
Mode: inhibit calcium ion influx into cell membrane
Use: hypertension
Side: dizziness , hypotension
Implementation: monitor BP
Beta blocker
Not suggested for uncomplicated hypertension, but use when comes with angina, heart failure, myocardial infarction
Mode: decrease cardiac output
Use: hypertension
Side: cold hands, fatigue,
Atenolol, metoprolol
Beta1 selective blockade
Mode: block beta1
Use: mild to moderate hypertension
Side: dizziness, fatigue, bradycardia
Implementation: stop when pulse<50
Propranolol
Beta1+2 nonselective blockade
Mode: inhibit beta2 receptor in bronchial system
Use: chronic stable, angina pectoris
Sise: slow bp, vomit, nausea, drowsiness
Alpha blocker(1)
Selectively block vascular a1 receptors
May cause postural hypotension
Can use with other drug when resistant hypertension
Doxazosin mesylate, prazosin, Terazosin, Alfuzosin
Alpha blocker
Mode: vasodilator
Use: hypertension, benign prostatic hyperplasia
Side: postural hypotension, nausea
Implementation: precautions of postural hypotension
Hydralazine
Direct vasodilator
Mode: vasodilates arterioles in smooth muscle by direct relaxation
Use: hype rtension
Side: hypotension, tachycardia, postural hypotension
Implementation: monitor bp
Centrally acting anti-hypertension drug
Hypertension drug that directly act on CNS
Decrease sympathetic outflow (no adrenaline)
Side: drowsiness
Methyldopa (不常見）
Centralply acting anti-hypertension drug
Mode: stimulate a2 receptors to decreasxe sympathetic outflow
Use: hypertension
Side: drowsiness, weakness
Implementation: monitor bp
For elderly using or pregnant women
Angina
No blood to heart due to narrowed blood vein
Episodic chest pain (陣痛）
Will shift to jaws and neck and arms
Nitrates
Cause peripheral vasodilation 週邊血管放鬆
-）demand less oxygen
Glyceryl trinitrate
Angina drug
Dilate coronary arteries and improve blood flow
Use: acute angina
Put tablet/ spray under tongue every 3-5min
3 tablets didnt help then 999
Side: flushing, postural hypotension
Isosorbide mononitrate, Isosorbide dinitrate
Chronic angina drug
Mode: decrease preload and after load by vasodilation
Use: chronic stable angina pectoris
Side: vascular headache (too relax), postural hypotension
Anti-platelet drug
Antiplatelet drugs reduce platelet aggregation
By inhibiting release of Thromeboxane-A2, ADP, SHT
Aspirin (cardiprin)
Antiplatelet drugmode:
Mode: inhibit COX enzyme and reduce Thromeboxane A2
Use: myocardial infarction, stoke, unstable angina
Side: stomach ulcer
Clopidogrel
Antiplatelet drug
Mode: inhibit platelet aggregation
Use: stroke, angina, myocardial infarction
Side: nose bleeding
Anticoagulent drug
Prevention and treatment of venous thrombosis and embolism
