Lesson 4 Cardiovascular

Question 1

Hypertension
Risk of?
How much is hypertension

Answer 1

Hypertension increase risk of stroke and myocardial infarction, renal failure
>100/160 consider as hypertension

Question 2

Angiotensin converting enzyme inhibitor

Answer 2

Angiotensin is a powerful circulating vasoconstrictor
Mode: lower blood pressure
Use: hypertension
Side: dry throat

Question 3

Perindopril, Captopril, Enalapril, Lisinopril, Ramipril

Answer 3

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

Question 4

Angiotensin 2 receptor blocker

Answer 4

Similar to angiotensin converting enzyme inhibitor, but no dry cough

Question 5

Angiotensin2 receptor blocker ARB

Answer 5

Valsartan, Losartan, Candesartan, Telmisartan
Mode: block vasoconstrictor effect of ACE
Use: Hypertension
Side: hypotension, renal failure
Implementation: monitor BP, mind for orthostatic hypotension

Question 6

Calcium channel blocker

Answer 6

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

Question 7

Dilitiazem, verapamil

Answer 7

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)

Question 8

Amlodipine, felodipine, Nifedipine, Nifedipine

Answer 8

Calcium channel blocker
Mode: inhibit calcium ion influx into cell membrane
Use: hypertension
Side: dizziness , hypotension
Implementation: monitor BP

Question 9

Beta blocker

Answer 9

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,

Question 10

Atenolol, metoprolol

Answer 10

Beta1 selective blockade
Mode: block beta1
Use: mild to moderate hypertension
Side: dizziness, fatigue, bradycardia
Implementation: stop when pulse<50

Question 11

Propranolol

Answer 11

Beta1+2 nonselective blockade

Mode: inhibit beta2 receptor in bronchial system
Use: chronic stable, angina pectoris
Sise: slow bp, vomit, nausea, drowsiness

Question 12

Alpha blocker(1)

Answer 12

Selectively block vascular a1 receptors
May cause postural hypotension
Can use with other drug when resistant hypertension

Question 13

Doxazosin mesylate, prazosin, Terazosin, Alfuzosin

Answer 13

Alpha blocker
Mode: vasodilator
Use: hypertension, benign prostatic hyperplasia
Side: postural hypotension, nausea
Implementation: precautions of postural hypotension

Question 14

Hydralazine

Answer 14

Direct vasodilator
Mode: vasodilates arterioles in smooth muscle by direct relaxation
Use: hype rtension
Side: hypotension, tachycardia, postural hypotension
Implementation: monitor bp

Question 15

Centrally acting anti-hypertension drug

Answer 15

Hypertension drug that directly act on CNS
Decrease sympathetic outflow (no adrenaline)
Side: drowsiness

Question 16

Methyldopa (不常見）

Answer 16

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

Question 17

Angina

Answer 17

No blood to heart due to narrowed blood vein
Episodic chest pain (陣痛）
Will shift to jaws and neck and arms

Question 18

Nitrates

Answer 18

Cause peripheral vasodilation 週邊血管放鬆
-）demand less oxygen

Question 19

Glyceryl trinitrate

Answer 19

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

Question 20

Isosorbide mononitrate, Isosorbide dinitrate

Answer 20

Chronic angina drug
Mode: decrease preload and after load by vasodilation
Use: chronic stable angina pectoris
Side: vascular headache (too relax), postural hypotension

Question 21

Anti-platelet drug

Answer 21

Antiplatelet drugs reduce platelet aggregation
By inhibiting release of Thromeboxane-A2, ADP, SHT

Question 22

Aspirin (cardiprin)

Answer 22

Antiplatelet drugmode:
Mode: inhibit COX enzyme and reduce Thromeboxane A2
Use: myocardial infarction, stoke, unstable angina
Side: stomach ulcer

Question 23

Clopidogrel

Answer 23

Antiplatelet drug
Mode: inhibit platelet aggregation
Use: stroke, angina, myocardial infarction
Side: nose bleeding

Question 24

Anticoagulent drug

Answer 24

Prevention and treatment of venous thrombosis and embolism

Question 25

Warfarin

Answer 25

Anticoagulant drug
Mode: inhibit body intaking vitamin k
Use: pulmonary embolism(肺栓塞）
Side: hemorrhage(流血）
Implementation: avoid food rich in vitamin k

Question 26

Heparin

Answer 26

Anticoagulant drug
Uses:
Side: hemorrhage
Monitor intake of vitamins k

Question 27

Diuretic

Answer 27

Increase the excretion of water and sodium

Question 28

Indapamide

Answer 28

Use: antihypertensive
Side: hypokalemia, hyponatremia, polyuria(多尿）
Hyperuricemia. 🌟🌟🌟
Implementation: am eat

Question 29

Loop diuretics

Answer 29

Very poful diuretic
Reduce peripheral and pulmonary edema

Question 30

Frusemide

Answer 30

Loop diuretics
Use:Peripheral edema
Side: Hypokalemia, hyponatremia, polyuria
Implementation: monitor electrolyte, body weight

Question 31

Spironolactone

Answer 31

Potassium sparring diuretics
Mode: compete with aldosterone in receptors cite, excrtion but remain potassium
Use: edema
Side: gynaecomastia: 男人生波, hyperkalemia, menstrual disorder
Implementation: am give, monitor electrolytes and body weight

Question 32

Osmotic diuretic->腦水腫
Mannitol

Question 33

Lipid lowering drug
HMG-Co A inhibitors

Answer 33

HMG CoA generate cholesterol

Question 34

Simvastatin, atorvastatin

Answer 34

Inhibit HMG COA that produce steroids
Use: hypercholesterolmia, triglyveride levels
Side: dirrhea, liver dysfunction
Implementation: pm give, monitor lipid profile