Medical/Surgical Mgmt Of CVD Flashcards
ACE inhibitor: Inhibit conversion of _____ to _____, decreases ___ retention and peripheral vaso_____ in order to ____ ____.
Angiotensin I, angiotensin II
Dilation
Decrease BP
Captopril (capotes), enalopril (vasotec), lisinopril (zestril)
ACE inhibitors
Angiotensin II receptor blockers (ARBs): blocks binder of _____ at the tissue/smooth muscle level, ____ ____.
Angiotensin II
Decreasing BP
Losartan (cozaar)
ARBs (angiotensin II receptor blocker)
Nitrates: decrease ____ through peripheral vaso____, reduce myocardial oxygen demand, reduce chest discomfort (angina); may also ____ coronary arteries, improve coronary blood flow.
preload
Dilation
Dilate
Nitroglycerin
Nitrates
Beta-adrenergic blocking agents: reduce myocardial demand by ___ ___ and _____; control ___, chest pain; reduce ____.
Reducing HR and contractility
Arrhythmias
BP
atenolol (tenormin), metropolis (lopressor, toprol XL), propranolol (inderal)
Beta blockers
Calcium channel blockers: inhibit flow of calcium ions, ____ ____, decrease ___, dilate coronary arteries, reduce ____, control ____ and chest pain.
Decrease HR
Contractility
BP
Arrhythmias
diltiazem (cardizem, procardia), amlopidine (norvasc)
CCB
Antiarrhythmics: alter ___, restore normal heart __, control arrhythmias, improve ____
Conductivity
Rhythm
CO
Digitalis: increases contractility and decreases ____. Mainstay in treatment of ____
HR
CHF
Diuretics: decrease ___ ___ by reducing preload/afterload. Control ____.
Myocardial work
HTN
Furosemide (lasix), hydrochlorothiazide (esidrix)
Diuretics
Aspirin: decrease ____ aggregation, may prevent ____
Platelet
MI
Tranquilizers: decrease ___ and ____ effects
Anxiety, sympathetic
Hyperlipidemia agents: reduce ___ ___ levels when diet and weight reduction not effective
Serum lipid
Cholestyramine (questran), colestipol (colestid), simvastatin (zocor), lovastatin (mevacor)
Hypolipidemic agents
ACUTE MI: activity can be increased once acute MI has stopped (peak in ___ ___ ___). Activity should be limited to ___ METs or ___% of age predicted HRmax for ___ weeks following MI.
Cardiac troponin levels
5
70%
4-6
ACUTE HF: oxygen demand should not be increased in pts in acute or ___ heart failure. Once they have been medically managed and no longer display signs of acute __, activity level can be __ ___ while monitoring ___ ___ to activity.
Decompensated
Decompensation
Gradually increased
Hemodynamics response
Thrombolytic therapy:
Administered for what?
Meds activate body’s ___ system, dissolve ___ and restore ___blood flow
Acute MI
Fibrinolytic
Clot
Coronary
Ventricular assist device (VAD) is implanted device that improves tissue perfusion and maintains cardiogenic circulation. Used for patients with what?
Cardiogenic shock unresponsive to meds
Severe ventricular dysfunction
Surgical circumvention of obstruction in coronary artery using anastomosing graft (saphenous vein, internal mammary artery); multiple graft may be necessary; result sin improved coronary blood flow, L vent function, anginal relief
CABG
Who receives a heart transplant?
End-stage myocardial disease (ex: cardiomyopathy, ischemic heart disease, valvular heart disease)
What is a heteroptic transplant?
Leaving natural heart and piggybacking donor heart
What is an orthotopic transplant?
Removing diseased heart and replacing with donor heart
Intravascular stents: endoprosthesis implanted postangioplasty to prevent restenosis and occlusion in ___ or ___ arteries. Often coated in medication to prevent ___.
Coronary, peripheral
Thrombosis
Under fluoroscopy, surgical dilation of blood vessel using small balloon-tipped catheter inflated inside lumen; relieves obstructed blood flow in acute angina or acute MI; results in improved coronary blood flow, improved L vent function, anginal relief
Percutaneous transluminal coronary angioplasty (PTCA)
