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Cardiopulmonary > Medications for Cardiovascular diseases > Flashcards

Medications for Cardiovascular diseases Flashcards

1
Q

Medications for ischemia heart disease

A

1) nitrates
2) beta-blockers
3) calcium-channel blockers
4) anticoagulants
5) thrombolytics

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2
Q

vasodilation

A

decreases demand on heart

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3
Q

heart demand increase

A

pain
increase in BP
increase in HR

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4
Q

Nitrates

A
  • powerful vasodilator(veins and arteries)
  • inhibits smooth muscle contraction
  • systemic vasodilation reduces cardiac workload by reducing both preload and afterload
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5
Q

administration of nitrates

A

1) sublingual
- emergency use(onset in 2-3 minutes)
2) oral
- long term use
3) chewable tablets
4) lingual spray
5) ointment forms
6) transdermal patch
- lasts up to 6 hours, generally given during day

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6
Q

side effects of nitrates

A
  • orthostatic hypotension = decreased BP from changing positions
  • reflex tachycardia = sudden decrease in BP so body increases HR to compensate
  • headache, dizziness, nausea
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7
Q

Beta-blockers

A
  • olol
  • beta-1 selective = blocks receptor on the heart
    • reduces contractility and exertional tachycardia
    • decreases HR by suppressing sympathetic activity
  • beta-2 selective = bronchodilator receptor
  • general beta blocker = decreases HR and decreased bronchodilation
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8
Q

PT implications for B-blockers

A
  • reduces HRmax by 20-30 bpm
  • bronchoconstriction may occur
  • orthostatic hypotension
  • some elderly may not tolerate
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9
Q

contraindications for B-blockers

A
  • HR < 60bpm(bradycardia)
  • Systolic BP < 100(hypotension)
  • moderate to severe LV failure
  • heart block
  • severe COPD
  • signs of peripheral hypotension
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10
Q

Calcium channel blockers

A
  • CCB
  • ipine
  • coronary vasodilation(increase blood supply to heart)
    • blocks calcium entry into vascular smooth muscle
  • side effects = reflex tachycardia
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11
Q

Diltiazem and verapamil

A
  • reduce cardia contractility

- side effects = may cause disturbance in heart rhythm(arrhythmia)

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12
Q

Anti-coagulants

A

1) heparin(IV injection)
2) Low-molecular-weight heparins(subcutaneous injection)
- Lovenox
3) Warfarin(oral)
- coumadin
4) aspirin and other anti-platelets

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13
Q

Heparin

A
  • anti-coagulant
  • prevent blood clot and embolism
  • inhibits formation of thrombin
  • monitor activated partial thromboplastin time
  • side effects = bleeding, thrombocytopenia, osteoporosis after long-term use
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14
Q

Warfarin

A
  • Coumadin
  • inhibits vitamin K-dependent activation of clotting factors
  • cannot take vitamin K supplements or eat foods high in vitamin K
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15
Q

monitor prothrombin time

A

normally maintain the International Normalized Ratio(INR) at 2 to 3
- allow abnormal INR for heart valve replacement

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16
Q

anti-platelets

A

suppress platelet aggregation by inhibiting the COX enzyme

- reduces activation of blood platelets
- COX important for the synthesis of prostaglandins and thromboxanes - Ex: aspirin, dipyridamole
17
Q

aspririn

A

For acute phase:
- limit the progression of platelet-induced occlusion
- prevent re-infarction, ischemic stroke, DVT, thromboembolism
For chronic anti-thrombotic therapy:
- very low dosage is effective
- very cost-effective

18
Q

aspirin contraindications

A

thrombocytopenia
aspirin related allergies
deep friction massage, vigorous mobilization

19
Q

aspirin side effects

A

increased risk of bleeding
GI irritation
toxic to liver and kidney in high doses

20
Q

ADP inhibitors

A

block ADP receptor on the platelet membrane

- well tolerated by pt’s

21
Q

glycoprotein 2b-3a inhibitors

A

block GP receptor on the platelet membrane

  • inhibit the ability of fibrinogen to activate platelets
  • via IV injection
22
Q

thrombolytic agents

A

dissolves clot

  • converts plasminogen to plasmin which then hydrolyzes fibrin
  • Ex: streptokinase and anisoylated plasminogen(antigen/autoimmune response)
  • Ex: urokinase and recombinant tissue plasminogen activator(no antigen effect)
23
Q

contraindications for thrombolytics

A
  • internal bleeding, recent stroke, healing wounds, cancer metastasis
  • precautions = no debridement, no rigorous manual techniques
24
Q

MONA

A

prevent further clot

  • M = morphine
  • O = oxygen
  • N = nitroglycerine
  • A = aspirin

Cardiopulmonary (6 decks)

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