Perfusion/Cardiac Flashcards
When should weight gain in a cardiac/valvular heart disease be reported?
3lbs in a day, 5 lbs in a week.
What are the classification scales of heart disease?
- Class I: exhibits no clinical manifestations with activity
- Class II: has clinical manifestations with ordinary exertion
- Class III: displays clinical manifestations with minimal exertion
- Class IV: has clinical manifestations at rest
What viral infection can lead to rheumatic endocarditis?
Strep throat
What are lab tests we can do to detect heart failure?
Blood cultures, WBC, Increased cardiac enzymes, elevated ESR and CRP, throat culture
What are the biggest symptoms of perfusion issues?
Pain, dizziness, syncope, dyspnea, edema, bleeding/bruising
What Lab tests are used to detect perfusion issues?
Creatine kinase
* Lactic dehydrogenase
* Natriuretic peptides
* Troponin
* Homocysteine
* C-reactive protein
* Serum lipids
* Platelets
* Prothrombin time (PT)
* Partial thromboplastin time (PTT)
* International normalized ratio (INR)
What diagnostic tests are used to detect perfusion/cardiac issues?
ECG, Stress test (pharmacological and exercise), Radiographic studies (Chest x-ray, ultrasound, arteriogram, venogram
Vasodilators
Lisinopril, losartan, nitroglycerine, hydralazine
Vasopressors
epinephrine, dopamine
How often should people be screened for blood pressure?
18-39 every 3-5 years. Every year for adults above 40
What are the 3 ways to surgically fix perfusion obstruction?
bypassing, removing, or compressing the obstruction
Symptoms of a heart attack
Chest pain, pain or discomfort in one or both arms, jaw, back or stomach, shortness of breath, lightheadedness, and nausea
What are the primary antihypertensive agents?
–Diuretics
–Angiotensin-converting enzyme (ACE)
inhibitors
–Angiotensin II receptor blockers
–Beta-adrenergic antagonists (Beta
Blockers)
–Calcium channel blockers
What are the drugs used to treat heart failure?
ACE inhibitors and angiotensin receptor blockers, diuretics, beta-adrenergic blockers, direct vasodilators, cardiac glycoside, phosphodiesterase inhibitors,
What do ACE inhibitors do?
Reduce preload and afterload, enhance excretion of sodium and water, and increases cardiac output
What is the drug of choice for heart failure?
ACE inhibitors
What is the MOA of angiotensin II receptor blockers
Same as ACE inhibitors, but these are used for patient who are unable to tolerate the adverse effects ACE inibitors
Diuretics
-Increase urine output
-reduce blood volume and cardiac workload
-reduce edema and pulmonary congestion
-prescribed in combination with other drugs
Beta blocker MOA:
Slow heart rate and reduce blood pressure, increase the inotropic effect (increase contraction strength), reduce workload (by decreasing preload and afterload)
Cardiac Glycosides
Increase force heartbeat, slow heart rate
Improve cardiac output
Second-line treatment for HF
Narrow therapeutic range
Direct Vasodilators
Relax Blood vessels, lower blood pressure
Phosphodiesterase inhibitors
-Block enzyme phosphodiesterase
-Increase calcium for myocardial contraction
-inotropic response and vasodilation
-Increase contractility and decrease afterload
-short term therapy only
Lab Tests that measure coagulation:
Activated clotting time, prothrombin time (PT) Internation Normalized ratio (INR), thrombin time (TT), Activated partial thromboplastin time (aPTT), Liver function (AST, ALP, ALT)
What is a normal platelet count?
150,000-400,000 mcL
Prothrombin normal time
11-13.5 seconds
INR normal
.8-1.1
Therapeutic INR:
2.0-3.0
anticoagulants
inhibit clotting factors
antiplatelets
inhibit platelet action
thrombolytics
dissolve existing thrombi
Hemostatics
inhibit fibrinolysis, promote clot stability
Vasodilators
Increase the diameter of the vessels and reduce angina. Eg. Angiotensin-converting enzyme inhibitors (lisinopril, losartan)
Vasopressors
Treats hypotension from blood loss, MI, drug issues, and hemorrhage. Eg. Epinephrine
Diuretics
Promote excretion of urine by preventing reabsorption of sodium in kidneys. (treats hypertension) Eg. furosemide, spironolactone, mannitol
Antidysrythmics
Correct erratic electrical impulses. Eg. amiodarone. diltaizem
Cardioglycoside
Lower heart rate and increase strength of contraction and output. Digoxin. (HF, atrial fibrillation, cardiogenic shock
Anticoagulants
Prevent clotting cascade. Heparin, warfarin, enoxaprin
Anticoagulants
heparin, warfarin, enoxaparin. prevents clotting cascade factors.
Antiplatelet
prevent p;latelets from aggreagationg
Antiplatelet
prevent platelets from aggregating. Eg. aspirin and clopidogrel
Thrombolytics
Disrupts blood clots that are impairng perfusion
Antilipidemics
Decrease lipid levels. atorvastatin, fluvastatin, lovastatin, pravastatin
