peripheral vascular disease Flashcards
what is intermittent Claudication ?
Walk pain rest cycle
can lead to tissue necrosis or amputation of the affected limb (lower extremities)
AKI< or = 0.9
what are the risk factors of IC?
- Age> or =65
- DM
- Smoking
- HTN
- History of ASCVD
- Family history of IC
what is the management of IC?
- risk factor modification
- Exercise training or rehabilitation
- Pharmacological
- revascularization
- Surgery (bypass grafting)
what is the pharmacological treat of IC?
Antiplatelet : decrease risk of MI , stroke , Cardiovascular mortality
- ASA (75-325 mg/dL)
- Clopidogrel (plavix)
- Ticagrelor (brilinta)
- Vorapaxar (Zonvity) –> added to ASA or clopidogrel
- Cilostazol (pletal)
what is the pharmacological treat of IC?
1)Antiplatelet : decrease risk of MI , stroke , Cardiovascular mortality
- ASA (75-325 mg/dL)
- Clopidogrel (plavix)
- Ticagrelor (brilinta)
- Vorapaxar (Zonvity) –> added to ASA or clopidogrel
2) Cilostazol (pletal) –> direct vasodilator + improve walking distance —> avoided in HF
3) Naftridrofuryl (Praxilene) –> increase glucose & ATP & pain free walking distance
4) high intensity statin
5) ACEI and ARBs —> HTN management
6) Ginkgo Biloba (Antiplatelet Antioxidant)
7) Propionyl L carnitine
8) L-arginine
9) percutaneous Revascularization
10) Bypass surgery
what is Raynaud’s phenomenon?
Ischemia and vasospasm of peripheral arteries
induced by cold or emotional stress
How to diagnose Raynaud phenomenon?
- episodic attacks of digital pallor
- cyanosis induced by cold exposure
- bilateral involvement of the extremities
which drug induce Raynaud?
Beta blockers
Ergot preparations
Sympathomimetics
How to treat Raynaud?
- CCBs:
a- Nifedipine: potent peripheral vasodilating effect
b- DHP:- Diltiazem less effective
- NTG ointment & patch
-PDE5I: Sildenafil , tadalafil ; vardenafil : 2nd line
- Others: prozacin - losartan - flouxetine - Botulinum toxin - misoprostol + cicaprost + beraprost + iloprost
