Peripheral Vascular Diseases Flashcards
PVD vs. PAD
only called PAD when arteries are affected
patho of PVD
–related to atherosclerosis processes in the extremities
risk factors of PVD/PAD
–smoking**
–diabetes
–high cholesterol
–heart disease
–stroke
–increased age > 50
etiology of PVD/PAD
–atherosclerosis (most common)
–thrombus
–inflammation (thromboangitis obliterans)
–vasospasm (Raynaud’s)
thromboangitis obliterans
inflammatory condition of the arteries
symptoms of PVD/PAD
–pain (calf, buttock pain)
–numbness/burning
–heaviness
–intermittent claudication
–wounds that don’t heal
–diminished sensation in extremities
–trophic skin changes
trophic skin changes
–shiny, thick toenails
–loss of leg hair
–diminished pulses
–elevation pallor, cyanosis
–reactive hyperemia
–erectile dysfunction
intermittent claudication
–consistent pain precipitated by consistent level of exercise
–ceases with rest
–caused by ischemic tissue
what does pain depend on with intermittent claudication?
–site of plaque build up
–collateral circulation
diagnosis of intermittent claudication
patient can usually describe walking a certain distance when pain starts
common site for PAD
femoral artery
symptoms of PAD in femoral artery
–pain
–decreased pulse
–coolness of leg
–pallor of leg
–loss of sensation in foot
etiology of PAD in femoral artery
–ischemia of muscle in lower leg
–cellular hypoxia
5 P’s of PVD/PAD
(1) pain
(2) pulselessness
(3) palpable coolness
(4) paresthesias
(5) paresis (weakness)
ankle-brachial index
–comparison of the BP in the leg v. the arm
–normal: ankle pressure is greater than brachial pressure
severe PAD ankle-brachial index
0.5
symptoms of PVD (venous)
–dull, achy pain
–lower leg edema
–pulse present
–drainage
–sores with irregular borders
–yellow slough or ruddy skin
location of sores in PVD (venous)
ankles
location of sores in PAD
toes and feet
symptoms of PAD
–intermittent claudication
–no edema
–no pulse or weak pulse
–no drainage
–round, smooth sores
–black eschar
chronic venous insufficiency
a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively
what does CVI cause?
causes blood to “pool” or collect in veins = venous stasis
symptoms of venous insufficiency
–lower extremity edema
–achiness or tiredness in legs
–leathery looking skin
–stasis ulcers
–flaking or itching skin
–new varicose veins
nonpharm treatment of PVD
Reduction of contribution factors
–smoking cessation
–increase physical activity
–weight reduction
–stress reduction
–diabetes management
–HTN control
Interventions aimed at the occlusion
–meds
–bypass operation
–intravascular balloon
–intravascular stent
pharm treatment of PVD
–antiplatelet agents
–anticoagulants agents
–thrombolytics
–lipid lowering agents
cilostazol (Pletal)
treatment for intermittent claudication
MOA for cilostazol (Pletal)
–platelet inhibitor
–vasodilation
adverse effects of cilostazol (Pletal)
–headache
–dizziness
–diarrhea
–abnormal stools
–palpitations
–peripheral edema
drug interactions with cilostazol (Pletal)
metabolized by Cytochrome P450
pentoxifylline (Trental) class
vasoactive agent
indication for pentoxifylline
treatment of intermittent claudication caused by PVD
MOA for pentoxifylline
–relieves leg pain by increasing blood flow and oxygen through the BV
–helps to increase walking distance and duration
adverse reactions of pentoxifylline
–N/V
–dizziness
route of pentoxifylline
PO TID
