Pharm- Cardio Renal ?s Flashcards
Blood Pressure is?
Force exerted againt artery walls determined by:
HEART RATE
STROKE VOLUME
TOTAL PERIPHERAL RESISTANCE
HTN Regulatory Systems
Autonomic Nervous System
Kidneys
RAAS
How does the Autonomic Nervous System regulate bp?
Baroreceptors found in carotid sinus and aortic arch.
Made up of alpha and beta receptors. When stimulated => Sympathetic N.S. response
(a and b receptors found throughout the body, just diff concentrations of each in diff body parts)
How do the kidneys regulate bp?
Release Renin when hypotensive
Long term regulation of bp through fluid/electrolyte balance
How does the RAAS regulate bp?
End products cause vasoconstriction of arteries and vol expansion by inc Na
Primary HTN
aka Essential HTN or Idiopathic HTN
No known cause
Secondary HTN
Has a known cause
Caused by some other disease process (ie Kidney disease)
bp ranges (Normal, PreHTN, Stage 1 HTN, Stage 2 HTN)
Normal: S <120 and D <80
PreHTN: S 120-139 or D 80-89
Stage 1 HTN: S 140-159 or D90-99
Stage 2 HTN: S >=160 or D >=100
Conditions related to untreated HTN
CAD, MI, Stroke, Renal Failure, Loss of Vision, Death
Non-med Tx options for HTN
Lifestyle Mods (wt loss, stress reduction, reg. aerobic exercise, smoking cessation, mod alcohol consumption, DASH diet)
DASH
Dietary Approaches to Stop HTN
Stepped Approach to Tx HTN
Step 1: Lifestyle Mods
Step 2: if step 1 does not work, drug Tx added
Step 3: if the patient’s response is low, drug doses or class may be changed
Step 4: includes all of the above with the addition of more anti-HTN agents until bp is controlled (eg multiple drugs)
Drugs used to Tx HTN
Diuretics: Thiazide diuretics are usually 1st line drugs
ACE Inhibitors: Captopril and Enalapril
ARBs: Irbesartan and Losartan
Vasodilators: Hydralazine
RAAS
Liver releases Angiotensinogen + Kidney releases Renin in response to hypotension = Angiotensin I (A1)
A1 + Lungs release ACE = Angiotensin II (A2)
A2 works on adrenal glands = Aldosterone: inc Na = inc bp & dec K
A2 works on kidneys = vasoconstriction in the arteries = inc bp
How many bpm produced by each of the following:
SA node
AV node
Ventricular cell
SA node: 60-100 bpm
VA node: 40-50 bpm
Ventricular cell: 10-20 bpm
ECG: P, Q, R, S, T
P: atrial depolarization Q: beginning of vent depolarization R: vent depolarization S: end of vent depolarization T: vent repolarization
ECG: PR Interval
time between atrial and ventricular contraction;
lag here indicated a heart block
ECG: QRS Complex
ventricle depolarization;
atrial repolarization
ECG: ST Interval
time between ventricle depolarization and repolarization;
lag here indicated MI (the heart is taking a long time to get ready to repolarize indicating damage to the myocardium)
Ectopic Focus
heart beat originatin from anywhere NOT the SA node
Pulse Pressure
Difference between systole and diastole
the heart relies on diastole for perfusion; the rest of the body relies on systole for perfusion
3 Types of Angina
Stable-resolves with rest; not associated with tissue damage.
Unstable-more severe narrowing of artery; maybe associated with a clot formation; pain at rest; inc rick of MI.
Variant (Prinzemetal)-caused by muscle spasm.
Blood Coagulation Homeostasis
the balance between clot formation and breakdown.
Platelet Aggregation
Platelets react to a change in chemicals in the blood stream to cause them to adhere to each other and to the site of damage.
