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Cardiopulm > Pharmacological management of CV disease > Flashcards

Pharmacological management of CV disease Flashcards

1
Q

parenteral medication?

A

doesn’t go through GI tract

-IV, sublingual, subcutaneous., intramm, inhaled

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2
Q

benefit to parenteral meds?

A

fast acting!

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3
Q

Enteral meds?

A

by mouth, rectum or transdermal

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4
Q

What does Digitalis do?

A

affects Na-K+ pump and ultimately affects the AV node to dec. conduction speed and increase myocardial contractility

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5
Q

side effect of digitalis?

A

hypokalemia

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6
Q

What do nitrates do for chest pain?

A

relaxes sm. mm to vasodilate–> dec. preload– >dec. afterload–> dec. demand–> relieves angina

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7
Q

who get prescribed nitrates?

A

CHF, acute MI, HTN

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8
Q

PT considerations for ppl on nitrates?

A

nitrates prior to ex. = reduce cardiac workload and improves cardiac fxn, inc. tolerance for activity before angina sets in

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9
Q

Beta Blockers

A

dec. HR, BP and myocardial contractility in order to allow for increased diastole and increase in blood supply to the myocardium

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10
Q

mech. of action for beta blockers?

A

compete with catecholamines for beta receptor sites

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11
Q

what do beta blockers treat?

A

mild HTN, arrhythmias, slows conduction through the AV node

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12
Q

side effects of beta blockers

A

bradycardia, hypotension, bronchospasm, AV block, nausea,fatigue, depression, sleep disturbances

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13
Q

Ca Channel Blockers

A

inhibit flow of Ca to dec. hr and contractility and vasodilate

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14
Q

type 1 Ca channel blockers

A

*verapamil and diltiazem- peripheral vasodilation, decreased HR, decreased contractility
(verapamil= strongest)
can be used with acute MI
verapamil also used as an antiarrthymic

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15
Q

type 2 Ca channel blockers

A

dihydropyridines (all end in “pines”)- strong periph. vasodilators
- no direct effect on HR or arrhymias,

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16
Q

which ca channel blockers are used in combination with beta blockers (to allow for lower doses of beta blockers) and in combination with nitrates to treat angina but cannot be used for acute MIs

A

type 2 ca channel blockers

17
Q

side effects of Ca channel blockers

A 
headache
hypotension
flushing 
edema
SA node dysfunction
tremors
mood swings
fatigue
reflex tachycardia
GI distress
18
Q

examples of Cardiac Glycosides

A

digitalis

digitoxin

19
Q

what are cardiac glycosides used to treat

A

CHF

20
Q

how do cardiac glycosides work?

A

increase Ca influx to myocardial cells
increase SV and contractility
increased renal profusion= diuretic effect
decreases conduction velocity through AV node

21
Q

problem with cardiac glycosides

A

low margin of safety- toxicity is easily reached

22
Q

s&s of digitoxin/digitalis toxicity

A

vomitting, nausea, fatigue, drowsiness, anorexia, confusion, visual disturbances, bradycardia, first degree heart block, PVCs, Vtach, a-fib

23
Q

what type of drug is lidocane?

A

subclass IB antiarrhythmics, blocks Na+ channels

24
Q

biggest problem with antiarrhythmics

A

they cause arrythmias

25
Q

class 1 antiarrythmics

A

block Na+ channels, decreases excitability

26
Q

class II antiarrythmics

A

B-adrenergic blockers

27
Q

class III antiarrhythmics

A

K+ channel blockers

28
Q

class IV antiarrhythmics

A

Ca channel blockers

29
Q

how do arrythmias develop?

A

heart is usually under the control of the SA node, if it slows down too much development of an ectopic pacemaker may develop (random cells begin to take over the job)

30
Q

action of diuretics

A

reduce circulating fluid to dec. blood volume and dec. blood pressure. Work on varrying places of the renal tube or loop of Henley

  • Lasix (greatest effects)
  • thiazides
31
Q

prob with diuretics?

A

hypotension and arrhythmias or hypokalemia

32
Q

how do ACE inhibitors work?

A

ACE is the enzyme needed to convert angiotensin I to angiotensin II and angiotensin II is a potent vasodilator that influences aldosterone production and sodium retention, this results in increased BP, well ACE inhibitors stop ACE enzyme from converting angio I to angio II so none of this can happen!

33
Q

what do statins do?

A

decrease LDL by inhibiting production of cholesterol in the liver and increase HDLs

34
Q

what does Niacin do?

A

decreases LDLs and triglycerides and increases HDLs

35
Q

what do fish oil and Omega 3 fatty acids do?

A

decrease triglycerides

Cardiopulm (10 decks)

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