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Boards Review > Pharmacological Management of Heart and Vascular Disorders > Flashcards

Pharmacological Management of Heart and Vascular Disorders Flashcards

1
Q

What do alpha adrenergic antagonists agents do?

A

Reduce peripheral vascular tone by blocking alpha-1-adrenergic receptors
-Causes dilation of arterioles and veins and decrease BP
Examples: Cardura, Minipress

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2
Q

What are the indications for adrenergic antagonists agents?

A
  • HTN

- BPH

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3
Q

What are the side effects of adrenergic antagonists agents?

A

dizziness
palpiations
orthostatic hypotension
drowsiness

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4
Q

What are the implications for PT when patients are on adrenergic antagonists agents?

A

Be careful during position changes b/c orhtostatic or dizzy

closely monitor patient during exercise

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5
Q

What do angiotensin-converting enzyme (ACE) inhibitor agents do?

A

-Decrease BP and afterload (forces that impede blood out of the heart)
-suppresses enzyme that converts angiotensin I to angiotensin II
Ex: Capoten, Vasotec

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6
Q

What are the implications for ACE inhibitors?

A

HTN

CHF

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7
Q

What are the side effects of ACE inhibitors?

A 
hypotension
dizziness
dry cough
hyperkalemia
hyponatremia
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8
Q

What are the implications for PT if a pt is taking ACE inhibitors?

A
  • Avoid sudden changes in posture (fainting from hypotension and dizziness)
  • Pts with heart failures should avoid rapid increases in physical activity
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9
Q

What do anticoagulant agents do?

A

inhibit platelet aggregation and thrombus formation

Ex: Heparin, Coumadin

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10
Q

What are the indications for anticoagulant agents?

A
  • post coronary angioplasty and coronary bypass graft

- prevention of venous thromboemboism and cardioembolic events in pts with Afib and prosthetic heart valves

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11
Q

What are the side effects of anticoagulant agents?

A

hemorrhage
increasd risk of bleeding
GI distress with oral version

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12
Q

What are the implications for PT if pt is on anticoagulants?

A
  • Avoid injury secondary to the risk of excessive bleeding or bruising
  • Pt education on side effects is also indicated to protect the pt
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13
Q

What do antihyperlipidemia agents do?

A

-5 different categories: most common is statins
-inhibit enzyme action in cholesteroal synthesis
-break down LDL
-Decrease Triglyceride levels
-increase HDL levels
Ex: Lipitor, Zocor

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14
Q

What are the implications for antihyperlipidemia agents?

A

hyperlipidemia
atherosclerosis
prevent coronary events in pts with coronary diseases, diabetes, or PVD

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15
Q

What are the side effects of antihyperlipidemia agents?

A

HA
GI distress
myalgia
rash

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16
Q

What are the implications for PT if pt is on antihyperlipidemia agents?

A

Aerobic exercise can increase HDLs and maximize effect of drug therapy
-pts on these can and would benefit from exercise

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17
Q

What do antithrombotic (antiplatelet) agents do?

A

inhibit platelet aggregation and clot formation

Ex: aspirin, plavix

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18
Q

What are the indications for antithrombotic (antiplatelet) agents?

A

post MI
Afib
prevent arterial thrombus formation

19
Q

What are the side effects of antithrombotic (antiplatelet) agents?

A

hemorrhage
thrombocytopenia (deficiency of platelets)
potential liver toxicity with use of aspirin
GI distress

20
Q

What are the implications for PT if pt is on antithrombotic (antiplatelet) agents?

A

Avoid injury- risk for excessive bleeding

Pt education regarding common side effects indicated to protect pt

21
Q

What do beta blockers (Beta-Adrenergic Blocking) agents do?

A

decrease myocardial oxygen demands by decreasing HR and contractility by blocking beta adrenergic receptors
Ex: Tenormin, Lopressor, Inderal

22
Q

What are the indications for beta blockers (Beta-Adrenergic Blocking) agents?

A 
HTN
Angina
arrhythmias
HF
migrains
essential tremor
23
Q

What are the side effects of beta blockers (Beta-Adrenergic Blocking) agents?

A 
bradycardia
cardiac arrthymias
fatigue
depression
dizziness
weakness
blurred vision
24
Q

What are the implications of PT if pt is on beta blockers (Beta-Adrenergic Blocking) agents?

A
  • HR and BP response to exercise will be diminished
  • RPE may be used to monitor exercise intensity
  • closely monitor pts during position changes b/c at increased risk for hypotension
25
Q

What do calcium channel blockers do?

A

Decrease entry of calcium into vascular smooth muscle cells resulting in diminished myocardial contraction, vasodilation, and decreased oxygen demands of the heart
Ex: Procardia, Cardizem

26
Q

What are the indications of calcium channel blockers?

A

HTN
angina pectoris
arrhythmias
CHF

27
Q

What are the sideffects of calcium channel blockers?

A

dizziness
HA
hypotension
peripheral edema

28
Q

What are the implications for PT if pt is on calcium channel blockers?

A

HR and BP response to exercise will be diminished
Watch for dizziness and orthostatic hypotension
observe pts for s/s of CHF worsening: worsening peripheral edema, dyspnea, or weight gain

29
Q

What are diuretic agents do?

A

increase the excretion of sodium and urine
causes reduction of plasma volume which decreases BP
Classifications: thiazide, loop, and potassium sparing agents
Ex: Diuril, Lasix

30
Q

What are the indications for diuretics?

A

HTN
Edema associated with HF
pulmonary edema
glaucoma

31
Q

What are the side effects of diuretics?

A 
dehydration
hyoptesnion
electrolyte imbalance
polyuria
increased LDL
arrhythmias
32
Q

What are the implications if pt is on diuretics

A

be careful with position changes

monitor pts closely for s/s of electrolyte imbalance and muscle weakness or cramping

33
Q

What do nitrate agents do?

A

decrease ischemia through smooth muscle relaxation and dilation of peripheral vessels
ex: nitrostat, nitorglycerin

34
Q

What are the indications for nitrates?

A

angina pectoris

35
Q

What are the side effects of nitrates?

A 
HA
dizziness
orthostatic hyoptension
reflex tachycardia
nausea
vomiting
36
Q

What are the implications for PT if a pt uses nitrates?

A

pts must be educated to come to a standing positions slowly

sublingual (under the tounge) administration is the preferred method during acute angina attack

37
Q

What do positive inotropic agents do?

A

increase the force and velocity of myocardial contraction
slow HR
decrease conduction velocity through the AV node
decrease the degree of activation of the sympathetic NS
Ex: Digoxin

38
Q

What are the indications for positive inotropic agents?

A

HF

Afib

39
Q

What are the side effects of positive inotropic agents?

A

cardiac arrhythmias
GI distress
dizziness
blurred vision

40
Q

What are the implications for PT if pt is on positive inotropic agents?

A
  • Monitor HR during activity

- Teach pt and family to take the pts pulse and seek health care provider’s advice for HR less than 60 or more than 100

41
Q

What do thrombolytic agents do?

A

-facilitate clot dissolution through conversion of plasminogen to plasmin
-plasmin breaks down clots and allows occluded vessels to reopen to maintain blood flow
Ex: Urokinase, Activase

42
Q

What are the indications of thrombolytic agents?

A

Acute MI
Pulmonary embolism
Ischemic stroke
Arterial or venous thrombosis

43
Q

What are the side effects of thrombolytic agents?

A

hemorrahge (specifically intracranial in certain populations)
allergic reaction
cardiac arrhythmia

44
Q

What are the implications for PT if pt using thromboloytic agents?

A

Avoid situations that may cause trauma due to the altered clotting activity

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