Pharmacological management of the Heart and Vascular Diseases Flashcards

1
Q

What do Alpha Adrenergic Antagonist Agents do?

A

It reduces peripheral vascular tone by blocking alpha-1-adrenergic receptors

It dilates arterioles and veins, DECREASING BLOOD PRESSURE

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2
Q

what are indications to use Alpha Adrenergic Antagonist Agents?

A

hypertension

benign prostatic hyperplasia

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3
Q

What are side effects of Alpha Adrenergic Antagonist Agents?

A

dizziness

palpitations

ORTHOSTATIC HYPOTENSION

drowsiness

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4
Q

What are implications in PT for pts using Alpha Adrenergic Antagonist Agents?

A

possible dizziness or orthostatic hypotension when rising from sitting or lying position

closely monitor during exercise

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5
Q

What decreases blood pressure and afterload by suppressing the enzyme that converts angiotensin I to angiotensin II

A

Angiotension-Converting Enzyme (ACE) Inhibitor Agents

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6
Q

What are indications to use ACE inhibitor agents?

A

hypertension

CONGESTIVE HEART FAILURE

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7
Q

what are side effects of using ACE Inhibitor Agents?

A

hypotension

dizziness

dry cough

hyperkalemia

hyponatremia

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8
Q

What are implications for Pt with ACE Inhibitor Agents?

A

avoid sudden changes in posture due to risk of dizziness and fainting from HYPOTENSION

Pts with heart failure should avoid rapid increases in physical activity.

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9
Q

What is the action of Angiotensin II Receptor Antagonist Agents?

A

It blocks angiotensin II receptors which limit vasoconstriction and stimulation of vascular tissue

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10
Q

What are indications for Angiotensin II Receptor Antagonist Agents?

A

hypertension

congestive heart failure

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11
Q

What are side effects of Angiotensin II Receptor Antagonist Agents?

A

dizziness

back and leg pain

angina pectoris

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12
Q

What are examples of Angiotensin II Receptor Antagonist Agents

A

Cozaar (losartan)

Atacand (candesartan)

Diovan (valsartan)

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13
Q

What is a class I antiarrhythmic agent?

A

Sodium channel blocker that controls cardiac excitation and conduction

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14
Q

What is a class II antiarrhythmic agent?

A

It is a beta blocker which inhibits sympathetic activity by blocking B-adrenergic receptors

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15
Q

What is a class III antiarrhythmic agent?

A

It prolongs repolarization by inhibiting both potassium and sodium channels

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16
Q

What is a class IV antiarrhythmic agent?

A

It is a calcium channel blocker which depresses depolarization and slow conduction through the AV node

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17
Q

Which is the MOST EFFECTIVE antiarrhythmic agent?

A

Class III

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18
Q

What is the indication to use antiarrhythmic agents?

A

cardiac arrhythmia

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19
Q

What are sides effects of antiarrhythmic agents?

A

exacerbation of cardiac arrhythmias

dizziness

hypotension

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20
Q

Implications of antiarrhytmic agents in PT

A

Encourage pts to adhere to prescribed dosing schedule and immed report any adverse reactions

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21
Q

What are examples of sodium channel blockers?

A

Quinidine (generic

Xylocaine (lidocaine)

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22
Q

What are examples of beta blockers?

A

Tenormin (atenolol)

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23
Q

What are examples that provide prolonged repolarization

A

Cordarone (amiodarone)

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24
Q

What are examples of Calcium channel blockers?

A

Cardizem (diltiazem)

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25
What do anticoagulant agents do?
They inhibit platelet aggregation and thrombus formation
26
What are indications of Anticoagulant agents?
post percutaneous transluminal coronary angioplasty and coronary artery bypass graft surgyery prevention of venous thromboembolism cardioembolic events in pts with fibrillation and prosthetic heart valves
27
What are side effects of anticoagulant agents?
hemmorhage increased risk for bleeding GI distress with oral medication
28
What are PT implications of anticoagulant agents?
PT must be careful to avoid injury secondary to risk of excessive bleeding or bruising Pt education is indicated to protect pt
29
What are examples of anticoagulant agents?
heparin Coumadin (warfarin) Lovenox (enoxaparin)
30
Statins are a antihyperlipidemia agent. What does it do?
1) inhibits enzyme action in cholesterol synthesis 2) breaks down LDL 3) Decrease triglyceride levels 4) increase HDL levels
31
What are indications for statins?
hyperlipidemia atherosclerosis prevent coronary events in pts with existing CAD, diabetes or peripheral vascular disease
32
what are side effects of statins?
headache GI distress myalgia rash
33
What are implications for using statins?
aerobic exercise can increase HDL and maximize effects of drug therapy
34
What are examples of statins?
Lipitor (atrovastatin) Zocor (simvastatin) Tricor (fenofibrate)
35
What med inhibits platelet aggregation and clot formation?
Antithrombic (antiplatelet) agents
36
What are indication of Antithrombic (antiplatelet) agents
post-myocardial infarction atrial fibrillation prevent arterial thrombus formation
37
What are side effects of Antithrombic (antiplatelet) agents?
hemorrhage thrombocytopenia potential lover toxicity with use of aspirin GI distress
38
What are implications of Antithrombic (antiplatelet) agents with PT?
PT must be careful to avoid injury secondary to risk of excessive bleeding. Pt education of common side effects good
39
What are examples of Antithrombic (antiplatelet) agents?
Bayer (aspirin)*** Plavix (clopidogrel) Persantine (dipyridamole
40
What do beta blocker agents (B-adrenergic blocking agents) do?
They decrease the myocardial oxygen demand BY DECREASING HR AND CONTRACTILITY BY BLOCKING B-ADRENERGIC RECEPTORS
41
What are indications of Beta Blocker agents?
Hypertension Anginas Arrhythmias Heart Failure Migraines Essential Tremors
42
What are side effects of Beta Blocker agents?
bradycardia cardiac arrhythmias fatigue depression dizziness weakness blurred vision
43
What are implications of Beta Blocker agents in PT?
HR and BP response to exercise will be diminished **Rate of Perceived Exertion may be used to monitor exercise intensity** Closely monitor patients during positional changes due to an increased risk for orthostatic hypotension
44
What are some examples of Beta Blocker Agents?
Tenormin (atenolol) Lopressor (metroprolol) Inderal (propanolol)
45
What action do calcium channel blocker agents have?
they decrease the entry of calcium into vascular smooth muscle cells... tf that mean? It means It thus diminishes myocardial contraction, vasodilation, and decrease oxygen demand of the heart (slows AV node conduction)
46
What are indications of Calcium Channel Blocker Agents?
hypertension angina pectoris arrhythmias congestive heart failure
47
What are side effects Calcium Channel Blocker agents?
dizziness headache hypotension peripheral edema
48
What are implications when using Calcium Channel Blocker Agents with PT
HR and BP response to exercise will be diminished. Monitor pt closely when moving to an upright position secondary to dizziness and/orthostatic hypotension Observe pt for signs and symptoms of congestive heart failure such as worsening peripheral edema, dyspnea or weight gain
49
what are examples of calcium channel blockers?
norvasc (amlodipine) Procardia (nifedipine) Calan (verapamil) Cardizem (diltiazem)
50
what is the action of Diuretic agents?
They increase the excretion of sodium and urine which causes a reduction in plasma volume which decreases BP
51
What are indication of Diuretic Agents?
hypertension edema associated with heart failure pulmonary edema glaucoma
52
What are side effects of Diuretic agents?
dehydration hypotension electrolyte imbalance polyuria increased low-density lipoproteins arrhythmias
53
What are implications of diuretic agents for PT?
POSITIONING CHANGES can increase the risk of dizziness and falls due to decrease BP. Monitor pts closely for signs and symptoms of ELECTROLYTE IMBALANCE AND MUSCLE WEAKNESS OR CRAMPING
54
What are examples of diuretic agents for PT?
Thiazide type: Diuril (chlorothiazide) Loop type: Isordil (isosorbide dinitrate) Anyl nitrite solution for inhalation
55
What do POSITIVE INOTROPIC AGENTS do?
They increase the force and velocity of myocardial contraction slow the HR decrease conduction velocity through the AV node decrease the degree of activation of the Sympathetic Nervous System
56
What are indications of POSITIVE INOTROPIC AGENTS?
heart failure (like CHF bro) atrial fibrillation
57
What are side effects of POSITIVE INOTROPIC AGENTS?
cardiac arrhythmias GI distress dizziness blurred vision
58
What are implications of POSITIVE INOTROPIC AGENTS while in PT
PTs should monitor HR during activity, teach the pt and family to take pt's pulses AND seek health care providers advice for rates less than 60 bpm or more than 100 bpm
59
What are examples of POSITIVE INOTROPIC AGENTS?
Lanoxin (digoxin)
60
What do THROMBOLYTIC AGENTS do?
they facilitate CLOT DISSOLUTION through conversaion of plasminogen to plasmin Plasmin breaks down clots and allows occluded vessels to reopen to maintain blood flow
61
What are indications to use THROMBOLYTIC AGENTS?
acute MI pulmonary embolism ischemic stroke arterial or venous thrombosis
62
What are side effects of thrombolytic agents?
hemorrhage (specifically intracranial in certain pops) allergic reaction cardiac arrhythmia
63
What are implications of using THROMBOLYTIC AGENTS with PT
PTs must avoid situations that may cause trauma due to altered clotting activity
64
What are examples of THROMBOLYTIC AGENTS?
Kinlytic (urokinase) Activase (alteplase)