Pharmacology Exam 4 - Pt 3 Flashcards
what 4 things is blood pressure affected by?
TPR
Vessel elasticity
Blood volume
Cardiac output
what are the 3 main sources of Total Peripheral Resistance?
Blood vessel diameter
Total vessel length
Blood viscosity
what is the BP formula
BP = CO x TPR
what is the CO formula
CO = HR x SV
what is secondary hypertension
HTN due to a target organ
EX) SNS, RAAS, reflex control of blood volume
what is ejection fraction
how much blood is pumping out of your system
normal - 50-70%
what is the relationship between Milrinone and ejection fraction
Milrinone will increase ejection fraction by increasing myocardial contraction (ICU dangerous)
what is the action of ACE inhibitors
Block angiotensin I to angiotensin II, leading to a decrease in BP and aldosterone secretion
DECREASE TPR and Blood Volume = DECREASE cardiac workload
what are important s/s of ACE inhibitors
Angioedema - tongue and lip swelling in the face, will begin to affect AIR (maslows)
Persistent Cough - change them to different drug
what drug do you start if a pt cannot tolerate an ACE inhibitor
Angiotensin II Receptor Blocker
what is the action of Angiotensin II Receptor Blockers
Bind with angiotensin II receptors in smooth muscle, blocking vasoconstriction and aldosterone release
Prevent blood vessels from contracting and increasing blood pressures
what s/s are red flags in ARBS
fever or persistent cough
what is the action of calcium channel blockers
Block calcium from passing into heart and blood vessels.
DECREASES myocardial contractility, taking so that blood vessels don’t block and narrow
REDUCES blood pressure
what is the action of vasodilators
Dilate blood vessels to decrease BP and oxygen demand on heart
- Will make heart pump more effectively
what are the important facts regarding Nitroprusside?
Dosage - IV drip, dangerous, ICU unit
- used in hypertensive crisis
what are the important considerations for giving BP medications?
- Before giving medication, always check BP - hold medication if BP is too low
- Decrease alcohol and salt intake for HTN patients
what is coronary artery disease
blood vessels become narrowed or blocked due to atherosclerosis
- This leads to SOB, angina, or MI
what are bile acid sequestrants
decrease plasma cholesterol by binding to bile acids in the intestine
- Break up fat to be absorbed in the intestines (dawn dish soap)
what are teachings for bile acid sequestrants
Take other drugs at least 1 hr before or 4-6 hrs after taking Bile Acid Sequestrants
what are HMG-COA Reductase Inhibitors
reduces liver cholesterol by blocking enzyme HMG-COA Reductase that the liver uses to manufacture cholesterol
- Used to decrease serum cholesterol and LDLs
what are pt teachings for HMG-COA Reductase Inhibitors?
- Most effective when taken at night
- Contraindicated with liver diseases or alcohol abuse
- Should be monitoring labs of renal, lipid panel (ex triglycerides), kidneys
common side effect of statins
rhabdomyolysis
what are cholesterol absorption inhibitors
decrease absorption of cholesterol in small intestine
what are pt teachings of cholesterol absorption inhibitors
- 2hrs before and 4hrs after any other drugs
- Take with food and take med at night
