RX of heart and valvular diseases

Question 1

Alpha adrenergic antagonist agents

Answer 1

Action- redeuce peripheral tone by blocking alpha one adrenergic receptors. Causes dilation and decreases BP

Indication- Hypertension benign prostatic hyperplasia

Side effect-Dizziness palpitations orthostatic hypertension drowsiness

PT implications- Be careful when sitting up or laying due to orthostatic hypotension

Examples- Cardura Minipress Hytrin

Question 2

Angiotensin converting enzyme inhibitor agents. ACE inhibitors

Answer 2

Action- Decrease BP and afterload by suppressing enzyme that converts angiotensin I to angiotensin II

Indication- Hypertension, congestive heart failure

Side effect- Hypotension, dizziness, dry cough, hyperkalemia, hyponatremia

PT implications- Avoid rapid position changes and rapid increase in physical activity

Examples: -prils
Captopril enalapril lisinopril ramipril

Question 3

Angiotensin II receptor antagonist agents

Answer 3

Action- Block angiotensin II receptor’s to limit vasoconstriction and vascular tissue stimulation

Indication-Hypertension, congestive heart failure,

Side effect- Dizziness, back and leg pain, angina

Examples: -Sartans Losartan Candesartan valsartan

Question 4

Anticoagulant agents

Answer 4

Action- Inhibit platelet aggregation and thrombus formation

Indication- After angioplasty, coronary artery bypass. Prevention of venous thromboembolism for atrial fibrillation and prosthetic heart valve.

Side effect- Hemorrhage, increased risk of bleeding G.I. distress with oral medication

Examples- Heparin, Coumadin aka-warfarin, Lovenox

Question 5

Anti-hyper lipidemia agents

Answer 5

Action- breakdown LDL Lipoproteins, triglyceride levels and increase HDL levels.

Indication-Hyper lipidemia arthrosclerosis prevent coronary events for: existing coronary disease, diabetes or PVD

Side effect- Headache G.I. distress, myalgia, rash

PT implications- Aerobic exercise can increase HDL and maximize drug therapy effects

Examples: -statins
Lipitor Atorvastatin Simvastatin

Question 6

Anti-thrombotic agents

Answer 6

Action- Inhibit platelet aggregation and clot formation

Indication- Post MI, atrial fibrillation, prevent atrial thrombus formation

Side effect- Hemorrhage thrombocytopenia potential liver toxicity from aspirin

Examples- Aspirin, Plavix, dipyridamole

Question 7

Beta blocker agents

Answer 7

Action- Decrease oxygen demand from heart by decreasing heart rate and contractility by blocking beta adrenergic receptors

Indication- Hypertension, angina, arrhythmia. heart failure, migraine, essential tremor

Side effect- Bradycardia, cardiac arrhythmia, fatigue, depression, dizziness, weakness, blurred vision

PT implications- HR and BP will be diminished. Rate of perceived exertion can be used for exercise and

Examples: -0lol
Atenolol, Lopressor metoprolol, Propanolol

Question 8

Examples of diuretic agents

Answer 8

Used with hypertension, heart failure associated edema, pulmonary edema, glaucoma

-Thiazide, Lasix, Potassium sparing- Dyreniun

Question 9

Anti-arrhythmic agents

Answer 9

Class I: Na cancel channel blockers control cardiac excitation conduction.

Class II beta blockers: inhibit sympathetic activity.

Class III K+ channel blockers: prolong repolarization by inhibiting inhibiting K and NA channels, most effective.

Class IV calcium channel blockers:Depressed deep polarization and slow AV node conduction

Question 10

What is Lanoxin (digoxin)

Answer 10

Positive inotropic agent to increase force and velocity of heart contraction, slow heart rate, decrease conduction velocity through AV node and decrease activation of the sympathetic nervous system