THERAPEUTICS(INTRO &CARDIAC FAILURE) Flashcards
ARTERIOSCLEROSIS & ATHEROSCLEROSIS
THICK AND STIFF ARTERIES
RESTRICT BLOOD FLOW
HEALTHY ARTERIES ARE FLEXIBLE AND ELASTIC
ARTERIOSCLEROSIS DUE TO THE ACCUMULATION OF FATS AND CHOLESTEROL CALLED PLAQUES
HOW DO WE ADDRESS REVERSIBLE FACTORS
CORONARY ARTERY AND VALVE SURGERY
ALCOHOL ABSTAINANCE
TREAT HYPERTENSION
HOW WE IMPROVE SYMPTOMS ASSOCIASTED WITH FLUID RETEINTION
REDUCE SALT INTAKE TO LESS THAN 2G PER DAY
REDUCE FLUID INTAKE TO 1-1.6L PER DAY
MONITOR WEIGHT GAIN
DRUGS USED OVER THE PAST DECADES
DIURETICS AND DIGOXINS
DIURETICS
IMPROVE SYMPTOMS OF FLUID ACCUMULATION
PROMOTE EXCRITION OF SALT(NA) AND WATER
REDUCE VENTRICULAR PRE LOAD BUT DOES NOT AFFECT STROKE VOLUME
DIGOXIN
IONOTROPIC INCREASE CONTRACTILITY INCREASE DEMAND OF OXYGEN INCREASE STROKE VOLUME,EJECTION FRACTION,ORGAN PERFUSION DECREASE OEDEMA AND AFTER LOAD
STEPS
STEP 1: DIURETIC(HCT OR FUROSEMIDE + ACE INHIBITOR OR ARB
STEP 2: CARVERDILOL OR SPIRONOLACTONE
STEP 3; CARVERDILOL + SPIRONOLACTONE
STEP 4: DIGOXIN
IN AN UNEXPLAINED HEART FAILURE
USE THIAMINE
hydrochlorothiazide (HCT)
IMPROVE SYMPTOMS OF FLUID RETEINTION(SHORTNESS OF BREATH AND LEG SWELLING)
IMPROVE EXCRETION OF SODIUM AND WATER
NO EFFECT ON MORTALITY
USED IN MILD VOLUME OVERLOAD AND NORMAL RENAL FUNCTION
ADVERSE EFFECTS: DEHYDRATION,HYPOTENSION,HYPOKALAEMIA,ELECTROLYTE ABNORMALITIES
CAUTION: RENAL OR HEPATIC IMPAIREMENT
GOUT
FUROSEMIDE
USED IN SIGNIFICANT VOLUME OVERLOAD OR RENAL OR HEPATIC IMPAIRMENT
IMPROVE SYMPTOMS OF FLUID RETENTION
NO EFFECT ON MORTALITY
ACE INHIBITORS
NAME END WITH PRIL.E.G. CAPTOPRIL,ENALAPRIL,RAMIPRIL
INHIBIHT ACE,THEREFORE BLOCK ANGIOTENSIN 2 FORMATION
IMPROVE SYMPTOMS
PROLONG SURVIVAL
PREVENT CLINICAL DETORIATION
ADVERSE EFFECTS: HYPOTENSION,ELECTROLYTE IMBALANCE,DRY COUGH,ANGIOEDEMA, AND DECREASE KIDNEY FUNCTION
WHY ACEI CAUSE DRY COUGH AND ANGIOEDEMA
THEY INHIBIT ACE WHICH CONVERT BRADYKININ TO INACTVE METABOLITES
THIS CAUSES INCREASE IN BRADYKININ
BRADYKININ CAUSE COUGH AND ANMGIOEDEMA
STENOSIS
ABNNORMAL NARROWING OF ANY PASSAGE IN THE BODY
ARBs
NAME END WITH SARTAN.E.G.VALSARTAN,LOSARTAN
BLOCK ANGIOTENSIN RECEPTORS
IMPROVE SURVIVAL
ADRENALINE
LUNG-B2-BRONCHODILATION HEART-B1-INCREASE CONTRACTILITY ARTERIES-A-VASOCONSTRICTION SKELETAL ARTERIES-B2-VASODILATION KIDNEY-B1-RENIN
BETA BLOCKERS
CARVEDILIN BLOCK B2,B1.A
SPIRONOLACTONE
USED IN CARDIAC FAILURE GRADED 3 OR 4 GIVEN WITH ACE INHIBITOR WEAK DIURETIC REDUCE OEDEMA FLUID FLOW IMPROVE SURVIVAL HYPERKALAEMIA AND GYNAECOMASTIA CAUTION: RENAL IMPAIRMENT
DIGOXIN
IMPROVE SYMPTOMS IONOTROPIC PREVENT CLINICAL DETERIORATION INCREASE CA2+ NO EFFECT OF MORTALITY
DRUG THAT WORSEN CARDIAC FAILURE
NSAID
DRUG THAT WILL INCREASE NA+
DRUGS IN ACUTE SEVERE HEART FAILURE WITH PULMONARY OEDEMA
OXYGEN
FUROSEMIDE 4
MORPHINE
IONOTROPIC DRUG:DOBUTAMINE,IF NO RESPONSE.THEN ADRENALINE IS GIVEN
ONCE A PATIENT IS STABLE AND MAINTAUINING BP ,ACE INHIBITOR IS GIVEN
MORPHINE
ANXIOLYTIC PROPERTIES
VASODILATOR
CAN CAUSE VOMITING AND POSSIBILITY OF ASPIRATIONO
BENZODIAZEPINES IS MOSTLY USED
