Thrombolytics and Anti-hypertensives Flashcards
What are the classes of thrombolytics? (EXAMPLES OF THEM)
Alteplase, reteplase, tenecteplase
Urokinase
Streptokinase
What is the source of Alteplase, reteplase, tenecteplase?
Recombinant DNA
What is the source of Urokinase?
Cultured human kidney cell
Alteplase, reteplase, tenecteplase NOTES.
More selective for fibrin-bound (clot-related) plasmin; mimics endogenous PAF
Urokinase notes
Less selective for fibrin-bound plasmin
What is the source of Streptokinase?
Streptococcus
What are the notes for streptokinase?
Less selective for fibrin-bound plasmin
When do we use thrombolytics?
emergency situations of ischemic myocardial infarction or ischemic stroke
What is the antidote for thrombolytics?
Antidote: aminocaproic acid, tranexamic acid
What is the primary goal in heart failure?
take stress off the heart
What are the factors that affect blood pressure?
cardiac output and systemic vascular resistance
what are the factors that affect cardiac output?
heart rate and stroke volume
what are the factors that affect stroke volume?
Contractility, Preload, Afterload
What happens when there is increased afterload in the heart?
decreased cardiac output
List the vasoconstrictive hormones
Angiotensin,
angiotensin II,
and aldosterone
What do Angiotensin, angiotensin II, and aldosterone do?
their activity increases blood pressure
What are examples of Ace inhibitors?
Enalapril, losinopril, captopril, benazepril, fosinopril, ramipril
(PRIL)
What are the adverse effects of ACEs?
angioedema and dry cough
What are the MOA of ACE and ARBs?
decrease potassium excretion so we need to watch for hyperkalemia and question co-administration with a potassium sparing diuretic
What are examples of ARBs?
end in-sartan
What happens when given ACE and angioedema is the result?
Angioedema (swelling) of the face and tongue can occur with ACEIs. If this happens, patients may try an ARB instead but should not continue an ACEI and should not be prescribed one in the future.
What are acute in the moment treatment medications?
MONA-Morphine, Oxygen, nitro-glycerin, Aspirin
What are treatment medications for AFTER they are home?
SAAB- statin, ace inhibitor, anticoagulant/antiplatelet, beta blocker
What is something you have to watch out for with a PT on an antihypertensive?
orthostatic hypotension
