Week 4 Flashcards
Peripheral Artery Disease:
most common form of ____
narrowing due to __________
focus on _______ extremities
goal to reduce __________ risk factors and decrease ____________
PVD
atherosclerosis
lower
cardiovascular, functional impairment
what are the risk factors for PAD?
over 65
smoking
diabetes
HPTN
hypercholesterolemia
impaired renal function
what are the symptoms of PAD?
pain, numbness, discomfort or cramping with exercise… pain in extremities!!
what would you observe during an exam that would indicate PAD?
-cool temp of skin
-change in skin color
-muscle atrophy
-lack of hair growth
-thick toenails
-decreased pulses
-wounds or ulcers
where do we measure BP using the Ankle-Brachial Index (ABI)?
is it calculated for each leg?
how would you calculate the pts right ABI?
supine position measure brachial, dorsalis pedis and posterior tibial arteries
yes
highest pressure in right foot/highest pressure in both arms
what is the normal range for ABI and what is considered diagnostic for PAD?
what’s considered severe PAD?
1-1.4 normal
0.9 or less = PAD
0.4 or less = severe
what med is used for claudication to control PAD?
dosing?
counseling points?
SEs?
who should not take it?
Cilostazol
100mg BID
may see improvements in 2-4 wks, but may take up to 12 weeks
HA, dizziness, nausea, diarrhea & palpitations
do not take if pt has HF
what meds treat reynauds?
they are only taken when?
CCBs like nifedipine, amlodipine and felodipine
during winter months
where do you feel for pulses for a diabetic foot exam?
dorsalis pedis artery and posterior tibial artery
how can we treat PAD? (minimize comorbidities)
-influenza vaccine
-proper foot care
-high intensity statin
-control T2DM
-antithrombotics: antiplatelets: ASA 81-325mg or clopidogrel 75mg or duel therapy
anticoags: rivaroxaban 2.5mg bid + ASA 81mg
-surgical interventions: if pt fails exercise and risk modifications
