Term
| Name 5 heart-related conditions that can be treated medically |
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Definition
Ischemia
Heart Failure
Arrhythmia
HTN
Lipid Disorders |
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Term
| Problem with electrical conduction system causing irregular heartbeat |
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Definition
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Term
| What is the difference between ischemia and infarction. |
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Definition
| Ischemia is reversible and infarction is not. Infarction is death of tissue |
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Term
| These type of drugs restore balance of supply and demand. They help increase circulation to the heart while increasing exercise tolerance also. |
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Definition
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Term
| Name 5 factors involved in anti-ischemic drugs |
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Definition
1. Occlusion (can correct with bypass or stent)
2. Systolic wall tension (afterload, radius, and wall thickness)
3. Ionotropic state
4. Preload
5. Heart Rate |
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Term
| The load in the ventricle has to work against to push the blood out |
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Definition
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Term
| Can you change wall thickness with medications? |
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Definition
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Term
| The force of muscle contraction |
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Definition
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Term
| Stretch of myocardial cells when ventricles are full of blood |
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Definition
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Term
| If you decrease heart rate what happens to perfusion time |
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Definition
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Term
| Name 3 medications that decrease demand on the heart |
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Definition
Beta blockers
Calcium channel blockers
Nitrates |
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Term
| This type of medication decreases heart rate (resting and exercise), decrease ionotropic state, and decreases VO2. |
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Definition
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Term
| This type of beta blocker is newer and is specific to beta 1 |
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Definition
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Term
| These muscles have more beta-2 blockers than the heart. |
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Definition
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Term
| When this is blocked, you will decrease the force and rate of contraction |
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Definition
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Term
| An alpha and beta blocker |
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Definition
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Term
| Found in vascular smooth muscle. When blocked, you will get vasodilation (helps address ischemia) |
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Definition
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Term
| Name 6 side effects of beta blockers |
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Definition
1. Bradycardia
2. AV blockade
3. CHF
4. Sedation
5. Fatigue
6. Asthmatic attacks in pts with respiratory disorders |
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Term
| What 2 things to calcium channel blockers do |
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Definition
Decrease ionotropic state
Peripheral vasodilation (reduced afterload) |
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Term
| With this, you may need to worry about BP bottoming out. The heart is not having to work as hard to get the blood out. |
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Definition
| Peripheral vasodilation provided by calcium channel blockers |
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Term
| Name 8 side effects of calcium channel blockers |
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Definition
Constipation
Edema
Nausea
Flushing
Dizziness
CHF
AV blockade
Sinus node depression |
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Term
| Nitroglycerin and related compounds. Primarily a venodilator reducing preload. Arterial dilator reducing afterload. Minor coronary dilator, sublingual or patch, flushing or hypotension. |
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Definition
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Term
| Name 4 side effects of nitrates |
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Definition
Tachycardia
Orthostatic Hypotension
Throbbing Headache
Dizziness |
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Term
| Name 4 types of drugs that increase supply on the heart. |
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Definition
Thrombolytic
Antiplatelet
Anticoagulant
Vasodilators (nitrates and calcium channel blockers minor effect) |
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Term
| These drugs restore acute occlusion (thrombus or coronary vessel), use within 3-4 hours of MI, streptokinase, recombinant tissue plasminogen activator (TPA). Production of plasmin. Increases potential for bleeding. |
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Definition
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Term
| What is the main side effect for thrombolytic drugs |
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Definition
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Term
| This medication should be used 3-4 hours of MI and can have an impact on the body for 4-6 weeks after the meds are taken |
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Definition
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Term
| This is a prophylactic drug that will decrease the likelihood of platelet aggregation. |
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Definition
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Term
| Includes aspirin and dipyridamole. Newer glycoprotein IIb/IIIa inhibitors that block platelet receptors. Newer antiADP drugs |
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Definition
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Term
| These are prophylactic drugs that inhibit the production of thrombin. Early on you could take heparin via IV and later you can take warfarin (coumadin) orally (effect of vitamin K) |
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Definition
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Term
| Use __ with pts on beta blockers |
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Definition
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Term
| Monitor INR with pts on these types of meds |
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Definition
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Term
| Antiplatelet and anticoagulants may be used post-MI to prevent what? |
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Definition
| Further injury especially for pts who did not get to the hospital in time for clot-buster meds |
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Term
| What all should medications do to help with heart failure (9) |
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Definition
1. Restore balance of work required and strength of heart
2. Break vicious cycle of dilation and weakness
3. Diuretics
4. Positive ionotropic drugs
5. Vasodilators
6. Calcium-channel blockers
7. ACE inhibitors
8. Morphine
9. Beta Blockers |
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Term
| This type of medication helps to decrease blood volume which decreases the load on the heart so that it has less pressure to work against. |
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Definition
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Term
| This medication can be used acutely for pulmonary edema or chronically for maintenance |
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Definition
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Term
| Name 4 side effects of diuretics |
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Definition
Dehydration
Hypotension
Hypokalemia
Hyperuricemia |
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Term
| What is a popular positive ionotropic drug? |
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Definition
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Term
| This medication increases intracellular calcium and also decreases HR and conduction (may be used for atrial fibrillation). |
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Definition
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Term
| This drug comes with a high risk of toxicity, nausea, fatigue, confusion, arrhythmia. Can be used chronically |
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Definition
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Term
| These type of drugs are used in critical care and given parenterally to increase contractility and BP. |
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Definition
1. Sympathomimetic
- Dopamine (inotropin) for hypotension
- Dobutamine (dobutrex) for selective beta 1
2. Amrinone (incor) and milrinone (primacor)
- Decreases breakdown of cyclic AMP
- Increases effectiveness of dopamine and dobutamine |
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Term
| These medications decrease the work of/on the heart. They work as smooth muscle relaxants. They include arterial dilators to reduce afterload and venous dilators to reduce preload. Both reduce systolic wall stress. |
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Definition
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Term
| Arterial dilators reduce what? |
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Definition
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Term
| Venous dilators reduce what? |
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Definition
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Term
| Name 3 types of Vasodilators |
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Definition
Venodilators
Arteriodilators
Combination |
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Term
| Give an example of a venodilator |
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Definition
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Term
| Give an example of a arteriodilator |
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Definition
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Term
| Give an example of a combination veno/arteriodilator |
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Definition
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Term
| These types of medications prevent conversion of AI to AII. Its preferred for suppressed LV function and improves diastolic function. It is not used with severly compromised renal function. |
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Definition
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Term
| In what 2 ways do ACE inhibitors effect angiotensin 2 |
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Definition
Vasocontriction
Retention of sodium and water |
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Term
| Name 5 side effects of Na Channel blockers |
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Definition
Headache
Tinnitus
Cardiac depression
GI upset
Allergic reaction (thrombocytopenic purpura) |
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Term
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Definition
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Term
| These are beta blockers that decrease the spontaneous activity due to sympathetic stimulation. They lengthen the refractory period and slow the conduction of the heart. |
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Definition
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Term
| Used for supraventricular arrhythmias or PVCs |
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Definition
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Term
| Name 3 class 2 antiarrhythmics |
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Definition
Atenolol
Labetolol
Metaprolol |
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Term
| These are K+ channel blcokers that prolong the refractory period by prolonging action potential. They slow repolarization and stabilize HR and conduction. Used for refractory V-tach and history of V-fib. |
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Definition
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Term
| AICD and catheter ablation are alternatives to this |
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Definition
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Term
| These are Ca channel blockers that decrease spontaneous depolarization of SA node and slow the conduction thru AV node. |
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Definition
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Term
| What is an example of an anti-HTN med? |
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Definition
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Term
| Anti-HTN meds inhibit the SNS. Name 3 places |
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Definition
Central
Ganglion
peripheral |
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Term
| RAAS (renin-angiotensin activating system) is also an anti HTN med. What is it? |
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Definition
ACE inbibitor
All receptor antagonist |
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Term
| What 3 things do diuretics do? |
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Definition
Decrease vascular volume
Loss of potassium
Potassium-sparing diuretics are also available |
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Term
| What do centrally-acting anti-HTN meds do? |
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Definition
-Bind to CNS autoreceptors
-Inhibit sympathetic output
-Decrease vasoconstriction |
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Term
| What do ganglionic blocker anti-HTN meds do? |
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Definition
| Prevent neurotransmission at sympathetic ganglia. Also inhibits parasympathetic transmission |
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Term
| What do peripheral blocker anti-HTN meds do? |
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Definition
| Beta blockers (reduce HR and contractility. Alpha blockers (reduce vasoconstriction) |
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Term
| These have a direct effect on vascular smooth muscle. Arterial ones reduce afterload and venous ones reduce preload. Some are only used for hypertensive crisis with monitoring because it really increases BP and you could have a stroke. |
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Definition
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Term
-HMG-CoA reductase inhibitors
-Decrease LDL (increase LDL receptor activity, inhibit cholesterol synthesis)
-Increase HDL |
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Definition
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Term
| What must you monitor closely when pts are on lipid meds or Niacin? |
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Definition
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