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51 Cards in this Set
- Front
- Back
Cardiovascular disease is an umbrella term for...
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a variety of diseases of the heart and blood vessels.
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Cardio diseases (5)
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1) Hypertension
2) Angina 3) Coronary artery disease 4) Cerehrovascular accident 5) Congestive heart failure |
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What is the leading cause of death in the US?
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Cardiovascular disease
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Is it possible for a patient to have several Cardiovascular diseases?
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Yes. And they may be on a medication for each
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How long can a cardiovascular drug be given for?
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It can often given for a lifetime.
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Congestive heart failure.
- occurs when the heart... |
- When the heart can't keep up with the body's oxygen demands.
- The pumping mechanism is inefficient due to injury to the heart muscle. - The heart can fail on the left or right side |
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Drug used to treat Congestive Heart Failure
- Example |
Cardiac / Digitalis Glycosides
EX. Digoxin (most commonly used) --> Some times perscribed with other drugs |
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Cardiac Glycosides
- Pharmacolofic effects (3) |
1) Increase force & strength of contraction of myocardium
2) Reduces edema that occurs with CHF by producing diuresis 3) Useful in treating arrhythmias |
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Cardiac Glycosides
- Uses (3) |
1) CHF
2) Atrial arrhythmias (A fib) 3) Research shows that it does not decrease mortality, --> so its use as a first line of therapy |
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Other drugs used for Heart Failure (6)
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1) Angiotensin-converting enzyme inhibitors (ACEI)
2) Angiotensin Receptor Blockers (ARB) 3) Beta adreneric blockers 4) Vasodilators 5) Diuretics 6) Aldosterone antagonists |
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ACE Inhibitors if Heart Failure
- used when? - time it take to improve symptoms - given along with what? |
- Used as first line of therapy
- Improves symptoms with in 4 to 12 weeks - Beta blockers are given at the same time. |
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Arrhythmias are...
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abnormal rhythms from abnormal impulse generation or abnormal impulse conduction
- automaticity is impacted |
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2 Ablsolute contraindications for elective treatment
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1) Acute / recent myocardio infarction within preceeding 3-6 months
2) Significant, uncontrolled hypertension. |
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Anti-arrhythmic Agents
- Fx - Drug used to treat arrythmias |
Fx - depress part of the heart that beats abnormaly
Drug - Digoxin is used to treat certain types of arrhytmias |
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Angina =
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a common CV disease characterized by...
- pain/discomfort in chest radiating to left arm/shoulder - may also radiate to the lower jaw (which can be confused as toothache) |
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Angina occurs when....
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coronary arteries do not supply enough oxygen to the myocardium
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Examples of Anti-anginal drugs (3)
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1) Nitroglycerin (used most often) or nitro-like compounds
2) Beta adrenergic blockers 3) Calcium channel blockers |
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Pharmacologic effects of anti-anginal drugs
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reduce workload of the heart by decreasing
- cardiac output - peripheral vascular resistance - or both |
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How are Anti- anginal drugs taken?
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Often taken sublingually
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Nitroglycerin-Like Compounds
- mechanism of action |
1) vasodilator (nitric oxide is potent vasodilator)
2) Reduces workload on heart by decreasing oxygen demand --> decreasing pain 3) Sublingually used to treat acue attacks w/ rapid onset |
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Nitroglycerin
- Sublingual drug - Where to find - Onset and effect lasting |
Avail (tablet or spray)
Find in emergency kit, but patient should be asked to bring their own to apts Rapid onset (few minutes) Effects lasting up to 30 mins. |
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Nitroglycerin Adverse Rxns
- occur because of... - symptoms (6) |
Occurs because of effect on vascular smooth muscle
Symptoms 1) headache 2) flushing 3) hypotension (enhanced by alcohol & hot weather) 4) lightheadedness 5) syncope 6) can produce burning/tingling under the tongue |
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Nitroglycerin
- Drug interactions - Example - Causes |
Interacts with Phosphodisterase 5 inhibitors that are used to treat ED (erectile dysfunction).
EX. Viagra, Levitra, Cialis Causes - BP to go dangerously low (movie: Somethings Gotta Give) |
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Nitroglycerin
- Storage (4) |
1) Degraded by heat / moisture; light is okay
2) Kept in glass because it can be absorbed by plastic 3) Unopened is good till expiration date 4) Expires in 3-6 months after opened |
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Calcium Channel Blockers
- Mechanism of action (2) |
1) Inhibits movement of Ca during contraction of cardiac & vascular smooth muscle
2) Vasodilation, decrease in peripheral resistance; --> decreases work of the heart |
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Calcium Channel Blockers
- Other uses other than for Heart Failure (2) |
1) arrhythmias
2) hypertension |
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Calcium Channel Blockers
- Examples (2) |
1) Verapamil
2) Nifedipine |
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Beta Adrenergic Blockers
- examples (3) |
1) propanolol
2) metaprolol 3) atenolol |
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Drugs ending in "-olol" are what type of drug?
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Beta Adrenergic Blockers
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If a patient has never had angina before this attack, they should do what?
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Go straigt to the ER
--> Send someone to accompany them. |
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Hypertension is know as?
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the silent killer
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The most common Cardiovascular disease is ?
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Hypertension
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Treatment of Hypertension (2)
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1) Lifestyle modifications
--> weight loss, exercise, healthy diet, lower alcohol consumption, smoking cessation 2) Drugs --> most patients require 1 or 2 drugs to control |
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Types of Diuretics (3)
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1) Thiazides (most common used)
2) Loop 3) Potassium Sparing |
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Diuretic Thiazides
- mechanism of action (4) |
1) Exact ation not determined
2) Work at the ascending loop of Henle in kidney 3) Reduces extracellular fluid volume initially 4) Changes sodium/calcium concentrations |
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How do NSAIDS interact with Diuretic Thiazides? (3)
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1) They reduce the effectiveness of the tiazide diuretics
2) Takes a few days for the interaction to develop --> so a few doses of NSAID can be used for acute pain 3) With long term NSAID use, BP will have to be closely monitored |
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How do NSAIDS interact with Diuretic Thiazides? (3)
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1) They reduce the effectiveness of the tiazide diuretics
2) Takes a few days for the interaction to develop --> so a few doses of NSAID can be used for acute pain 3) With long term NSAID use, BP will have to be closely monitored |
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Diuretic Thiazides
- Example (1) |
1) Hydrochlorothiazide (HCTZ)
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Diuretic Loop
- Mechanism of action (2) |
1) Inhibit reabsorbtion of sodium with concurrent loss of fluids
--> more loss than thiazides 2) Work at the loop of henly in kidney |
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Diuretic Loop
- adverse rxns - drug interaction - example |
Adverse rxns - similar to thiazides
Drug interaction - with NSAID Example - furosemide |
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Diuretic Potassium Sparing
- mechanism of action (2) |
1) Acts at a different site in kidney than the thiazide or loop
2) Designed to reduce amount of potassium loss |
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Diuretic Potassium Sparing
- example (2) |
1) Spironolactone
2) Triamterene |
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How do diuretics and potassium relate?
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Thiazides and Loops cause loss of potassium
--> the lack of potassium must be managed Potassium salts are often taken during diuretic therapy |
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Why is potassium important?
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It is necessary for...
- nerve impulses - normal renal fx - contraction of smooth muscle, cadiac muscle, and skeletal muscle |
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General types of Beta Blokers (2) for Hypertension
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1) Selective to B1 & B2
2) Non-selective |
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Beta Blockers for Hypertention
- Examples (2) & are the selective or non-selective? |
1) Propanolol
--> non-selective 2) Metoprolol --> B1 selective more than B2 selective |
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Calcium Channel Blockers for Hypertension
- mechanism of action (1) |
1) Inhibits movement of extracellular calcium into cells producing systemic vasodilation
--> reducing load on heart |
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Calcium Channel Blockers for Hypertension
- pharmacological effects (2) |
1) Smooth muscle relacation; dialation of arteries
2) Reduce heart rate and contractility |
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Calcium Channel Blockers for Hypertension
- Examples (2) |
1) verapamil
2) nifedipine |
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Calcium Channel Blocker Drugs end in...?
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"-dipine"
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Ca Channel Blockers
- drug interactions (1) |
1) Carbamazepine
--> a drug used for managing trigeminal neuralgia (sometimes used in dentistry) --> May increase toxicity from carbamazipine |