Relier Pairs Week 2 Cardiovascular System Diseases & Drug TherapyVersion en ligne Heart diseases Brief anatomy of cardiovascular system Drug treatments Non pharmaceutical treatments par Audree Dulnuan 1 Action potential 2 Diastolic blood pressure 3 Reading blood pressure 4 Vein 5 Feedback mechanisms 6 Repolarization 7 Artery 8 Garlic 9 Ventricles 10 Atria 11 Depolarization 12 Plant sterol esters 13 Systolic blood pressure 14 Red yeast rice 15 Alpha tocopherol (vitamin E) Receive blood brought to the heart from the veins Lowers LDL cholesterol Measures the pressure when the heart contracts & ejects blood Lowers cholesterol & improve cardiovascular health Pump blood to the lungs or other body tissues through the arteries Electrical signal that causes cardiac muscle to contract Flow of positively charged sodium & calcium ions into the cell Systolic over diastolic pressure Antioxidant for cardiovascular disease, cancer, diabetic, neuropathy Carries blood away from the heart to the body Measures the pressure when the heart relaxes & fills Capacitance, Cardiac Output (CO), Peripheral vascular resistance, renin angiotensin Treats atherosclerosis, hypertension, skin fungal infections, & some cancers Carries blood from tissues back to the heart Flow of positively charged potassium ions out of the cell 1 Alpha-blockers 2 Beta-Blockers 3 Hypertension 4 Thiazide diuretics 5 (ARBS) Angiotensin Receptors Blockers 6 (ACE) Angiotensin- Converting Enzyme 7 Direct renin inhibitor 8 Calcium Channel Blockers Beneficial in men w benign prostatic hypertrophy Ends w Pril. Hyperkalemia, hypotension Ends w Olol. acebutolol, atenolol, betaxolol, bisoprolol used in asthma & COPD Elevation of systolic blood pressure, diastolic blood pressure, or both (called the silent killer) Aliskiren (Tekturna). Diarrhea, skin rash, don’t use pregnant. Ends w Pine, injections: diltiazem, verapamil. Bradycardia, nausea, constipation. Fluid retention Lowers blood pressure by eliminating sodium & water from the body Ends w Tan. Headache, dizzy, don’t use pregnant 1 Sinus rhythm 2 Atropine 3 Beta-blockers & Calcium Channels Blockers 4 Digoxin 5 Flutter 6 Potassium channel blockers (Class III Antiarrhythmics) 7 Sodium Channel Blockers (Class I Antiarrhyttmics 8 Fibrillation 9 Bradycardia 10 Arrythmia 11 Tachycardia Also used w hypertension & arrhythmias Increased heart rate Ends w ide. Reserved for life threatening arrhythmias. Deviation from normal sinus rhythm Select portions of the heart beat slightly out of sequence Used in atrial flutter or fibrillation. Antidote is DigiFab Ends w one. Amiodarone: fatal toxicities to lungs, liver & heart. Dronedarone: not used w symptomatic heart failure Low dose may worsen bradycardia, high dose may increase heart rate too much Normal heart rhythm Decreased heart rate Large portions of heart beat out of sequence 1 Acute MI 2 Myocardial infarction 3 Chronic therapy 4 Ranolazine (ranexa) 5 Anticoagulants, ACE, Beta-Blockers, Calcium Channel blockers 6 Nitrates 7 Angina pectoris When cardiac muscle is deprived of oxygen long enough that cells die or infarct Medical emergency: oxygen, nitroglycerin, aspirin Also used for hypertension, arrhythmias, & Angina except anticoagulants Chest pain caused my myocardial ischemia Anticoagulants, beta blockers, ACE, antihyperlipidemics, nitrates ISDN, ISMN, nitroglycerin. Short acting: not swallowed, angina, MI. Long acting: angina attacks For chronic angina in combination w other drugs. Edema, palpitations, bradycardia 1 Hydralazine w nitrate 2 (ARNIS) Angiotensin Receptor Neprilysin Inhibitors 3 Digoxin 4 Loop diuretics 5 Heart failure 6 ACE, Angiotensin Receptor, Beta Blockers 7 Aldosterone Antagonist Sacubitril & Valsartan (Entresto). Not used pregnant, dizzy, falling Produce fast & profound diuresis by inhibiting reabsorption of sodium, chloride, & water in the kidneys Increase urine production by inhibiting the hormone aldosterone The heart is no longer able to pump enough oxygen rich blood to meet the body’s need Also used in arrhythmias & heart failure Also used in hypertension, arrhythmia, angina, & heart failure Also used in agina & MI 1 High density lipoprotein (HDL) 2 HMG-CoA Reductase Inhibitors (Statins) 3 Atherosclerosis 4 Cholesterol 5 Bile acid Sequestrants 6 Fibril Acid Derivatives 7 Omega 3 fatty acids (epanova, lovaza, vascepa 8 Ezetimibe (zetia) 9 Low density lipoprotein (LDL) Bad cholesterol Narrowing of arteries due to deposits of cholesterol & fat on their inner surfaces Ends w statin. GI upset, muscle pain/ weakness. Increases blood glucose, myopathy, rhabdomyolysis fenofibrate, fenofibric, gemfibrozil. GI upset, muscle cramps. Not used w gallbladder problem For hypertriglyceridemia. Bad breath, GI upset, caution w fish/ shellfish allergy Odourless, white, wax like, present in all animal food but not plant Cholestyramine, colesevelam. Flu like symptoms, constipation Good cholesterol Lowers cholesterol inhibits absorption in small intestines. Respiratory infections, pain in joints, caution w liver/kidney disease 1 Cerebrovascular accident (CVA) or stroke 2 Transient ischemic attack (TIA) 3 Embolus 4 Thrombus 5 Hemorrhagic stroke 6 Ischemic stroke 7 DVT symptoms 8 Deep Vein Thrombosis (DVT) 9 Thrombolytics 10 Anticoagulants & anti platelets 11 Pulmonary embolism (PE) Blood clot that stays where it originated Dissolved formed clots Blood clot obstructs a blood vessel supplying the brain, ischemia or infarction Brief interruption in blood flow to an area of the brain Interrupts oxygen supply to a localized area of the brain A piece of cloth that breaks off & travels to the lung or blocks arteries Swelling, discolouration, pain Blood clot that circulates in the blood Reduces risk of blood clots: warfarin, heparin, aspirin, plavix Formation of blood clot in one or more deep veins Blood vessel that supplies an area of the brain ruptured, bleeding in or around the brain 1 Thrombolytic Agents 2 Vitamin K Antagonist 3 Antiplatelet agents 4 Heparin & LMWH’s 5 Direct Thrombin Inhibitors 6 Glycoprotein Antagonist 7 Mephyton Vitamin K or phytonadione 8 Dabigatran (pradaxa) 9 Factor Xa Inhibitors Injections alteplase, tenecteplase, vomiting, allergy, arrhythmias, fever Deltaparin, enoxaparin. Bruising, bleeding, antidote: protamine sulfate Clopidogrel (plavix) discontinue prior surgery risk of bleeding, ticagrelor, prasugrel Bivalirudin (angiomax) headache, nausea, bleeding & back pain High alert injections Epitifibatide: bleeding & thrombocytepenia. tirofiban: bleeding & hypersensitivity Hemorrhage, risk of thrombotic events, antidote: idarucizumab Apixaban, edoxaban, rivaroxaban. Antidote: andexanet Warfarin (coumadin) lessions, purple/blue toe syndrome, avoid alc & vitamin K Warfarin reversal
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