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38 Cards in this Set
- Front
- Back
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in heart failure what can no longer meet the metablic demands of the body?
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cardiac output
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what are some major signs of heart failure?
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cardiomegally- enlargement of the heart.(hypertrophy)
gallop rythm (s-3). normal heart has two beats at a time. This is when the heart beats 3 times. hematomegaly-enlarged liver splenomegaly-enlarged spleen peripheral edema-swelling of tissues. ascites-accumulation of fluid in the peritoneal cavity. |
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what are symptoms of right-sided heart failure (chronic)
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anorexia and nausea, pain in upper right quadrant, oliguria during day (low out put of urine) and polyuria( excessive urine) at night.
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what are some symptoms of left sided heart failure (acute)
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dyspnea (shortness of breath)
orthopnea (shortness of breath when lying flat) paroxsmal nocturnal dyspnea- sudden, severe shortness of breath at night that awakens a person from sleep, often with coughing and wheezing. |
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in addition to lifestyle modifications, what are some drug classifications that can be used to treat heart failure?
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diuretics (All diuretics increase the excretion of water from bodies).
cadiac glycosides (ability to increase cardiac output by increasing the force of contraction by increasing intracellular calcium as described below, increasing calcium-induced calcium release and thus contraction) beta blockers- or beta-adrenergic blocking agents, beta-adrenergic antagonists, or beta antagonists, are a class of drugs used for various indications, but particularly for the management of cardiac arrhythmias, cardioprotection after myocardial infarction[1] (heart attack), and hypertension. ace inhibitors-angiotensin-converting enzyme inhibitors are a group of drugs used primarily for the treatment of hypertension (high blood pressure) and congestive heart failure |
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cont. in addition to lifestyle modifications, what are some drug classifications that can be used to treat heart failure?
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angiotensin II receptor antagonists- group of pharmaceuticals which modulate the renin-angiotensin-aldosterone system. Their main use is in hypertension (high blood pressure), diabetic nephropathy (kidney damage due to diabetes) and congestive heart failure.
phosphodiasterase inhibitors- is a drug that blocks one or more of the five subtypes of the enzyme phosphodiesterase (PDE), therefore preventing the inactivation of the intracellular second messengers cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) by the respective PDE subtype(s). beta antagonist- A bronchodilator medicine that opens the airways by relaxing the muscles around the airways that may tighten during an asthma attack or in COPD vasodilators-Agents that act as blood vessel dilators (vasodilators) and open vessels by relaxing their muscular walls |
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beta blockers are?
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in order to not cuase the heart failure to worsen we want to blocks the Sympathetic Nervous system causing bronchoconstriction, use caution for asmatic pts, also highers glucose, use caution for diabetics, also increases blood pressure.They are inoytopic negative, chronotropic negative and dromotropic negative
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what does inotropic mean?
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affect influence myocardial contractility. positve inotropic effect strengthen or increase the force of myocardia contractility.negative inotropic weaken or decrease the force of myocardial contraction.
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what is chronotropic?
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affecting the rythm of the heart by the SA Node. Positive increases he heart rate nad negative decreases the heart rate.
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what is dromotropic?
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refers to drugs that affect conduction velocity through specialized conducting tissue. Positive dromotropic action speeds conduction, while a negative dromotopic action drug delays conduction.
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what is beta agonist
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a bronchodialator medicine that opens the airways by relaxing the muscles around the airways that might tighten during an asthma attack or in COPD helps with shortness of breath.
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what is cardiac glycosides?
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treatment of heart failure. Effects caused by ability to increase cadiac output by increasing the force of contraction by increasing intracellular calcium
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what is digitalis toxicity?
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excess doses of digoxin (cardiac glycoside) over a period of time.
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what is bradycadia?
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resting heart rate of under 60 beats per min may cause cardiac arrest in some people.
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what is tachycardia?
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heart rate that exceeds the normal range for a resting heart rate could be dangerous depending on speed and type of rythm
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what is dysrythmia?
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abnormal electrical activity in the heart. heart beat may be to fast or too slow.
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what is atheriosclerosis
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hardening of arteries
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what is angiotensin II receptor antagonists?
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block angiotensin II from binding with receptor sites and as a result of lower blood pressure by inhibiting peripheral vasoconstriction.
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atherosclerosis
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accumulation of fatty deposits in the walls of the arteries.
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what are the 2 most common diseases affecting the heart?
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Congestive heart failure- the ability of the heart to pump blood is decreased so that the heart pumps out less blood than it recieves, accumulating inside the chambers causing the heart to enlarge.
Coronary artery disease- an insufficient flow of blood through the coronary arteries to the heart. |
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what is thrombus?
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is a clot in the cardiovascular system. It may be occlusive or attached to the vessel or heart wall with out obstructing the lumen
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what is embolus?
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a detached blood clot that moves through the blood stream and occludes a vessel.
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what is the atrial flutter?
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abnormal heart rythm occurs in the atria of the heart.
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what is atrial fibrillation?
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most common cardiac aryhthriam (abnormal rythm) and involves the 2 upper chambers.
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what should you do before administering a cardiac glycoside?
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take the pulse, if it is below 60 or above 100 you must hold the medication and call the doctor. Pts should wear a medic alert bracelet.
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what are signs and symptoms of digitalis toxicity?
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anorexia and nausea, bradycardia, tachycardia, gastric upset or pain, dysrhythmias and visual disturbances.
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what is the antidote of rdigitalis poisoning?
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digibind
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what is digitalization?
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is the process during which a pt gets a loading dose of digitalis to raise the blood level to the effective level. after that has been accomplished, the pt will recieve maitenance doses to maintain a therapeutic blood level.
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Blood pressure range
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Systolic/diastoly
Less than 120 and less than 80 is normal 120-139/80-89 is prehypertensive 140-150/90-99 hypertension stage 1 greater than 160/ greater than 100 hypertension stage 2 |
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Regimen for reducing blood pressure
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Ace inhibitor
Beta blocker Calcium channel blocker Diuertic |
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Diuertics in BP use what drug
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Thiazide first than spironolactone
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what drug do you uses in hypertensive crisis
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diazoxide and sodium nitropriside
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Thiazide drugs
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Cheapest on the market. Used to block kidney excretion of calcium. induce gout and worsen diabetes mellitus
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Loop diuretics
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increased NA, CL, and K excretion. Also loose large amount of magnesiu,. Used in edema, hypertension and chronic renal failure.
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loop diuretic toxicity
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hypokalemia, magnesium depletion, hyperuricemia, ototoxicity, chronic dilutional hyponatremia. Side effects dizziness, faintness, confused, convulsions and coma.
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Osmotic diuretics
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most common drug Mannitol. To make people produce urine, can kick start a kidney when it has shut down. Sucks fluid from different parts of the body. Use in post brain surgery to prevent swelling and can reduce intraocular pressure.
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Diuretics are useful when?
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heart, liver and renal failure and managing Blood pressure.
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antialdosterone drug
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spironolactone (adactone) Helps you retain potassium, help control BP. Toxicity is gynocomastia, hyperkalemia and gi disturbances.
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