Pharmacology - Cardiac Drugs- Definitions-Olol

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hemostasis

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regulation in body systems to maintain a stable, constant condition

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anemia

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meaning "without blood", is a deficiency of red blood cells (RBCs) and/or hemoglobin. This results in a reduced ability of blood to transfer oxygen to the tissues, causing tissue hypoxia.

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erythropoiesis

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process by which red blood cells (erythrocytes) are produced

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pernicious anemia

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in pts after gastrectomy, or chronic small bowel disease, and strict vegetarians - have no gastric cells which secrete instrinsic factor to absorb B12

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thrombolytic

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Myocardial infarction
Stroke (ischemic stroke)
Massive pulmonary embolism
Acute limb ischaemia
Heparin used, but not with streptokinase - which can cause a allergic reaction if pt ever treated with it b4

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thrombus

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blood clot in an intact blood vesselSome of the conditions which elevate risk of blood clots developing include atrial fibrillation (a form of cardiac arrhythmia), heart valve replacement, a recent heart attack, extended periods of inactivity (see deep venous thrombosis), and genetic or disease-related deficiencies in the blood's clotting abilities.
Heparin/warfarin used

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embolus

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when a thrombus detaches and travels to another part of the system and causes a blockage
again Heparin/warfarin

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inotropic

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an agent which increases or decreases the force or energy of muscular contractions. Negatively inotropic agents weaken the force of muscular contractions. Positively inotropic agents increase the strength of muscular contraction.
STROKE VOLUME INCREASES

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chronotropic

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automaticity
Chronotropic drugs may change the heart rate by affecting the nerves controlling the heart, or by changing the rhythm produced by the sinoatrial node

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dromotropic

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A dromotropic agent is one which affects the conduction velocity of the AV node, and subsequently the rate of electrical impulses in the heart.[1][2]

Non-dihydropyridine calcium channel blockers such as verapamil block the slow inward calcium current in cardiac tissues thereby having a negatively dromotropic, chronotropic and inotropic effect[3]. This (and other) pharmacological effect makes these drugs useful in the treatment of angina pectoris. Conversely, they can lead to symptomatic disturbances in cardiac conduction and bradyarrhythmias, and may aggravate left ventricular failure[4].

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diuresis

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increases production of urine by the kidney

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angina

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chest pain due to ischemia (a lack of blood and hence oxygen supply) of the heart muscle

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atherosclerosis

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a disease affecting arterial blood vessels. It is a chronic inflammatory response in the walls of arteries, in large part to the deposition of lipoproteins (plasma proteins that carry cholesterol and triglycerides). It is commonly referred to as a "hardening" or "furring" of the arteries. It is caused by the formation of multiple plaques within the arteries.
treated with anticoagulants and statins

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automaticity

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In biology the term Automaticity also refers to the ability of the cardiac muscles to depolarize spontaneously, i.e without external electrical stimulation from the nervous system. This spontaneous depolarization is due to the plasma membranes within the heart that have reduced permeability to potassium (K+) but still allow passive transfer of sodium ions, allowing a net charge to build. Automaticity is most often demonstrated in the sinoatrial node, the so called "Pacemaker of the Heart." Abnormalities in automaticity result in rhythm changes.

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ectopic

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Cardiac ectopy occurs when electrical signals for a heartbeat originate in the wrong part of the heart muscle.

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arrhythmia

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group of conditions in which the electrical activity of the heart is irregular or is faster or slower than normal.

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myocardial infarction

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more commonly known as a heart attack, is a medical condition that occurs when the blood supply to a part of the heart is interrupted. The resulting ischemia or oxygen shortage causes damage and potential death of heart tissue

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cardiac glycoside agents

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Lanoxin/digoxin - increase CO decrease workload, increase Stroke volume, slows conductivity-
long half life, toxicity,

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nursing interventions to the admin of cardiac glycosides

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assess apical pulse/teach pt to take radial pulse/hold if less than 60/min
follow dig levels
check K+ and renal function studies
instruct pts to eat high K+ foods
weight daily/call MD if gain of 5lbs/wk
if pt misses a dose, instruct to take when next scheduled
honor drug holidays

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discuss factors which may predispose a patient to the admn of digitalis toxicity

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use with the elderly may already have decreased liver and renal function
has a long half life
if used with diuretics which cause hypokalemia

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discuss how the major antiarrythmic agents act to correct rhythm disturbance of the heart

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Sodium NA blockers- Quinidine sulfate - decreases the workload of the heart, decreases inotropic, chronotropic, dromotrophic
Lidocaine - decreases automaticity in the ventricles
beta adrenergic blockers- Inderal/propranolol- decrease chronotropic (HR) negative inotropic -negative conductivity, decreases renin response (beta 1), decreases glucose release (beta 2)
Calcium channel blockers- verapamil/Isoptin- dilates peripheral and coronary arteries, decreases inotropic and dromotropic, decreases workload, and increase o2 supplied to heart

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id the most common adverse effects associated with the antiarrhythmic agents

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Quinidine sulfate - diarrhea
Lidocaine- paresthesias, light-headedness, visual disturbances, hearing disturbances, confusion
cardioselective beta blockers-bradycardia, hypotension, bronchconstriction, low glucose levels, impotence
calcium channel blockers- hypotension, bradycardia, peripheral edema,

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id the meds -antiarrythmics

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Quinidine Sulfate
Lidocaine
Inderal/propranolol
verapamil/Isoptin

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nursing interventions for antiarrythmics

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Lidocaine-alleries to local anesthestics and heartblock
assess for BP, hypotension, bradycardia, pedal edema and flushing

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compare the mechanisms of action and the major classes of Antianginal agents

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they decrease cardiac workload and/or decrease O2 supply
Nitrates, Beta Blockers and Calcium Channel Blockers

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Names of the antianginal agents

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Nitroglycerin/nitrate
verapamil/Isoptin(ccb)
Inderal/propranolol(bb)

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describe the stepped-care approach to anihypertensive therapy

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goal of therapy is to decrease BP to below 140/90 with lowest amt of meds

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compare the mechanisms of action, major adverse effects and nursing implications associated with the 3 major classes of antihypertensive agents

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Ace- block enzyme action
AIIRAs block actions of angiotensin II on body cells
Beta Blocking- decreases BP by decreasing HR and contractibility
Alpha 1 blocking - decrease peripheral resistance, causing dilation of bl.vessels
Calcium channel blcoker - decreases BP by dilating peripheral vessels
alpha 2 blocking agent - dilates peripheral bl. vessels, decreases HR and BP

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Name the most common meds within the 3 major classes of antihypertensive agents

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beta blockers- propranolol/Inderal
CCB- Procardia/nifedipine
Alpha1- B - prazosin/Minipress
Alpha2- clonidine/Catapres

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ID the major therapeutic uses of diuretic agents

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decrease BP by decreasing blood volume