• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/60

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

60 Cards in this Set

  • Front
  • Back
What is the equation for cardiac output?
Stroke volume x HR
Stroke Volume is determined by what three things?
Myocardial contractility, afterload, preload
Heart rate is increased by the beta1-adernergic receptors and decreased by what?
The parasympathetic system via the vagus nerve
Define Cardiac Output?
Amount of blood pumped from the ventricle per minute
What is the load against which the myocardium must eject against?
Afterload
Does afterload deal w/ resistane/pressure or prefussion?
Resistance & pressure
What is the number one problem of preload?
Prefussion
Is fluid in the lungs, crackles, cough, orthopenea, COPD, JVD a afterload or preload problem?
Preload
Preload is known as the __________ applied to muscle prior to contraction, the greater the filling pressure the greater the _________?
STRETCH, CONTRACTION
How is cardiac output increased?
Increase stroke volume or heart rate
Preload is equal to End Diastolic or systolic pressure?
End Diastolic Volume
Afterload is equal to End-systolic wall stress or?
Resistance
List the four things that regulate arterial pressure in order to fastest responses to slowest?
Autonomic Nervous System (w/in seconds), Renin-angiotension-aldosterone system (days), Kidneys (days-wks), Natriuretic peptides (volume overload)
What are a protective measure for the cardiovascular system during volume overload or hypervolemia?
Natriuretic Peptides
What three things do natriuretic peptides?
Suppress rennin-angiotension-aldosterone system (BNP & ANP), inhibit myocytes, promotes dilation of arterioles & veins
How does the Renin-Angiotensin-Aldosterone System aid in regulating blood pressure, blood volume, & fluid & electrolyte balance?
Vasoconstriction, release of aldosterone
How does aldosterone regulate blood volume & blood pressure?
Aldosterone causes sodium retention & excretion of potassium & hydrogen
Can the RAAS system cause cardiac remodeling & fibrosis?
Yes, can cause hypertrophy & remodeling
What is released secondary to a decrease in blood pressure, bv, plasma sodium, or renal perfusion pressure?
Renin
What enzyme catalyzes the conversion of angiotensin I into angiotensin II?
ACE (Angiotensin-Converting Enzyme)
Why are ACE inhibitors used in tx of hypertension, heart failure, diabetic nephropathy, & myocardial infarction?
They can reduce levels of Angio II, increase levels of bradykinins, can dilate vessels, reduce BV
Can ACE inhibitors prevent or reverse pathologic changes in the heart caused by RAAS system?
Yes
Why are ACE inhibitors used to tx hypertension?
Minimal orthostatic hypotension, used in pt. w/ asthma, can exercise, no lethargy, reduce risk of cardiovascular mortality caused by HTN
What benefits do Ace inhibitors produce when txing HF?
Lower arterial tone, improve regional blood flow reduce cardiac afterload, increase cardiac output, dilate renal blood vessels
How do Ace inhibitors suppress aldosterone and local production of angio II in the heart?
Prevent or reverse pathologic changes in cardiac structures
What is the number one ACE drug?
Captopril
What drug is approved for people w/ a risk for stroke, CAD, diabetes, peripheral vascular disease?
Ramipril
What are the three main adverse effects of ACE inhibitors?
First dose hypotension, cough (persistent, dry, irritating, nonproductive), Hyperkalemia (because of the inhibition of aldosterone-causes K retention)
Nearly all ACE inhibitors are administered orally except for which one?
Enalaprilat (Vasotec)
Except for which ACE drugs can be taken w food?
With the exception for which ACE inhibitor, all have prolonged half-lives, and can be administered just once or twice a day?
Catopril
ACE inhibitors block the production of angio II, How do ARB’s effect Angio II?
ARB’s block the ACTION of angio II
Which ARB is used for hypertension?
All ARB’s are approved and have equal effects to ACE inhibitors
Which ARB is approved for Heart Failure & MI?
Valsartan (Diovan)
Which ARB is used for stroke prevention & Diabetic Nephropathy?
Losartan(Cozaar)
Name the three main adverse effects of ARB’s?
Angioedema, fetal harm, renal failure
Do ARB’s have bradykinin accumulation or problems w/ hyperkalemia?
NO
What are the two Aldosterone Antagonists used in the tx. of hypertension and heart failure?
Spironolactone & Eplerenone
What are Elerenone’s?
new class of selective aldosterone receptor blockers
Do Aldosterone Antagonists prevent or reverse pathologic effects of aldosterone on cardio structure & fxn?
THEY may
How do Aldosterone Antagonists work?
They block the receptors for aldosterone, this blockade produces retention of K & the loss of Na & H2O
How long do Aldosterone Antagonists take to have optimal results in txing hypertension?
4 weeks
How do Calcium Channel Blockers work?
Prevent Ca ions from entering the cells
Where does calcium play a critical role?
In the function of the vascular smooth muscle (regulate contraction in VSM) & heart
If Ca channels are blocked, what will happen to contraction?
Contraction will be prevented & vasodilation will result
Calcium blockade regulate the function of what three things on the heart?
Myocardium, SA node, AV node
What do Calcium Channel Blockers do to the myocardium?
Decrease the force of contraction
What do Calcium Channel Blockers do to the SA & AV nodes?
SA: decrease in heart rate, AV: decrease in velocity of conduction
What Calcium channel blocker is approved to act on vascular smooth muscle & the heart?
Verapamil
What are the adverse effects of Therapeutics?
Constipation, dizziness, facial flushing, headache, GINGIVAL HYPERPLASIA, bradycardia
What type of CCB cause significant blockade of calcium channels in blood vessels & minimal blockade of calcium channels in the heart?
Dihydropydridines
What is the drug prototype for Dihydropyridines?
Nifedipine
Dihydropyridines activate baroreceptors which causes what to occur?
Sympathetic stimulation of the heart, increases HR & contractile force
If a Dihydropyridines dilate veins, it will reduce ventricular filling and decrease what?
Cardiac preload
What CCB has selective dilation of arterioles, but no effect on veins?
Hydralazine
When is Hydralazine used?
Essential in HTN (used to lower blood pressure) & HF
What are the adverse effects of Hydralazine?
Reflex tachycardia, Increased blood volume, systemic lupus erythematosus like syndrome
What are the drug of choice for hypertensive emergencies, because they are an extremely effective vasodilator?
Sodium Nitroprusside (Nipride)
Does Sodium Nitoprusside cause venous or arteriolar dilation?
Both & does not cause reflex tachycardia
What are the two adverse effects of Sodium Nitoprusside?
Hypotension, Cyanide poisoning