Heart Vessels And Blood

Front 1

Calcium channel blocker’s prevent calcium ions from entering cells having greatest effect on

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Heart and vessels

Front 2

calcium channel blocker, is a class IV antidysrhythmic; Adverse effects: constipation, facial flushing, HA, edema, bradycardia, AV block and decreased contractility; Drug interactions: digoxin increase AV block risk, beta-adrenergic blocker same effect, grapefruit juice: verapamil toxicity; use: essential hypertension, cardiac dysrhythmia, and angina pectoris

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Verapamil (calan, isoptin)

Front 3

Calcium channel blocker; use angina pectoris, essential hypertension, and cardiac dysrhythmias; adverse affects same as verapamil, except less constipation

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Diltiazem

Front 4

Calcium channel blocker especially to dilate vessels; Little in heart so no dysrhythmia treatment; use: angina, hypertension (investigational to suppress preterm labor)

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Nifedipine (adalat, procardia)

Front 5

Direct action on vascular smooth muscle to dilate vessels; Use: essential hypertension, hypertensive crisis and heart failure; adverse effects: reflects tachycardia, increased blood volume, systemic lupus erythematosis like syndrome

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Hydralazine (Apresoline)

Front 6

More intense vasodilation van hydralazine, therefore reserved for extreme hypertension because of adverse effects; use: severe hypertension; adverse effects reflex tachycardia, sodium and water retention, hypertrichosis (excessive hair growth), pericardial Effusion

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Minoxidil

Front 7

Use: hypertensive emergencies; adverse effects: hypertension, cyanide poisoning

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NA nitroprusside (nitropress, nipride)

Front 8

Cardiac glycosides; purple Foxclove; views: heart failure and control dysrhythmias, slows and strengthens, increases cardiac output; adverse effects: dysrhythmias (secondary to hypokalemia loss with diuretics); narrow Therapeutic range; toxic symptoms: anorexia, nausea, vomiting, fatigue, visual disturbances; monitor serum drug levels; drug interactions: diuretics, ACE inhibitors, sympathomimetics, quinidine, and verapamil; Be sure to assess apical pulse, must be greater than 60 to administer prior to administration

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Digoxin (lanoxin)

Front 9

Oldest, best studied most widely used class one antidysrhythmic, sodium channel blocker; bark of cinchona tree; Also has antimalarial and antipyretic properties; slows impulse conduction and atria, ventricles and HIS-purkinje system; Delays repolarization; strongly anti-cholinergic; blocks vagal input to heart, increasing SA node automaticity and AV conduction; widens QRS complex and prolongs QT interval; use: SVT, ventricular dysrhythmias, atrial flutter, atrial Fibrillation’s and sustained v tach

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Quinidine

Front 10

Similar to Quinidine, class I antidysrhythmic in action and use; serious side effects limit use though; to use atrial and ventricular dysrhythmias; adverse affects: systemic lupus erythematosis like syndrome, blood dyscrasias

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Procainamide (procan)

Front 11

Class 1B just rhythmic; for ventricle dysrhythmias only use IV; slows conduction and atria, vents and HIS-purkinje System, reduces automaticity, accelerates repolarization

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Lidocaine (xylocaine)

Front 12

Ben’s a pro, and now a pro, lisinopril; decrease levels of angiotensin II and bradykinin to dilate blood vessels and decrease volume; use: hypertension, myocardial infarction; adverse effects: cough, hypotension, hyperkalemia and angioedema; therapeutic action is to lower blood pressure

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ACEI – angiotensin converting enzyme Inhibitors

Front 13

A class II antidysrhythmic; use: treat dysrhythmias; adverse affects: heart failure, AV block, sinus arrest, hypotension and bronchospasm

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Propranolol (Inderal)

Front 14

Class III antidysrhythmic agent, a potassium channel blocker; only approved for life-threatening ventricular dysrhythmias as last resort, because of toxicity; adverse effects: pulmonary toxicity, pneumonitis, pulmonary fibrosis; cardiotoxicity, thyroid toxicity, liver toxicity

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Amiodarone (pacerone)

Front 15

Most effective drugs for lowering cholesterol and LDL, can raise HDL and lower TG in some patients; use: hypercholesterolemia, primary and secondary prevention of CV events, primary prevention and people with normal LDL, post MI therapy and diabetes; Actions: reduce LDL, elevate HDL, reduce GG; adverse effects: myopathy/rhabdomyolysis (muscle injury and weakness) and hepatotoxic; Drug selection: Any Staten to lower LDL by 30 to 40%, greater than 40% use atorvastatin or simvastatin

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Statins

Front 16

Reduce LDL and TG, increases HDL better than others; does little to improve outcomes

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Niacin (nicotinic acid)

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Use: acute angina attack, vasodilator; adverse effects: HA, orthostatic hypotension, reflex tachycardia; tolerance develops rapidly, used in lowest effective dosages; patches and sustained release should be intermittent; SL for acute angina: give as soon as pain begins, do not delay, call 911, Take another at 5 minutes and a third at another 5 minutes if not relieved

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Nitroglycerin

Front 18

Anticoagulant (does not dissolve clots); Rapid acting; injection only; IV Subcutaneous; suppresses coagulation, can prevent clots and prevent extension of clot; does not break down a current clot; short half-life 1.5 hours; use: pregnancy if needed, pulmonary embolism, evolving stroke, DVT, open heart surgery, renal dialysis, prevent postop venous thrombosis, adjust to thrombolytic for AMI; Adverse effects: hemorrhage, spinal/epidural hematoma, heparin induced thrombocytopenia; For overdose use protamine sulfate; Measured in units not milligrams so I: measured by blood activated partial thromboplastin time; therapeutic levels of heparin increases by 1.5 to 2 times

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Unfractionated heparin

Front 19

Low molecular weight heparin; adverse effects: bleeding, thrombocytopenia, OD treat with protamine sulfate also; very expensive; Lovenox first available in USA, more money in USA on this than any other drunk

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Enoxaparin (lovenox)

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Oldest oral anticoagulant, does not dissolve clots; prevent thrombosis; delayed onset so not an emergency, given with parenteral heparin and continued or early after heparin discontinued; uses: prophylaxis, suppresses coagulation by decreasing factors VII, IX, X And prothrombin, vitamin K is antedote; Monitor treatment with prothrombin time; results not reported an international normalized ration; adverse effects: hemorrhage; vitamin K treat severe OD; dietary vitamin K can reduce anticoagulant effects; Mayonnaise, canola oil, soy bean and green leafy vegetables; Patients should keep intake of these foods constant; patient also monitor for bleeding and do not use sharp objects such as razors electric razors are better

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Warfarin (Coumadin)

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Oral prodrug, rapid onset; No need to monitor coagulation; few drug/food interactions; Lower risk of bleeding; use: atrial fibrillation, knee/hip replacement; Adverse effects: bleeding, G.I. disturbance

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Dabigatran etexilate (Pradaxa)

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Oral anticoagulant inhibitor factor XA; use: knee and hip replacement, nonvalvular atrial fibrillation; Adverse effects: bleeding, spinal epidural hematoma

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Rivaroxaban (xarelto)

Front 23

Not for patients with peptic ulcer history; monitor for bleeding; take in definitely after myocardial infarction

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ASA antiplatelet

Front 24

Tissue plasminogen activator manufactured via recombinant therapy, thrombolytic; use: acute myocardial infarction, stroke from clot, not from ruptured aneurysm or other bleed, acute massive PE; treat within two hours of symptom onset; adverse effects: bleeding, reperfusion dysrhythmias after restoring blood flow

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Alteplase (Activase)

Front 25

Factor VIII concentrates for hemophilia A; recombinant factor VIII are agents of choice; Adverse effects: allergic reactions; does: on demand/prophylactic

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Given IV route

Front 26

Factor I X concentrates for him aphelia be given on demand; dose determined by sight and severity of bleeding

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Push at earliest sign of bleeding

Front 27

Analog of antidiuretic hormone can’t stop/prevent bleeding in patients with mild hemophilia A; and releases stored factor VIII; given nasal spray/IV infusion

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Desmopressin (stimate)

Front 28

Mostly receive through dietary: Fish meat and dairy products; necessary for cell growth and division; replacement is parenteral, it could be given orally, but for several neurologic deficit’s Parenteral administration is indicated

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Vitamin B 12

Front 29

Take with vitamin C, between meals, use straw

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Ferrous sulfate

Front 30

Produced by recombinant DNA technology; use: to treat anemia of chronic renal failure, chemotherapy induced anemia, HIV patients taking Zidovudine, Occasionally anemic patients scheduled for elective surgery; check hematocrit/hemoglobin for therapeutic effect; requires vitamin B 12, folic acid and iron to be effective so educate on increase intake of food to high in iron and vitamin C; stimulates production of RBCs

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Erythropoietin (Epogen)

Front 31

White cell growth factor produced by recombinant DNA technology; used for patient undergoing myelosuppressive chemotherapy

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Filgrastim (Neupogen)