10272306
Description
Flashcards by Elizabeth Then, updated more than 1 year ago
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Created by Elizabeth Then
about 7 years ago
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| Question | Answer |
| Blood pressure regulation | BP=CO X TPR |
| Angiotensin converting enzyme inhibitors | drugs which end in pril ACE= stops conversion of angiotensin 1- angiotensin 2, stops fluid retention, stops vasoconstriction, dilates bv |
| ACH inhibitor and nursing | contraindicated in renal failure, angioedema renal artery stenosis monitor bp, renal function, K concentration |
| Angiotensin converting enzyme inhibitor Adverse effects | Cough most common hypotension hyperkalaemia angioedema |
| What are risk factors of kidney impairment of ACE? | interferring with RAAS system, as increase in renin levels, decrease in blood flow |
| Angiotensin II receptor antagonists | ends in sartan similar to ACE except NO COUGH used as second line drug similar side effects to ACE expect cough and angioedema, as stops production of vasoconstrictor and aldosterone |
| Thiazide diuretics and nursing | act on distal convoluted tubule adverse affects: POSTURAL HYPOTENSION electrolyte disturbances gout contraindications: severe renal impairment |
| Thiazide diuretics | e.g. hydrochlorothiazide, indapamide effects by: diuretic effect by acting on DCT, reduces BP, and vasodilatory effect |
| Calcuim channel blockers | 3 major classes verapamil: centrally acting, reduce HR, contraction, cause constipation (do not use with beta blockers) diltiazem: effects on HR and contraction Dihydropyridines: nifedipine, amlodipine, lercanidipine peripherally actin, can cause flushing, palpitations, edema. uses: hypertension, IHD, tachyarrhythmias |
| Calcium channel blockers and nursing | diltiazem and verapamil rarely used unless for controlling heart rate some have short half lives and are given as SUSTAINED RELEASE |
| Beta blockers uses | ends in lol hypertension, reduce HR, IHD, CHF, rapid AF, essential tremor, migraine prophylaxis act on cardiac tissue, reduce, CO, HR, renin release in kidneys |
| Beta blockers adverse effects and contraindications | exacerbation of asthma, peripheral vasucular disease, bradycardia, heart block contrainidications, acute asthma (as attach to beta 2 receptor in lungs and airways), hypotension, bradycardia |
| Heart failure definition | heart incapable of insufficient blood pumping for needs of tissues at usual filling pressure symptoms: decrease co, dizziness, fatigue |
| ACE/ARB in heart failure | increase dose, until max tolerated dose to benefit pt specific to hf dose may be limited by: hyprkalaemia, renal impairment, hypotension |
| Loop diuretics | act on loop of henle in nephron reduction of sodium reabsorption e.g. frudimide, reduce fluid volume, which reduces fluid overload and improves symptoms, NO EFFECT IN LONG TERM |
| Beta blockers in HF | contraindicated in acute HF, but demonstrated benefit in chronic HF. |
| Loop diuretic advantages and adverse effects | Advantages: rapid onset, relief of symptoms adverse effects: polyuria, frequency, incontinence, postural hypotension, severe deafness if given IV too rapidly aim is to reduce lowest dose necessary |
| Digoxin | decreases HR very low therapeutic index adverse effects: nausea, vomiting, visual changes, cardiac arrhythmias requires digoxin concentrations |
| Aldosterone antagonists mechanism and adverse effects | spirinolactone or epleronone works on aldosterone receptor to reverse fluid retention, fibrosis, is k sparring results in diurectic effect more gradual than loop diuretic adverse effects: hyperkalaemia, dehydration, renal impairment, gynaecomastia |
| Sacubitril/valsaran- angiotensin receptor neprilysin inhibitor | new drug breaks down vasodilators by increasing blood flow should be used within 36 hours of ACE inhibitors and ARNI increase bradykini which results in increase in angioedema |
| Nitrates mechanism and adverse effects | nitric oxide peripheral vasodilation= reduce cardiac work, decrease o2 dilate coronary arterioles= increase o2 adverse effects: hypotension, headache, tolerance ( need nitrate free period, 6-8 hrs as losses effect. |
| Angina drugs | relieve symptoms acutely nitrates rapid onset prevent symptoms beta blockers, nitrates (long-acting), calcium channel blocers reduce risk of IHD anti-platelet, lipid lowering, ACE-I/ARB |
| Beta blockers and calcium channel blockers in angina | beta blockers and verapamil should be never combined (risk of heart block, HF, bradycardia) beta blocker and diltiazem, should be combined with caution usually dose titrated until symptoms resolved |
| Nitrates | short acting nitrates- GTN quick onset given in acute chest pain, sublingual, spray, IV long acting - isosorbide mononitrate, only works b/w 6-8 hrs of nitrate free period |
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