Cardiovascular System 2

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angina pectoris: pain and pressure in the chest caused by a lack of proper blood flow and oxygenation to the heart muscle
Arrhythmia: Irregular heartbeats resulting from a malfunction in the conduction system
Arteriosclerosis: A disease of the arterial vessels resulting from thickening, hardening, and loss of elasticity in the arterial walss
artherosclerosis: a form of artheriosclerosis resulting from cholsterol-lipid calcium deposits in the walls of the arteries
Conjestive heart failure (CHF): a condition in whic the heart is unable to pum the amounts of blood needed to meet the requirements of the body
Coronory artery disease (CAD): A term used to describe blood vessels disorders that affect the coronary arteries:
Hyperlipidemia: high or excessive amounts of lipid (fat) in the blood that leads to arteriosclerosis and atherosclerosis
Hypertension: high blood pressure: considered to be >140/90 mm Hg over several readings
myocardial infarction: an even in which part of the heart muscle dies because of an interuption or cessation of blood flow
prehypertensive state: BP in the range of 120/80 to 140/90
thrombosis: the formation of a blood clot within the vascular system
name conditions that can lead to hypertension?: heart condition
hyperthyroidism
kidney conditions
name risk factors that can lead to hypertension?: primary: genetic, age, gender, race
secondary: lifestyle, diet, anxiety, alcohol consumption, sodium intake
what is drug action of bile acid sequestrants?: bile acid sequestrants increase the loss of LDL through increased defacation.
bile acid sequestrant cholstryamine: Questran
route: po (powder)
dose: 4g qd or bid
action: bile acid sequestrants increase the loss of LDL through increased defacation.
>>constipation, flatulence
do not chew or crush tablets
Tk ac
bile acid sequestrant colestipol: Colestid
route: po
dose: 5-30 q qd (may be given in divided doses)
action: bile acid sequestrants increase the loss of LDL through increased defacation.
>>constipation, flatulence
do not chew or crush tablets
Tk ac
What are HMG-COA reductase inhibitors referred to as?: the HMG-COA reductase inhibitors are referred to as statins.
Name drug action of statins or HMG-CoA reductase inhibitors?: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
what is the overall effect of statins or HMG-CoA reductase inhibitors?: statins or HMG-CoA reductase inhibitors raise the rate of HDL and lower the LDL and VLDL cholesterol levels.
HMG-CoA reductase inhibitor lovastatin: Mevacor
ind: antihyperlipidemic
route: po
dose: 10-80 mg qd in single or divided doses
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
>>photosensitivity, GI upset
Tk c meals
HGA-CoA reductase inhibitors simvastatin: Zocor
ind: antihyperlipidemic
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
route: po
dose: 5-40 mg qd
HGA-CoA reductase inhibitor pravastatin: Pravachol
ind: antihyperlipidemic
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
route: po
dose: 10-40 mg qhs
>>photosensitivity
HGA-CoA reductase inhibitor atrovastatin: Lipitor
ind: antihyperlipidemic
action: HMG-CoA reductase inhibitors or statins inhibit an enzyme responsable for one of the first steps in the overall conversion of fats into cholesterol
route: po
dose: 10-80 mg qd
>>photosensitivity
Name drug action of fibric acid antihyperlipidemics?: fibric acid antihyperlipidemics work by inhibiting the extraction of free fatty acids, which reduces the liver's ability to produce triglicerides. this agent also increases HDL.
fibric acid antihyperlipidemic gemfibrozil: Lopid
route: po
dose: 600 mg po bid before morning and evening meals
action: fibric acid antihyperlipidemics work by inhibiting the extraction of free fatty acids, which reduces the liver's ability to produce triglicerides. this agent also increases HDL.
>>dizziness, blurred vision
miscellaneous antihyperlipidemic nicotinic acid: Niaspan (legend)
Niacin (OTC) [read package insert for dose]
route: po
dose: 1-2g tid c meals or pc
>>photosensitivity
name drug action of antiarrhythmic agents: all antiarrhythmic agents work on the conduction system in the heart to produce regular heartbeats.
antiarrhythmic agent quinidine sulfate, quinidine gluconate: Quinidex (po)
Quinalan (IV)
ind: tacycardia and other arryhthmias
route: po, IV
dose: 200-300 mg tid to qid
action: all antiarrhythmic agents work on the conduction system in the heart to produce regular heartbeats.
>>GI upset
do not crush or chew sustained-release tablets
Tk c food
Tk utd
ATTENTION: explain the difference between quinine and quinidine: quinine: antimalarial agent

quinidine: cardiac aget
antiarrhythmic agent procainamide: Pronestyl
route: po, IM, IV
action: slow down the speed of heart conduction
ind: tachycardia and other arrhythmias
inj form used in life threatening tachycardia events.
dose: tbd by dr. based on weight and age of patient
Tk utd
antiarrhythmic agent diospyramide: Norplace
route: po, inj
action: slows down the heart, inj form used in life-threatening tachycardias
dose: 100-200mg q6h or 300-SR q12h
>>dry mouth, dizziness, difficulty urinating, constipation, blurred vision
Do not break or chew tablet
Tk utd
antiarrhythmic agent lidocaine: Xylocaine
ind: acute mgmt of ventricular arrhythmias
route: inj, IV
dose: for IV, 50-100 mg at a rate of 25 to 50 mg/minute
kept in ER crash carts. used in code blue situations.
name common treatment options available to Americans suffering from CHF?: digoxin and diuretics.

diuretics releive edema often associated with CHF
explain the 4 steps of controlling HBP?: step 1: weight reduction
ACE inhibitors
Beta-blockers
Calcium channel blockers
Diuretics

step 2: adrenergic blockers

step 3: vasodilators
Angiotensin converting enzyme agent (ACE Inhibitor) enalapril: Vasotec
ind: mild to severe HTN
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po, IV
dose: 10-40 mg qd or bid prf HTN
Tk utd
>>HA, hypotension, nausea, vomiting
Angiotensin converting enzyme agent ACE inhibitors lisinopril: Prinivil, Zestril
ind: hypertension
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po
dose: 20-40 mg qd or bid
>>HA, hypotension, nausea, vomiting
Angiotensin converting enzyme agents ACE inhibitors benazepril: Lotensin
ind: hypertension
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po
dose: 20-40 mg qd or bid
>>HA, hypotension, nausea, vomiting
angiotensin converting enzyme agents ACE inhibitors captopril: Capoten
ind: HTN
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
route: po
dose: 25 mg bid or tid
Tk ac
>>HA, hypotension, nausea, vomiting
angiotension converting enzyme agents ACE inhibitors fosinopril: Monopril
ind: hypertension
route: po
action: ACE inhibitors reduce BP by causing a decrease of pressure in the arteries.
dose: 20-40 mg qd
Tk ac
>>HA, hypotension, nausea, vomiting
angiotensin II receptor antagonist losartan: Cozaar
ind: HBP
action: inhibit the affects of angiotensin II receptors located in vascular muscle which reduces BP via antagonistic effects on vasoconstriction
route: po
dose: 50mg qd
Tk utd
Angiotensin II Receptor Antagonist valsartan: Diovan
ind: HBP
action: inhibit the affects of angiotensin II receptors located in vascular muscle which reduces BP via antagonistic effects on vasoconstriction
route: po
dose: 80-320mg qd
Tk utd
beta-blocking agents atenolol: Tenormin
ind: HTN, angina pectoris, after MI
action: block various enzymes that can cause HBP, including epinephrine
route: po, IV
dose: 50 mg qd
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea
beta-blocking agents propranolol: Inderal
ind: HTN, angina, arrhythmias and migraines
action: block various enzymes that can cause HBP, including epinephrine
route: po, IV
dose: for hypertension 40mg bid
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea
beta-blocking agents metoprolol: Lopressor
ind: hypertension, angina pectoris, arrhythmias
route: po, IV
action: block various enzymes that can cause HBP, including epinephrine
dose: po 100-450 mg bid or tid
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea
beta-blocking agent pindolol: Visken
ind: hypertension
route: po
action: block various enzymes that can cause HBP, including epinephrine
dose: max. of 60 mg qd
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea
beta-blocking agent acebutolol: Sectral
ind: hypertension, ventricular arrhythmias
route: po
action: block various enzymes that can cause HBP, including epinephrine
dose: 400-800mg qd
Tk utd
those with asthma or respiratory problems should take beta-1 specific agents as beta-2 agents can affect respiratory function.
>>dizziness, hypotension, diarrhea
calcium channel blockers diltaziem: Carziem CD
ind: angina pectoris, chronic stable angina, essential hypertension
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po, IV
dose: po for HTN, 180-360 mg qd in divided doses tid or qid
Tk utd
do not crush or chew extended release tablets
>>dizzy, drowsy, blurred vision
calcium channel blockers nifedipine: Procardia, Adalat
ind: chronic stable angina, HTN
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po
dose: for HTN 30 or 60 mg qd
Tk utd
do not chew or break extended release tablets
>>dizzy, drowsy, blurred vision
calcium channel blockers verapamil: Calan, Isoptin
ind: angina, chronic atrial flutter, or fibrillation, essential hypertension
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
dose: po for HTN 80mg tid; for SR formulation 120mg or 240mg qd
Tk c food
Tk utd
>>dizzy, drowsy, blurred vision
calcium channel blockers amlodipine: Norvasc
ind: HTN, chronic stable angina, variant angina
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po
dose: for HTN, 5-10 mg qd
Tk utd
>>dizzy, drowsy, blurred vision
calcium channel blocker felodipine: Plendil
ind: HTN
action: decrease calcium intake by the heart and blood vessels resulting in slowed heart rate, and reduced stress on heart muscle
route: po
dose: 2.5 to 10 mg qd
Tk utd
do not crush or chew tablet
>>dizzy, drowsy, blurred vision
name agents commonly used to treat anginal attacks?: nitrates, calcium channel blockers, beta-blockers
anticoagulant heparin: Liquaemin
ind: decrease clotting factor in blood
route: IV, SC (only inj forms)
>>possible hemmorhage (prethrombin time (PT) tests must be done to monitor how long it takes the blood to form clots when on this medication
antidote: phtonadione inj (vit K)
anticogulant warfarin: Coumadin
ind: reduce clotting factor of blood
route: po, IV
>>possible hemmorhage; prethrombin time (PT) tests must be done to monitor how long it takes the blood to form clots when on this medication
antidote: phtonadione inj (vit K)
antiplatelet agent aspirin: aspirin
ind: reduce the arterial thrombi of blood
route: po
dose: 81 to 325 mg qd
action: work mainly on arterial thrombi which are made of platelet aggregates
antiplatlet agent dipyridamole: Persantine
ind: reduce the arterial thrombi of blood
action:work mainly on arterial thrombi which are made of platelet aggregates
dose: 75 to 100 mg qid
route: po
antiplatelet agent ticlopidine: Ticlid
ind: reduce the arterial thrombi of blood
action: work mainly on arterial thrombi which are made of platelet aggregates
route: po
dose: 250 mg bid with food
antiplatelet agent clopidogrel: Plavix
ind: reduce the arterial thrombi of blood
action: work mainly on arterial thrombi which are made of platelet aggregates
route: po
dose 75 mg qd
thrombolytic streptokinase: Streptase
ind: thrombolism
action: enzyme extracted from bacteria destroys clots after they are formed
used in ER dept ASAP after MI to break up clot
thrombolytic urokinase: Abbokinase
ind: thrombolism
action: lytic agent retrieved from a human protein that reduces thrombolism
thrombolytic alteplase: Activase, tPA
ind: thrombolism
action: natural enzyme that is normally produced by body to dissolve blood clots

>$1000/dose

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