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WVC cardiac meds &
WVC cardiac meds & rhythm values
| Question | Answer |
|---|---|
| Calcium Channel Blockers: | diltiazem, amlodipine, nacardipine, nifedipine |
| Calcium Channel blockers action: | increase myocardial oxygen supply, therefore lowering the heart rate. Calcium channel blockers cause the coronary arteries to dilate (NO CALCIUM= DILATION) (ex.diltiazem, amlodipine) |
| ACE Inhibitors: | enalapril, enalaprilat, captopril, fosinopril, moexopril, ramipril, trandolapril |
| Angiotensin-converting enzyme (ACE) inhibitors action: | block conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevents degradation of bradykinin & other vasodilatory prostaglandins. ACE inhibitors also ↑ plasma renin levels. Net result =systemic vasodilation (enalapril) |
| Nitrates: | Nitroglycerin, amyl nitrite, isosorbide dinitrate |
| Nitrates action: | ^ coronary blood flow by dilating cor.arteries & improving flow to ischemic regions, Produces vasodilation Decreases left ventricular end-diastolic pressure and left ventricular end-diastolic volume (preload); Reduces myocardial oxygen consumption |
| Beta Blockers | atenolol, carvedilol, metoprolol tartrate, propranolol |
| Beta blockers action: | Blocks stimulation of beta1(myocardial)-adrenergic receptors. Does not usually affect beta2(pulmonary, vascular, uterine)-receptor sites ( atenolol) |
| Cardiac glycosides: | digoxin |
| Cardiac glycosides Action | Increases the force of myocardial contraction; Prolongs refractory period of the AV node; Decreases conduction through the SA and AV nodes |
| Centrally acting antiadrenergics: | guanfacine, methyldopa |
| Centrally acting antiadrenergics action | Stimulates CNS alpha2-adrenergic receptors, producing a decrease in sympathetic outflow to heart, kidneys, and blood vessels. Result is decreased blood pressure and peripheral resistance, decrease in heart rate, & no change in cardiac output. (methyldopa) |
| Loup diuretics: | furosemide, bumetanide, torsemide |
| Loup diuretics Action | Inhibits the reabsorption of Na & Cl from the loop of Henle and distal renal tubule; Increases renal excretion of H2O, Na, Cl, Mg, K & Ca; Effectiveness persists in impaired renal function ( furosemide/ lasix) |
| Thizide & thiazide like diuretics: | Hydrochlorothiazide, chlorothiazide, methyclothiazide |
| Thizide & thiazide like diuretics Action | Increases excretion of Na & H2O by inhibiting Na reabsorption in the distal tubule; Promotes excretion of Cl, K, H, Mg, Ph, Ca, HCO3. ( Hydrochlorothiazide) |
| Vasodilators: | diazoxide, epoprostenol, fenoldopam, hydrALAZINE, hydralazine/isosorbide dinitrate, minoxidil (systemic), nitroprusside, papaverine |
| Vasodilator action | Directly relaxes vascular smooth muscle in peripheral arterioles. Produces ↓ in BP, reflex tachycardia and increased cardiac output; Inhibits insulin release from the pancreas and decreases peripheral utilization of glucose |
| lipid-lowering agents/ hmg coa reductase inhibitors/ statin: | atorvastatin, cerivastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin |
| lipid-lowering agents/ hmg coa reductase inhibitors/ statin action: | Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, an enzyme which is responsible for catalyzing an early step in the synthesis of cholesterol (lovastatin) |
| PR interval | 0.12-0.20 sec (up to 5 small blocks) (represents the time required for atrial depolarization) |
| P wave | deflection representing atrial depolarization |
| PR segment | segment from end of p wave to beginning of QRS complex. Electrical impulse is traveling through AV node. |
| QRS complex | 0.04- 0.10 (up to 3 small blocks) ventricle depolarization. From beginning of qrs to the J point. |
| ST segment | from j point to beginning of t-wave. Represents early ventricular repolarization. |
| T wave | represents ventricular repolarization |
| U wave | represents late repolarization. |
| QT interval | represents the total time required for depolarization and repolarization. |
| calcium channel blockers Indications | Hypertension; Angina ; SVT & rapid ventricular rates in a-flutter or a-fibrillation (ex.diltiazem, amlodipine) |
| thiazide diuretics Indications | Management of mild to moderate hypertension; Treatment of edema associated with Congestive heart failure; Renal dysfunction; Cirrhosis; Glucocorticoid therapy; Estrogen therapy (ex. Hydrochlorothiazide) |
| Nitrates Indications | Indications management of angina pectoris; treatment of CHF; treatment of acute MI; Treatment of CHF associated with acute MI (ex. Nitroglycerin) |
| hmg coa reductase inhibitors (statin) Indications | Primary prevention of CAD in asymptomatic pts. with increased total & (LDL) cholesterol and decreased (HDL) cholesterol; Slows the progression of coronary atherosclerosis (ex. lovastatin) |
| ace inhibitors Indications | management of hypertension; Management of symptomatic heart failure; Slowed progression of asymptomatic left ventricular dysfunction to overt heart failure (ex. enalapril) |
| loop diuretics Indications | Edema due to heart failure; Hypertension; hepatic impairment or renal disease (ex.furosemide/Lasix) |
| beta blockers Indications | Management of hypertension; Management of angina pectoris; Prevention of MI (ex. atenolol) |
| centrally acting antiadrenergics Indications | Management of moderate to severe hypertension (with other agents) (ex. methyldopa) |
| Coronary arteries | Right main; Left main; Left anterior descending (LAD); circumflex |
| Total lipids | 400-1000 |
| LDL | 60-80 ----geri 92-221 |
| HDL | >40 increased with geri patients |
| Triglycerides Male | 40-160 |
| Triglycerides Female | 35-135 |
| Triglycerides Geri | 55-260 |
| Cholesterol | 122-200----geri 144-280 |
| HDL/ LDL ratio | 3:1 |
| angiotensin ii receptor antagonists Indications | Hypertension (alone or with other agents) (EX. olmesartan) |
| angiotensin ii receptor antagonists Action | Blocks vasoconstrictor and aldosterone-secreting effects of angiotensin II at various receptor sites including vascular smooth muscle and the adrenal glands (EX. olmesartan) |
| angiotensin ii receptor antagonists | olmesartan, candesartan, eprosartan, irbesartan, losartan, telmisartan, valsartan |
| Potassium Sparing Diuretics: | spironolactone, triamterene |
| potassium sparing diuretics Indications | Management of primary hyperaldosteronism; Management of edema associated with CHF, cirrhosis and nephrotic syndrome; Management of essential hypertension; Treatment of hypokalemia (ex. spironolactone,) |
| Potassium Sparing Diuretics Action | Causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions by antagonizing aldosterone (spironolactone,) |
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