HEART DRUGS & ECGs Flashcards
potassium-sparing diuretics that inhibit aldosterone activation
Spironolactone (Aldactone) and eplerenone (Inspra)
first-line drugs for chronic HFrEF
ACE inhibitors
ACE inhibitors block the RAAS by inhibiting the conversion of angiotensin I to angiotensin II. They reduce afterload and SVR and inhibit the development of ventricular remodeling by inhibiting ventricular hypertrophy.
MED For patients who are unable to tolerate ACE inhibitors
angiotensin II receptor blockers (ARBs) are recommended.
They prevent the vasoconstrictor and aldosterone-secreting effects of angiotensin II by binding to the angiotensin II receptor sites. ARBs promote afterload reduction and vasodilation.
directly block the negative effects of the SNS (e.g., increased HR) on the failing heart
β-Blockers
reduce symptoms of fluid overload and congestion in both HFrEF and HFpEF
Diuretics
Diuretics reduce edema, pulmonary venous pressure, and preload.
Digoxin (Lanolin)
inhibits Ca from leaving the cardiac cell which allows complete emptying of ventricles
decreases heart rate by inhibiting Na, K pump
digoxin toxicity: hypokalemia, hypercalcemia, and hypomagnesemia
Check apical HR for one minute prior to administration, hold if < 60
Normal Digoxin Level
0.5-2 ng/mL
loop diuretics
furosemide
used to treat Acute decompensated heart failure ADHF in the absence of hypotension
Vasodilators
Nesiritide (Natrecor): Recombinant form of Brain Natriuretic Peptide (BNP) that causes arterial and venous dilation.
Nitroglycerin
main effects include a reduction in pulmonary artery wedge pressure and decrease in dyspnea. Because the primary adverse effect is symptomatic hypotension, BP is carefully monitored.
Vasodilators
Nesiritide (Natrecor): Recombinant form of Brain Natriuretic Peptide (BNP) that causes arterial and venous dilation.
Nitroglycerin
primary venodilator that reduces circulating blood volume. It also improves coronary artery blood flow by dilating the coronary arteries
nitroglycerin
NTG reduces preload, slightly reduces afterload (in high doses), and increases myocardial O2 supply.
increase myocardial contractility and are used for patients with evidence of cardiogenic shock or with low CO
Inotropic agent:
Dobutamine: selective β-agonist that works mainly on the β1-receptors in the heart and does not increase Systemic Vascular Resistance
Milrinone: has both inotropic and vasodilator properties. Milrinone improves myocardial contractility, increases CO, and reduces BP (decreases afterload).
Peripheral Artery Disease (PAD) Sx
Thin, shiny, and taut skin
Loss of hair on the lower legs
Diminished distal pulses
Pallor of foot with leg elevation
Reactive hyperemia of foot with dependent position
Intermittent claudication ( ischemic muscle pain is caused by exercise, resolves within 10 minutes or less with rest, and is reproducible. The ischemic pain is due to the buildup of lactic acid from anaerobic metabolism. Once the patient stops exercising, the lactic acid clears, and the pain subsides.)
Paresthesia
Pain at rest (w/ advanced disease)
meds for Peripheral Artery Disease (PAD)
Angiotensin-converting enzyme (ACE) inhibitors
Antiplatelet agents
Aspirin (ASA)
Clopidogrel (Plavix)
are examples of
Antiplatelet agents
a type of anticoagulant (blood thinning drugs) that work by binding selectively and reversibly to the clotting factor Xa
Factor Xa inhibitors
Factor Xa plays a crucial role in the blood clotting mechanism when you get an injury by forming a mesh to prevent loss of blood. However, clots can form within the body and cause blockages in the arteries, veins, and heart causing heart attacks and stroke.
