Heart & Vascular Disease Phamarcology

Question 1

Alpha Adrenergic Antagonist Agents: Action and Side Effects

Answer 1

A: reduce peripheral vascular tone by blocking alpha1-adrenergic receptors

S/E: dizziness, palpitations, orthostatic hypotension, drowsiness

Question 2

Alpha Adrenergic Antagonist Agents: Indications

Answer 2

hypertension, benign prostatic hyperplasia (noncancerous enlargement of the prostate gland)

Question 3

Alpha Adrenergic Antagonist Agents: PT Implications

Answer 3

use caution during prone-sit/ sit-stand due to risk of dizziness/ orthostatic hypotension
closely monitor pt during ther ex

Question 4

Alpha Adrenergic Antagonist Agents: Examples

Answer 4

cardura, minipress

Question 5

Antiotensin-Converting Enzyme (ACE) Inhibitor Agents: Action & Side Effects

Answer 5

A: decrease BP and afterload by suppressing enxyme that converts angiotensin I into angiotensin II

S/E: hypotension, dizziness, cry cough, hyperkalemia (abnormally high levels of potassium in the blood), hyponatremia (low sodium concentration in the blood)

Question 6

ACE Inhibitor Agents: Indications

Answer 6

hypertension, congestive heart failure

Question 7

ACE Inhibitor Agents: PT implications

Answer 7

avoid sudden changes in posture due to dizzinees/fainting from hypotension
pts w/ heart failure should avoid rapid increases in physical activity

Question 8

ACE Inhibitor Agents: Examples

Answer 8

Capoten, Vasotec

Question 9

Anticoagulant Agents: Action and Side Effects

Answer 9

A: inhibit platelet aggregation & thrombus formation

S/E: hemorrhage, increased risk of bleeding, gastrointestinal distress w/ oral meds

Question 10

Anticoagulant Agents: Indications

Answer 10

post percutaneous transluminal coronary angioplasty & coronary artery bypass graft surgery
prevention of venous thromboembolism/ cardioembolic events in pts w/ atrial fib & prosthetic heart valves

Question 11

Anticoagulant Agents: PT implications

Answer 11

therapist must be careful to avoid injury 2nd to risk of excessive bleeding/bruising
pt education regarding common S/E

Question 12

Anticoagulant Agents: Examples

Answer 12

Heparin, Coumadin

Question 13

Antihyperlipidemia Agents: Actions and Side Effects

Answer 13

A: 5 categories- most common = statins inhibit cholesteral synthesis, breakdown low-density lipoprotiens (LDL), decrease triglyceride levels, increase HDL levels

S/E: headaches, gastrointestinal distress, myalgia (pain in a muscle/ group of muscles), rash

Question 14

Antihyperlipidemia Agents: Indications

Answer 14

hyperlipidemia, atherosclerosis, prevent coronary events in pts w/ existing coronary artery disease/ diabetes/ PVD

Question 15

Antihyperlipidemia Agents: PT implications

Answer 15

aerobic exercise can increase HDL and maximize effects of drug therapy

Question 16

Antihyperlipidemia Agents: Examples

Answer 16

Lipitor, Zocor

Question 17

Antithrombotic (aka Antiplatelet) Agents: Action & Side Effects

Answer 17

A: inhibit platelet aggregation & clot formation

S/E: hemorrhage, thrombocytopenia (deficiency of platelets in the blood), potential liver toxicity w/ aspirin use, gastrointestinal distress

Question 18

Antithrombotic (aka Antiplatelet) Agents: Indications

Answer 18

post MI, atrial fib, prevent arterial thrombus formation

Question 19

Antithrombotic (aka Antiplatelet) Agents: PT implications

Answer 19

be careful to avoid injury 2nd to risk of excessive bleeding

pt education about common side effects

Question 20

Antithrombotic (aka Antiplatelet) Agents: Examples

Answer 20

Aspirin, Plavix

Question 21

Beta Blocker (Beta-Adrenergic Blocking) Agents: Actions & Side Effects

Answer 21

A: decrease myocardial O2 demand by decreasing heart rate & contractility via ß-adrenergic receptors

S/E: bradycardia, cardiac arrhythmia, fatigue, depression, dizziness, weakness, blurred vision

Question 22

Beta Blocker Agents: Indications

Answer 22

hypertension, angina, arrhythmia, heart failure, migraines, essential tremor (benign rhythmic shaking)

Question 23

Beta Blocker Agents: PT Implications

Answer 23

HR and BP response to exercise will be diminished
Rate of perceived exertion may be used to monitor intensity
Monitor pts closely during position changes due to increased risk for orthostatic hypotension

Question 24

Beta Blocker Agents: Examples

Answer 24

Tenormin, Lopressor, Inderal

Question 25

Calcium Channel Blocker Agents: Actions & Side Effects

Answer 25

A: decrease entry of calcium into vascular smooth muscle cells = diminished myocardial contraction, vasodilation, decreased O2 demand from heart S/E: dizziness, headache, hypotension, peripheral edema

Question 26

Calcium Channel Blocker Agents: Indications

Answer 26

hypertension, angina pectoris, arrhythmia, congestive heart failure

Question 27

Calcium Channel Blocker Agents: PT implications

Answer 27

Diminished HR and BP response to exercise Monitor pt when moving to upright position 2nd to dizziness/ orthostatic hypotension Observe pt for signs of congestive heart failure (worsening peripheral edema, dyspnea, weight gain)

Question 28

Calcium Channel Blocker Agents: Examples

Answer 28

Procardia, Cardizem

Question 29

Diuretic Agents: Actions and Side Effects

Answer 29

A: increase excretion if sodium & urine = reduction in amount of plasma & BP Classifications: thiazide, loop, potassium sparing S/E: dehydration, hypotension, electrolyte imbalance, polyuria, increased LDL, arrhythmia

Question 30

Diuretic Agents: Indications

Answer 30

hypertension, edema associated w/ heart failure, pulmonary edema, glaucoma

Question 31

Diuretic Agents: PT Implications

Answer 31

position changes can increase risk of dizziness/ falls due to decreased BP Monitor pts closely for signs of electrolyte imbalance/ muscle weakness/ cramping

Question 32

Diuretic Agents: Examples

Answer 32

Diuril, Lasix

Question 33

Nitrate Agents: Actions and Side Effects

Answer 33

A: deceased ischemia through smooth mouscle relaxation and dilation of peripheral vessels S/E: headache, dizziness, orthostatic hypotension, reflex tachycardia, nausea, vomiting

Question 34

Nitrate Agents: Indications

Answer 34

angina pectoris

Question 35

Nitrate Agents: PT Implications

Answer 35

pts must be educated to sit-stand SLOWLY to minimize risk of orthostatic hypotension Sublingual administration of nitroglycerin is preferred method to treat acute angina attack

Question 36

Nitrate Agents: Examples

Answer 36

Nitrostat, Nitorglycerin

Question 37

Positive Inotropic Agents: Actions & Side Effects

Answer 37

A: increase force/ velocity of moycardial contraction, slow HR, decrease conduction velocity through AV node, decrease degree of activation through Sympathetic Nervous System S/E: cardiac arrhythmias, gastrointestinal distress, dizziness, blurred vision

Question 38

Positive Inotropic Agents: Indications

Answer 38

heart failure, atrial fib

Question 39

Positive Inotropic Agents: PT Implications

Answer 39

Therapist should monitor HR during activity, teach pt & family to take pulse, seek doctor's advice for HR 100 bpm

Question 40

Positive Inotropic Agents: Examples

Answer 40

Digoxin

Question 41

Thrombolytic Agents: Action & Side Effects

Answer 41

A: facilitate clot dissolution (converts plasminogen to plasmin) S/E: hemorrhage (specifically intracranial in certain populations), allergic reaction, cardiac arrhythmia

Question 42

Thrombolytic Agents: Indications

Answer 42

acute myocardial infarction, pulmonary embolism, ischemic stroke, arterial/ venous thrombosis

Question 43

Thrombolytic Agents: PT Implications

Answer 43

be careful to avoid situations that may cause trauma due to altered clotting activity

Question 44

Thrombolytic Agents: Examples

Answer 44

Urokinase, Activase