Module 5 Flashcards
(48 cards)
HTN
Hypertension = High Blood Pressure
most forms of HTN are idiopathic or “essential” - meaning the cause is not identifiable.
less than 10% caused by renal endocrine, or other abn such as morbid obesity or sleep apnea.
CAD
Coronary artery disease = coronary heart disease (CHD)
is a narrowing of the small blood vessels that supply blood and oxygen to the heart
CHF risk factors:
Congestive heart failure - causes of CHF include alcohol, pregnancy, viral…but most common cause of CHF is high blood pressure in conjuction with clogging and hardening (atherosclerosis) of the arteries (often occurs post MI)
Myocardial infarction MI
Heart attack - Permanent loss of heart muscle cause by CAD. MI is irreversible (meaning it causes scarring of the myocardium)
*leading cause of death in the US for male and female
ANGINA
ANGINA PECTORIS - heart pain caused by CAD
Angina is heart pain that is reversible - it is due to lack of oxygen to the heart muscle.
HF
Heart Failure - is a condition in which the heart fails to pump adequate a mounts of blood. HF often occurs months or years after a heart attack.
Risk factors - CHF is high blood pressure in conjuction with clogging and hardening (atherosclerosis) of the arteries (often occurs post MI)
HF prognosis
is very poor, worse than most cancers. with FH pressure builds up within the heart and fluids accumulate in body tissues
One of a patient with HF and the other of a highly conditioned athlete during competition. Which of the two have the most heart exposure to the transmitter Norepinephrine? Grandma with HF or Michael Jordan?
The answer is Grandma with HF. HF pt will be exposed to more NE “24/7” than the heart of a trained competing athlete during the period of athletic performance. High NE loads improve the hearts performance in the short term, but they are toxic if exposure is 24/7.
* The body tries to “help” the pump (heart) by releasing more NE, but it eventually remodels and destroys the heart
arrhythmia
better said as dysrhythmia - is used to describe an abn heart rate or rhythm.
ECG
is the best way to diagnose the nature of the rhythm, but not the underlying disease.
ABN of heart rhythm
- fast heart rates (tachycardia)
- slow heart rates (bradycardia)
- many weird conduction patterns and most bizarre configuration is no rhythm ast all
Dietary “Cholesterol” from
red meat, egg yolk and dairy products.
Dietary “triglyceride” from
oils, margarine, and sugar
* excess sugar is converted into triglycerides for storage
Lipid disorders
Fats are essential to good health; but eating too must fat, and of the wrong type, or having a disorder of lipids, can lead to atherosclerosis and other diseases.
Risk factors for Hyperlipidemia
are mostly genetics, poor diet both.
Initial drug therapy in treating hypertension involves prescribing an ACE-inhibitor, a calcium channel blocker, or?
A. a loop diuretic B. a cardiac glycoside C. a thiazide diuretic D. an antiarrhythmic drug E. vitamins A and D ans: C
Hypertension drugs
ACE-inhibitor/ARB, CCBs, vasodilators and diuretics.
ACE = Angiotensin Converting Inhibitor
Hypertension ladder - non drug therapy
The standard approach to treatment is a “stepped-care” or increasing complexity, starting with:
- salt reduction
- weight loss
- exercise
- smoking cessation
Diuretics
or “water pills”, through various mechanisms, promote excretion of Na+ and water by the kidneys
HCTZ
Hydrochlorothiazide is the prototype Thiazide diuretic, often used in combination with a potassium sparing diuretic.
furosemide (Lasix)
drug work for Loop Diuretics (not used for HTN)
inhibits reabsorption of Na+/H2O in the ascending loop of Henle.
Potassium Supplements
K+ as a drug is given to pt who are taking loop diuretics to avoid complications of hypokalemia.
- Oral usually given
- IV K+ usually given only in urgent situations or in the ICU
- Banana - good source of K+
Thiazides and Loop diuretics cause
loss of K+ (which we don’t have much) as well as Na+ (which we have a lot).
***loss too much of K+ can cause serious side efffects: Muscle weakness, dysrhythmias, and nerve conduction problems.
Potassium Sparing Diuretics drug
are used to help maintain blood K+ levels - drug like triamterence (Dyrenium)
