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HSC116 > Module 6: Cardiovascular (Angina and HF) > Flashcards

Module 6: Cardiovascular (Angina and HF) Flashcards

(63 cards)

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1
Q

Side effects of nitrates?

A

Headache
Hypotension
Reflex tachycardia

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2
Q

How can headache (adverse effect) from Nitrate be treated?

A

Analgesics - acetaminophen

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3
Q

Does the headache from nitrates remain forever?

A

No, it diminishes over time.

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4
Q

What are the therapeutic uses of nitrates?

A
  • to relieve an attack (when attack begins)
  • to prevent an attack (before attack is expected)
  • to decrease the number of attacks (used regularly on a long term basis)
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5
Q

In what forms can nitrates be administered?

A 
Sublingual/oral
Spray
Patch
Paste 
IV
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6
Q

What drug do nitrates interact with?

A

Sildenifil (viagra)

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7
Q

How does sildenifil (viagra) interact with nitrates? Side effects?

A

Inhibits cyclic GMP.

Intensifies nitrates = severe vasodilation = life threatening hypotension

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8
Q

What do nursing have to watch for in patients using nitrates?

A

Blood pressure

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9
Q

Types of beta blockers and their functions?

A

B1 - HEART = decreases heart rate and contractility

B2 - LUNGS = bronchoconstriction

(Some drugs are more selective for B1, therefore reduced risk of bronchoconstriction)

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10
Q

What are the various uses of beta blockers?

DAMP H3

A 
Dysthymias
Angina
Myocardial infarction
Pre/eclampsia
Hypertension 
Heart failure 
Hyperthyroidism
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11
Q

What are the adverse effects of beta blockers?

everything slow (HR, BP, BR =?)

A

Bradycardia
Hypotension
Bronchoconstriction
Fatigue

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12
Q

How are beta blockers administered?

A

IV (faster onset)

ORAL

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13
Q

Prefix for beta blockers?

A

lol

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14
Q

What do non-selective beta blockers do?

A

Block both B1 and B2 receptors

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15
Q

What do selective beta blockers do? And what are they also referred as?

A

Block only B1 receptors and known as cardio-selective

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16
Q

What do calcium channels do?

A

Regulate function of the myocardium, the sinoatrial node(SA), and the atrioventricular node (AV)

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17
Q

What is the function of CCBs?

A

Block calcium channels - prevents calcium ions from entering cells.

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18
Q

What desired effects do CCBs produce? How does channel blocking help in patients experiencing an angina?

A

Decrease BP
Decrease HR
Decrease electrical conduction
Decrease force of contraction

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19
Q

What is dysrhythmia?

A

Disturbance in the rate of cardiac muscle contractions or any variations from the normal rhythm or rate of heart beat.

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20
Q

What is preeclampsia?

A

High BP in pregnancy

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21
Q

What are the therapeutic uses of CCBs(calcium channel blockers)?

AMHD

A

Angina
Myocardial infarction
Hypertension
Dysrhythmias

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22
Q

What are the side effects of CCBs?

A 
Hypotension 
Bradycardia 
Dizziness 
Flushing
Contraindicated in pts with heart failure
Monitor BP, HR (<50 bpm), ECG, response
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23
Q

Various administration routes for CCBs?

A

IV and Oral

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24
Q

What is the prefix for CCBs? Are there any exceptions?

A

“ine”

Except for diltiazem, verapamil

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25
What does the “push compartment” layer on CCBs tablets do?
Allows sustained release Has a nonabsorable shell that slowly releases drug for body to absorb
26
What is heart failure?
Weakened heart muscle = unable to pump blood adequately throughout the body.
27
Does heart failure happen suddenly?
No -over time! Underlying conditions weak the organ
28
In what percentages does heart failure affect the population?
Affects 1% of ppl aged 50 and over. Affects 5% of ppl aged 75 and over.
29
What’s the mortality rate of those with heart failure?
10% of pts with heart failure die within a year. 50% die within 5 years of diagnosis
30
What is systolic heart failure?
Weak heart muscle = less blood pumped out of ventricles
31
What is diastolic heart failure?
Stiff heart muscle won’t relax normally = less blood fills in ventricles
32
Causes of heart failure?
``` Myocardial infarction Coronary artery disease Valve disease Idiopathic cardiomyopathy Viral and bacterial cardiomyopathy Myocarditis Pericarditis Arrhythmias Chronic hypertension Throid disease Pregnancy Septic shock ```
33
What is idiopathic cardiomyopathy?
Unknown cause behind weakened heart muscle that makes it harder for your heart to pump blood to rest of body
34
What is myocarditis?
Inflammation of the heart muscle. Affects heart’s electrical system = reduces heart’s ability to pump and causes rapid or abnormal heart rhythms.
35
What is pericarditis?
Inflammation of the lining outside the heart.
36
What is a septic shock?
Life threatening- when BP drops dangerously low after an infection.
37
How is heart failure clinically evaluated?
``` Symptoms Functional limitations Cardiovascular disease/risk factors Comorbid conditions Volume status ```
38
What are the initial investigations for suspected heart failure?
``` Blood work Labs Chest radiograph Electrocardiogran BNP (blood test -measures levels of protein called brain natriuretic peptide that is made by heart and blood vessels - higher than normal if you have heart failure) ```
39
How is ventricular function assessed?
echocardiogram | Radionucleotide ventriculography
40
How is suspected heart failure diagnosed?
Step 1: clinical evaluation Step 2: clinical investigations Step 3: assessment of ventricular function
41
What is ejection fraction?
It is the percentage of blood pumped out of the left ventricle with each contraction (out of the total percentage of blood in ventricle).
42
How do you calculate ejection fraction?
% of blood pumped out / total blood in ventricle
43
What is normal ejection fraction?
60%
44
What are abnormal % of ejection fraction?
``` 40-45% = mild dysfunction 30-40% = moderate 10-25% = severe ```
45
How do you measure ejection fraction?
Echocardiogram
46
Explain the basic treatment progression for heart failure?
Ace -> beta blockers -> spironolactone -> seek specialist (move if up still symptomatic)
47
If ACE inhibitors are not tolerated as treatment for heart failure what alternative should be considered?
Angiotention II receptor antagonist
48
What should be used during tx for heart failure to aid with congestive symptoms/fluid retention?
Diuretics
49
What purpose do diuretics serve during tx of heart failure?
Help control congestive symptoms and fluid retention
50
What medication should be used if pt is symptomatic despite titrating from ACE (including use of angiotention II antagonist) to beta blockers, with the use of diuretics?
Digoxin
51
When is digoxin used?
When ACE (including angiotensin II), beta blockers, and diuretics fail to provide therapeutic relief from symptoms.
52
What is atrial fibrillation? (Aka AFib or AF)
Most common type of heart arrhythmia(irregular heartbeat). Occurs when 2 upper chambers of heart experience chaotic electrical signals.
53
What medication is the first line of defense during atrial fibrillation?
Digoxin
54
What is a common symptoms of ACE inhibitors during heart failure tx? What can be done?
Severe cough. Switch to angiotention II receptor antagonist
55
Where does Digoxin come from?
Fox glove plant
56
What are the therapeutic uses of Digoxin?
Congestive heart failure | Dysrhythmias
57
How does Digoxin work?
Increases the pumping force of heart (positive inotrope) Binda to sodium pump(Na-K-ATPase) Slows conduction through heart
58
Side effects of Digoxin?
Bradycardia Nausea Vision disturbances
59
What 2 types of heart failure meds are to be careful with? Why?
Aminodarane and Verapamil Significantly increase digoxin blood levels
60
How to insure digoxin blood levels are not high?
Serum blood concentration. | Check HR prior to administration
61
What are precautions that need to be taken with Digoxin?
Check serum blood concentration for significantly high levels in blood. Check HR before administration
62
What does the increased force of contraction by the heart due to Digoxin do?
Improves circulation which leads to reduced sympathetic activity, which then reduced peripheral resistance with reduction in heart rate.
63
What does Digoxin do within the heart (AV node)?
Slows down conduction velocity through the AV node, which sccounts for its use in atrial fibrillation.

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