REHAB ESSENTIALS

Question 1

Name the three types of diuretics

Answer 1

Thiazides, Loop diuretics, potassium sparing agents

Question 2

What are the two indications for Diuretics?

Answer 2

hypertension, congestive heart failure

Question 3

Furosemide (Lasix) is an important diuretic, How does this diuretic work?

Answer 3

Loop diuretic; it works in the kidneys specifically the loop of Henley

Question 4

Spironolactone is another important diuretic – how does this drug different than other diuretics and why do some patients need it?

Answer 4

Spironolactone is a Potassium sparing agents. They reabsorb potassium when trying to get rid of sodium and water.

Question 5

Name four potential adverse effects of diuretics

Answer 5

1. Possible fluid depletion; electrolyte imbalance
2. Orthostatic hypotension
3. Weakness, fatigue
4. Confusion, mood changes

Question 6

The following are cardiac-related indications for prescribing what?cardiovascular problems
Hypertension
Angina
Arrhythmias
Heart failure
Recovery from MI

Answer 6

Beta Blockers

Question 7

the following are additional indications for prescribing this type of medication?Migraines
Reynaud’s disease
Situational anxiety

Answer 7

Beta Blockers

Question 8

These types of drugs try to lyse (break up) activity in the SNS. They are responsible for stimulating the heart and causing constriction of blood vessels.

Answer 8

Sympatholytics: Beta Blockers

Question 9

these drugs bind to heart, block effects of epinephrine (adrenaline) and norepinephrine (noradrenaline)
Decrease heart rate and contraction force
Can also produce a more general decrease in sympathetic responses (sympatholytic effect)

Answer 9

Beta blockers

Question 10

What suffix do beta blockers typically have on their generic name?

Answer 10

Common beta blockers:
“-olol suffix”

Question 11

What makes them cardio-selective vs. non-selective is?

Answer 11

How much affinity they have for the beta-1 subtype of receptor

Question 12

The beta-1 subtype predominates where?

Answer 12

on the heart

Question 13

Cardioselective drugs have a higher affinity for what type of receptor?

Answer 13

higher affinity for beta-1 receptors

Question 14

Beta-2 receptors are found predominantly where?

Answer 14

on the lungs

Question 15

Nonselective drugs bind more equally to what?

Answer 15

heart and lunges

Question 16

name the four rehab concerns related to the adverse effects of beta blockers:

Answer 16

1. Can cause bronchoconstriction, especially if used by someone using a nonselective drug and likely already has a bronchoconstrictive disease (e.g. asthma, COPD)
2. Can cause orthostatic hypotension, common in any drug that is used to lower blood pressure
3. Psychotropic effects (depression, lethargy, decreased libido), especially in older men
4. Decrease maximal exercise capacity

Question 17

General rule, What will reduce maximal heart rate about 20-30 beats per minute?

Answer 17

beta blockers

Question 18

How do alpha blockers work to decrease the work of the heart?

Answer 18

Alpha blockers block the Alpha-1 receptor on blood vessels and smooth muscle, causing vasodilation

Question 19

How do presynaptic adrenergic inhibitors, like Reserpine, work to decrease the work of the heart?

Answer 19

Inhibit the release of norepinephrine at the arteriole, reducing pressure in the arterial system

Question 20

Vasodilators are also indicated for hypertension and congestive heart failure. How are these drugs different from beta-blockers and diuretics in terms of their mechanism of action?

Answer 20

Vasodilators act directly on vascular smooth muscle and inhibit contraction. Beta Blockers bind to heart

Question 21

What are the 4 adverse effects that might occur as a result of vasodilator usage and why do these occur?

Answer 21

1. reflex tachtycardia
2. orthostatic hypotension
3. dizziness, headaches
4. edema, fluid retention

Question 22

What is the effect of chronic overactivity of the renin-angiotensin system on blood pressure and on blood vessels?

Answer 22

Causes increased BP, damage to CV system and kidneys

Question 23

ACE inhibitors are an important treatment for hypertension and congestive heart failure. How do they work?

Answer 23

Angiotensin Converting Enzyme (ACE) inhibitors
Inhibit the angiotensin converting enzyme (ACE)
Decrease formation of angiotensin II

Question 24

What suffix do ACE inhibitors typically have?

Answer 24

“-pril” drugs

Question 25

What is an annoying side effect of ACE inhibitors and why does this occur?

Answer 25

They produce an annoying dry cough

Question 26

Angiotensin II receptor blockers also work on the renin-angiotensin system to reduce blood pressure and ease the work on the heart. How does the efficacy of these drugs compare to ACE inhibitors?

Answer 26

May be as effective as ACE inhibitors, but have fewer side effects

Question 27

What suffix do angiotensin II receptor blockers typically have?

Answer 27

“-sartan” drugs

Question 28

what are the 3 indications for calcium channel blockers?

Answer 28

1. Hypertension 2. Angina pectoris 3. Arrhythmias

Question 29

What is the mechanism by which calcium channel blockers work?

Answer 29

Calcium channel blockers limit the entry of calcium into vascular smooth muscle and cardiac muscle

Question 30

The first three calcium channel blockers were developed, and most common still: Diltiazem (cardizem), Verapamil (Calan, Isoptin), Nifedipine (Adalat, Procardia) what suffix is typically used for these drugs now?

Answer 30

“-ipine” type drugs

Question 31

What are the adverse effects of calcium channel blockers and why are these effects observed?

Answer 31

1. Swelling in feet, ankles 2. Orthostatic hypotension 3. Altered heart rate 4. People that don’t have arrhythmia could develop arrhythmias