Term
| What are the most common cardiovascular diseases? |
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Definition
-Congestive heat failure
-hypertension
-angina
-arrythmias
-myocardial infarction (blood clots in coronoary arteries) pulmonary emboli and deep vein thrombolism
-atherosclerosis |
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Term
| What is congestive heart failure? |
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Definition
*a complex condition characterized by a weakened heart
*systolic dysfunction-cardiac contraction is impaired or weak
*Diastolic dysfunction- relaxation of the heart is impaired and abnormal filling of the heart
*failure of the heart to pump enough blood to the peripheral organs
*peripheral organs receive low blood flow, reduced oxygen and nutrients which may lead to organ damage
*in some individuals, fluid backs up in the lung, resulting in pulmonary congestion; fluid congestion may also develop in peripheral organs
*the wall of the heart becomes thin-volume in more than normal |
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Term
| What are the signs and symptoms of CHF? |
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Definition
*shortness of breath
*fatigue
*not being able to walk well |
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Term
| How does the body try to compensate for the low blood pressure and organ blood flow? |
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Definition
*the sympathetic nervous system increases circulating catecholamines to increase heart rate, force of contraction, increase vasoconstriction to elevate blood pressure in an effort to increase blood flow
*the kidney senses low pressure and releases renin which activates "Angie" and "Al" who come to the rescue. Renin stimulates the liver to release angiotensin I htat is converted to angiotensin II ("angie") in the lungs by angiotensin converting enzyme (ACE). Angiotensin II is a potent vasoconstrictor which increases pressure. AngII also activates aldosterone to conserve sodium and water which increases blood volume to elevate blood pressure and flow. "Angie" stimulates remodeling and thickening of the heart.
*however, these compensatory mechanisms worsen the heart failure overtime. |
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Term
| What drugs are used to treat congestive heart failure? |
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Definition
First Line of Therapy: "PRILS" (ACE)inhibitors or "ARBs" (Angiotensin II receptor blocker) + DIURETIC
may add
*"Dig" Digoxin
*"OLOLs" Beta Blockers
*Spironolactone
*Vasodilators |
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Term
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Definition
| Angiotensin Converting Enzyme Inhibitors |
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Term
| What is the goal of "PRILS"? |
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Definition
| to inhibit the renin-angiotensin 1 - angiotensin II cycle by inhibiting the conversion of ang I to ang II |
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Term
| What is the prototype of "PRILS"? |
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Definition
| captopril (Capoten)- short half life |
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Term
| What is a longer acting "PRIL"? |
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Definition
| enalapril (Vasotec) administered once a day. take on empty stomach |
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Term
| What are the therapeutic effects of "PRILS"? |
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Definition
*decrease mortality
*improve cardiac function by retarding cardiac remodeling
*inhibit ang II vasoconstriction: dilate resistance vessels, reduce afterload or workload on the heart, increase perfusion of organs; dilate veins and reduce preload on the heart
*inhibit ang II induced aldosterone release which decreases blood volume by increasing fluid and sodium loss |
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Term
| What are the adverse effects of "PRILS"? |
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Definition
low incidence
*dry hacking cough, 10-20% more common in women
*hyperkalemia
*neutropenia
*renal damage (monitor for increased creatinine)
*captopril also produces tachycardia, gastric irritation, proteinuria, rash
*enalapril also produces headache, dizziness, fatigue, nausea, diarrhea, decreased hematocrit |
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