Term
|
Definition
CO = HR x SV
MAP = CO x PVR |
|
|
Term
|
Definition
- Renin converts Angiotensinogen to Angiotensin I
- Angiotensin Converting Enzyme (ACE) converts Ang I to Ang II, which is a very potent vasoconstrictor |
|
|
Term
|
Definition
- Aldosterone: increase reabsorption of Na+ and H+ from renal tubules to INCREASE PLASMA VOLUME
- Prostaglandins: produced in kidneys. counteract vasoconstrictive effects to ensure kidney perfusion!! |
|
|
Term
|
Definition
Smoking
Obesity
Physical Inactivity
Poor diet
Dyslipidemia
Diabetes Mellitus
Microalbuminuria (kidney dysfunction)
>55 males, and >65 females
Fam Hx of CVD |
|
|
Term
|
Definition
>60 and no other conditions = <150/90mmHg
<60 and no other conditions = <140/90mmHg |
|
|
Term
|
Definition
Diuretics
Alpha and Beta Blockers
Dual Alpha and Beta Blockers
Alpha 2 Agonists
Vasodilators
Calcium Channel Blockers
ACE Inhibitors
ARB's (angiotensin II receptor blockers)
Vasopeptidase Inhibitors
Renin Inhibitors |
|
|
Term
|
Definition
MOA: reduce plasma volume/Na+ levels by decreasing reabsorption in the kidneys.
Classes: Thiazide, Loop, Potassium sparing/aldosterone antagonists, carbonic anhydrase inhibitors |
|
|
Term
| Loop Diuretics: MOA and Drugs |
|
Definition
MOA: inhibits reabsorption of Na and Cl in ascending LoH and dist tubule
Furosemide (Lasix)
Bumetanide (Bumex) |
|
|
Term
| Loop Diuretics: Adverse Drug Effects |
|
Definition
Dehydration
Hypokalemia, Hyponatremia, Hypocalcemia (bad for patients w/renal stones)
Hyperglycemia
Increased LDL's |
|
|
Term
| Thiazide Diuretics: MOA and Drugs |
|
Definition
MOA: promote Na+ and K+ excretion and reabsorption of Ca++
Hydrochlorothiazide (HydroDiuril)
TZD-like: Metolazone (Zaroxolyn) |
|
|
Term
| Thiazide Diuretics: Adverse Drug Effects |
|
Definition
Orhostatic Hypotension
Hypokalemia
Hyperglycemia, Hypercalcemia
May increase uric acid levels
Photosensitivity |
|
|
Term
K+ Sparing Diuretics
Aldosterone Antagonist
MOA and Drugs |
|
Definition
MOA: act in collecting tubule to inhibit Na+ reabsorption and K+ excretion. Blockade of the aldosterone receptor.
K+: Triamterene (Dyrenium)
AA: Spironolactone (Aldactone) |
|
|
Term
K+ Sparing Diuretics
Aldosterone Antagonist
Adverse Drug Effects |
|
Definition
Hyperkalemia
Nausea, abdominal pain, diarrhea
Gynecomastia (Aldactone) |
|
|
Term
| Carbonic Anhydrase Inhibitor (diuretic) |
|
Definition
| MOA: inhibits CA causing the reduction of H+ ion secretion at the renal tubule resulting in similar diuretic effects to other classes. |
|
|
Term
| PT Considerations for Diuretics |
|
Definition
Hypokalemia: muscle cramps/weakness, and arrhythmias
Orthostatic hypotension: unsteady gait and fall risk (syncope)
Dehydration
Urinary incontinence |
|
|
Term
| Beta Blockers: MOA and Drugs |
|
Definition
MOA: reduce HR, contractility, PVR. blocking beta receptors leads to blocking of renin release from kidneys, decreasing ATII and aldosterone, causing vasodilation. B1 acts on heart B2 pulmonary.
Atenolol (Tenormin)
Metoprolol (Toprol/Lopressor)
Propranolol (Inderal)
Carvedilol (Coreg) |
|
|
Term
|
Definition
Bradycardia (leads to heart block)
Fatigue, dizziness
Depression, sexual dysfunction
Hyperlipidemia
Bronchoconstriction (caution w/COPD Asthma) |
|
|
Term
| PT Considerations w/patients on B Blockers |
|
Definition
| Monitoring: BP, pulse, energy level, dyspnea. |
|
|
Term
| Alpha-Blockers: MOA and Drugs |
|
Definition
MOA: vasodilation and decrease in PVR by selectively blocking alpha-1 adrenergic receptors
Doxazosin (Cardura)
BPH/Enlarged Prostate Treatment:
Tamulosin (Flomax) |
|
|
Term
|
Definition
Postural hypotension
Tachycardia
Arrhythmias |
|
|
Term
| Alpha-2 Adrenergic Agonist: MOA and Drugs |
|
Definition
| Stimulates A-2 adrenoreceptors in brain stem, activating inhibitory neuron which reduces sympathetic outflow from CNS, decreasing PVR. |
|
|
Term
| Alpha-2 Adrenergic Agonist: ADE's |
|
Definition
Rebound HTN
bradycardia
Raynaud's phenomenon
syncope
angina, CHF, EKG abnormalities |
|
|
Term
| Direct Vasodilators: MOA and Drugs |
|
Definition
MOA: works to cause relaxation of vascular smooth muscle (vasodilation of vessels)
Hydralazine (Apresoline)
Nitroglycerin (Nitrostat) |
|
|
Term
| Calcium Channel Blockers: Drugs |
|
Definition
Non-Dihydropyridine:
-Diltiazem (Cardizem)
-Verapamil (Calan/Verelan)
Dihydropyridine
-Amlodipine (Norvasc)
-Nifedipine (Adalat/Procardia) |
|
|
Term
| Calcium Channel Blockers: MOA and ADE's |
|
Definition
MOA: blockade of calcium influx into smooth muscle w/net vasodilation and decreased PVR
ADE's:
Headache, dizziness, flushing
Hypotension, bradycardia
Sweating, swelling/edema, constipation
DO NOT use CCB and BB's together because of negative inotropic effects (reduce HR) |
|
|
Term
| ACE Inhibitors: MOA and Drugs |
|
Definition
MOA: block action of ACE, blocking production of ATII
Lisinopril (Prinivil/Zestril)
Enalapril (Vasotec) |
|
|
Term
|
Definition
Cough
Hypotension
Hyperkalemia
Angioedema |
|
|
Term
| ATII Receptor Blockers(ARB's): MOA&Drugs |
|
Definition
MOA: Allow action of ACE, but block receptor by binding to ATII receptors.
Valsartan (Diovan)
Losartan (Cozaar) |
|
|
Term
| ATII Receptor Blockers(ARB's): ADE's |
|
Definition
hypotension
hyperkalemia
angioedema
NO COUGH like ACE-inhibitors |
|
|
Term
| Renin-Inhibitor: MOA and Drugs |
|
Definition
| MOA: Inhibition of renin prevents conversion of angiotensinogen to ATI (inhibits RAAS) |
|
|
Term
| PT Interventions: HR and orthostatic hypotension |
|
Definition
HR: notify physician if HR <60 bpm, monitor for reflex tachycardia
Orthostatic Hypotension: notify physician if systolic BP < 90 mmHg. Instruct patient to perform leg ext, ankle pumps, before rising from chair or bed. |
|
|
Term
| PT Interventions: Dehydration, Urinary incontinence, diuretic-induced hypokalemia |
|
Definition
Dehydration: check for skin turgor, temp, and moisture (even mucus membranes)
Urinary: annoying interruptions and increased fall risk
Diuretic-induced hypokalemia: muscle weakness or cramping which can affect therapy. |
|
|
Term
| PT Interventions: Heat, exercise performance, compliance w/lifestyle mods |
|
Definition
Heat and added vasodilation lowers BP and can cause syncope so AVOID HEAT MODALITIES!!!****
BB's, CCB's, Diuretics and vasodilators all decrease exercise performance.
ppl need to comply with medications |
|
|
