Term
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Definition
Pathophysiology
--supply and demand: oxygen
--caronary vascular tone
-platelet aggregation-if you get it on the area of the artery=ANGINA |
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Term
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Definition
SUPPLY-coronalry blood flow, oxygen concentration, coronary microcirculation, Arterial pO2 Hgb concentration
DEMAND: Heart rate, contractility, Intramyocardial wall tension
-pressure
-volume |
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Term
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Definition
Pain Characteristics
-Quality
-location
-duration
-precipitating factors
-relieving factors
-radiation |
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Term
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Definition
-implies significant vascular narrowing
-exertion
-reproduceable with physical activity
-coronary occlusion frequently 70% or more |
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Term
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Definition
Different pathophysiology-something has changed
-clot formation or spasm
-10-15% will infarct
-change in
--intensity
--frequency
--duration |
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Term
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Definition
-Decreased oxygen demand
-Decreased wall stress
-Vasodilation
--coronary arteries
--collateral circulation
--coronary stenosis |
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Term
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Definition
| ORAL-chewable(sorbitrate), sublingual, buccal, sustained release, spray, intravenous, Topical |
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Term
|
Definition
ONSET: 1-3 minutes
DURATION: 10-30 minutes
-protect from heat, light
-keep in original container
-Expires in six months after opening
-if no relief after 3-call medical control |
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Term
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Definition
ONSET: 1-2 min
DURATION: 10-30 min
-longer shelf life |
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Term
|
Definition
ONSET: 1-2min
DURATION: 3-5 min
DOSE: start @5-10mcg/min and titrate q5min-10min
-does not require special tubing |
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Term
| Transdermal Nitroglycerin |
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Definition
ONSET: 30min
DURATION: 4-8hrs
COST: $40-45 per month
-Nitrate free interval |
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Term
ORAL Nitroglycerine
Isosorbide dinitrate |
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Definition
ONSET: 15-40min
DURATION: 2-6hrs
-metabolized to mononitrate
-COST: $5 per month generic |
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Term
Oral Nitroglycerin
Isosorbide mononitrate |
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Definition
ONSET: 15-40min
DURATION: 4-8 hrs
COST: $40 per month |
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Term
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Definition
-Hypotension
-HA
-Flushing
-Nausea
-Bradycardia
-Reflex Tachycardia |
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Term
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Definition
-Due to sulfhydryl depletion and the nitrate receptor
-Develops within 24hrs
-Nitrate Free interval: 8-12hrs |
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Term
|
Definition
Uses
-DECREASE-O2 Demand, Catacholamine induced increases in HR, BP, and contractility
-Increase ventricular volume-decrease rate allows for filling time
-May inhibit platelet activity-insignificant |
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Term
Beta Blockers
Characteristics |
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Definition
Lipophilicity-related to outside effects
-Selectivity
-all lose selectivity at high doses
ISA |
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Term
Beta Blockers
ADVERSE EFFECTS |
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Definition
Fatigue
Malaise
Depression
Impotence
Caution-DO NOT ABRUPTLY DISCONTINUE |
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Term
Beta Blockers
Patient considerations |
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Definition
| Lung disease, Diabetes, Peripheral vascular disease, heart block, CHF, Hyperlipidemia |
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Term
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Definition
| EFFECTS-Decrease oxygen demand, aterial pressure, coronary vascular resistance, Myocardial contractility |
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Term
|
Definition
EFFECTS
-Predominantly peripheral vascular effects
-Refelx tachycardia
-Decrease Left ventricular systolic pressure
-May decrease contractility and Left ventricular volume
-Vasodilator
-Decreases BP |
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Term
Nifedipine (Procardia)
ADVERSE EFFECTS |
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Definition
Dizziness, Hypotension, Peripheral edema, Flushing
DOSE: 10-30mg tid-qid |
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Term
| Verapamil, Diltiazem (cardizem) |
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Definition
EFFECTS-predominantly mycardial effects
-decreases HR, LV systolic pressure, contractility
-Verapamil depresses CONTRACTILITY more than diltiazem
-Diltiazem contraindicated in WPW-can cause reflex tacchycardia |
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Term
| Verapamil, Diltiazem (Cadrizem) |
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Definition
DOSAGES:
Diltiazem .25mg/kg initial bolus (over 2 minutes)
-Miantenance infusion-5-15mg/hr
-Verapamil 5-10mg, IV
ADVERSE EFFECTS:
Bradycardia, CHF, CP, 2nd/3rd deg AV blocks, V-fib, V-tach, dyspnea |
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