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Spaziani's Drugs for cardiovascular system
 

Spaziani's Drugs for cardiovascular system

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    Spaziani's Drugs for cardiovascular system Spaziani's Drugs for cardiovascular system Presentation Transcript

    • DRUGS FOR CARDIOVASCULAR SYSTEM C35-36
    • INTRODUCTION Coronary Heart Disease (CHD )  Largest killer of men and women in USA  2500 deaths per day  Although numbers are high, death rate has decreased by 36% from 1999 to 2005.  R/O CHD increases as cholesterol increases  Antihyperlipidemic & Cholesterol lowering drugs to treat 
    • RISK FACTORS FOR HEART DISEASE  Can’t Control Age  Gender  Family history (genetics)   Can Control Diet  Weight  activity 
    • INTRODUCTION CON’T Hypertension=>140/90  Untreated hypertension can lead to cardiovascular problems as well as renal and respiratory problems  Early treatment reduces risk  Antihypertensive drugs to treat 
    • INTRODUCTION CON’T Coronary Artery Disease (CAD), Peripheral Vascular Disease (PVD), Cerebral Vascular Disease (CVD)  All caused by narrowing of arteries (plaque)  Result in pain when tissues are denied oxygen  Antianginal Drugs used to treat 
    • INTRODUCTION CON’T Blockage of vessels by blood clots can occur  Can cause heart attack (MI) or Stroke  Anticoagulants, antiplatelets or thrombolytics to treat 
    • INTRODUCTION CON’T Heart Failure (CHF)  Heart fails as a pump  Higher risk over 65, Obese, & African Americans  Most common cause of hospitalization in Americans over 65  Ace Inhibitors first drug of choice  Also Cardiotonic & Inotropic drugs 
    • INTRODUCTION CON’T Conduction disorders:  Cardiac arrhythmias  Abnormally slow or rapid heart rates  Irregular heart beats  Antiarrhythmic drugs to treat 
    • ANTIHYPERLIPIDEMIC Lipids: group of fats in blood.  Cholesterol and triglycerides are two lipids in the blood  Levels of cholesterol above 240 and triglycerides above 150 associated with atherosclerosis  Atherosclerosis=condition of plaque formation (lipid deposits) in lining of blood vessels. Causes narrowing of vessel  Ateriosclerosis=thickening and loss of elasticity of the arteries (hardening of the arteries) 
    • ANTIHYPERLIPIDEMICS CON’T High triglycerides may be forerunner to diabetes  Triglycerides and cholesterol travel throughout body bound to a lipoprotein.  LDL==bad cholesterol  HD==good cholesterol  LDL cholesterol is diverse…. All through body. When cells have all the cholesterol they need, excess is discarded into blood. (results in plaques—atherosclerosis)  HDL—transport cholesterol to liver where metabolized and excreted. Good cholesterol, more condensed 
    • ANTIHYPERLIPIDEMICS CON’T Higher the HDL, lower risk of atherosclerosis  Lab test: lipid profile—  Total cholesterol (<200 optimal)  LDL (< 100 optimal)  HDL (60)  Triglycerides (<150)   Therapeutic lifestyle changes (TLC) Low cholesterol diet  Quit smoking  Weight management  30 min physical activity/day 
    • STATINS Action: Inhibit manufacture of, or increase breakdown of cholesterollower cholesterol levels  USE:  Hyperlipidemia  Prevent coronary events  Slow progression of atherosclerosis  Reduce death from stroke, MI 
    • STATINS  Side Effect: Mild  Headache  GI   CI: Serious liver disorder  Use cautiously in alcholism   Drug Names Lipitor (atorvastatin)  Prevachol (prevastatin)  Crestor(rosuvastatin)  Zocor (simvastatin) 
    • BILE ACID RESINS Bile is produced in liver  Stored in gallbladder  Emulsifies (breaks down) fats for ease of absorption into intestine  Action: bile acid resins bind to bile acid to make them “insoluble”—can’t be absorbed into intestine and systemically. Instead: secreted in feces….thereby decreasing cholesterol levels 
    • BILE ACID RESINS  Use:   Hyperlipidemia Side effects GI  Constipation  Cramps  Nausea   CI:   Biliary obstruction Drug Names  Questran (cholestyramine)
    • OTHER ANTIHYPERLIPIDEMICS Action: increase breakdown of LDL’s decrease cholesterol Use: Hyperlipidemia Side effects: GI upset Lopid (gemfibrozil) Zetia (ezetimibe)
    • NURSING PROCESS  Constipation r/t medication Cholesterol levels and liver function studies  Ongoing assessment of lab values 6 weeks to 6 months  Assess bowel function  Bile acid resins may interfere with fat-soluble vitamins (A,D,E,K) and folic acid  Avoid grapefruit juice in large amounts ( may increase risk of toxicity 
    • ANTIHYPERTENSIVES Hypertension—causes heart to work too hard, and contributes to atherosclerosis  Increases r/o heart failure, heart disease, stroke, kidney disease  Primary Hypertension:  no known cause  Linked to risk factors of diet and lifestyle   Secondary Hypertension: Known Cause Kidney disease  Tumor of adrenal glands 
    • ANTIHYPERTENSIVES  Treatment of hypertension  Weight loss Stress reduction Exercise Smoking cessation Reduction of Alcohol consumption Dietary changes Drug therapy  See p 329 in textbook      
    • ANTIHYPERTENSIVES Drug therapy  Diuretics  Beta adrenergic blockers (Beta blockers)  Calcium channel blockers  Other antihypertensives 
    • ANTIHYPERTENSIVES  Actions: adrenergic blockers, calcium channel blockers, vasodilators Lower bp by vasodilaing arterial blood vessels  Creates increase in lumen  Allows blood to circulate  DIURETICS:  Act by increasing excretion of sodium  Ace Inhibitors act by suppressing the renin-angiotensinaldosterone system   USE: treatment of hypertension
    • ANTIHYPERTENSIVES  Side Effects: Dizziness  Hypotension (orthostatic) 