Lipids & Cardiovascular Disease
What are etiology of cardiovascular disease
Genetics
Lifestyle
Diet
Lack of exericise
What are factors that determine blood pressure?
Cardiac output - volume of blood pumped per minute
Stroke volume
Heart rate
Diseases associated with HF
CAD, Valvular HD, MI, Chronic HTN, Congenital HD
Most common type of angina
Classic (stable)
What are interventions for someone on anticoagulation therapy?
vital signs, PT/PTT, signs of bleeding, educate on use of electric razors, avoid aspirin
Hold pressure on wound for 5-10 minutes
What are normal cholesterol levels
less than 200 mg/dl
Non-pharmacologic treatment for HTN?
Reduce alcohol, change diet, exercise, stop smoking, reduce stress, weight management
Non pharmacologic methods to treat HF
Weight loss w/exercise
Stop smoking
Restrict fluids
Reduce alcohol intake
Change diet limiting trans/saturated fats
Pharmacologic methods of angina
Nitrates, beta blockers, CCB
What foods should be avoided for someone on anticoagulation therapy?
Vitamin K rich foods
tomatoes, dark leafy greens, bananas
What is titled "good cholesterol"
High Density Lipoprotein (HDL) due to high protein content
What are complications of Ace Inhibitors (enalapril & captopril)?
Hyperkalemia
Rash
Angioedema (give epinephrine & stop medication)
Cough (stop medication)
Neutropenia (notify provider at first sign of infection)
What is afterload?
the amount of pressure the aorta needs to overcome to eject blood from the LV
What is the most common symptom of someone taking nitro
headache
Labs to monitor while on warfarin (Coumadin) therapy?
PT & INR, liver enzymes
What labs should be monitored while taking statins?
HDL, LDL, VLDL, AST, ALT, CK
Complications of ARB's (losartan)
Angioedema
Fetal injury (2nd & #rd trimester) Category D
HYPOtension, dizziness
Complications of digoxin (Lanoxin)
Dysrhythmias (monitor K+)
GI: N/V/AP
CNS: fatigue, blurred vision
Interactions with nitrates
Alcohol
Sildenafil
Antihypertensive medications
Interactions with clopidogrel (Plavix)?
NSAID's, heparin, warfarin, PPI's decrease effectiveness
Can pregnant women use statins?
NO! Pregnancy Cat X!
Interactions of CCB's (verapamil, nifedipine, diltiazem)
Grapefruit juice leads to toxicity
Increases digoxin levels = dig toxicity
Antidote for Digoxin Toxicity
Activated charcoal
Digoxin immune Fab
Cholestyramine
How do I educate someone to take nitroglycerin
Let medication dissolve under tongue
Stop activity
Take 1 tab wait 5 minutes
If still in pain call 911 & take 2nd tab
Unrelieved pain take a 3rd tab
Protamine sulfate