Blood Pressure
What systolic BP would make you take BP on both arms?
150 or above and 100 or below
A 20 point difference between arms can indicate a blockage. The higher BP is the accurate one. The lower BP is due to the blockage reducing the blood flow. Patients will commonly have arm/shoulder/clavicle pain
Retake the arms to make sure that there is not machine error!
Plavix!
apixaban = Eliquis
rivaroxaban = Xarelto
warfarin = Coumadin, Jantoven
ticagrelor = Brilinta
prasugrel = Effient
What is Zetia (ezetimibe)?
Ezetimibe is a medication used to lower cholesterol levels in the blood. It works by preventing the absorption of cholesterol from the intestines. It's often prescribed for people who can't take statins or don't achieve sufficient cholesterol lowering with statins alone (usually used in addition to statins).
There are other medications are often paired with statins like gemfibrozil or fenofibrate! HOWEVER, patients should NEVER be on two statins!
What is a normal heart rate range?
60-100 bpm
- 100 bpm or above is tachycardia
- 60 bpm or less is bradycardia
- BP machines do not always show an accurate HR. Make sure to verify with the EKG machine if you see a HR in the 40's or 150 bpm+
What do you use diuretics to treat?
Diuretics, also known as "water pills," are commonly used in the treatment of edema caused by heart failure to help reduce fluid buildup and relieve symptoms like shortness of breath and swelling. They work by increasing urine output, which helps the body eliminate excess water and salt.
Short acting vs long acting: Metoprolol tartrate vs Metoprolol succinate
Metoprolol tartrate = short acting (usually taken multiple times a day)
Metoprolol succinate = long acting (usually taken once daily)
What does DVT stand for?
Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein, most commonly in the legs or pelvis. They can break off and travel to other areas of the body like the lungs: pulmonary embolism (PE)
Risk factors:
1. Long distance travel
2. Hormone use/birth control use
3. Cancer treatment
4. Recent surgery
5. Smoking
6. Pregnancy or genetic predisposition
What lab work looks at cholesterol levels?
Lipid panel
A basic lipid panel is a blood test that measures the levels of different fats (lipids) in your blood, primarily cholesterol and triglycerides. It can assess your risk for developing heart disease, stroke, and other cardiovascular problems.
This is a fasting lab!
What is the main purpose of a cardiac ablation?
To correct an abnormal heart rhythm (arrhythmia)
Cardiac ablation uses heat or cold energy, delivered through a catheter, to destroy heart tissue causing abnormal rhythms, aiming to restore a normal heartbeat. Reoccurrence of arrythmia can happen after this procedure, so some patients will get multiple rounds of cardiac ablations.
What is edema?
Edema is swelling caused by excess fluid trapped in the body's tissues, often seen in the legs, ankles, feet, or hands. It can result from conditions like heart failure, kidney disease, liver problems, or standing/sitting too long.
Fun fact: there are two types! Pitting and non-pitting
What is orthostatic hypotension?
Positional blood pressure drop- usually associated with dizziness/lightheadedness
- Blood pools in the legs due to gravity and weak venous valves
- Can lessen effects by eating salt, drinking fluids, leg strengthening exercises
Blood thinners are prescribed to prevent or treat serious conditions. List one condition that someone would be prescribed a blood thinner for.
Stroke, heart attack, blood clots (DVT/PE), arrhythmias (a-fib), valve replacements
Name that side effect!
Statins
Statins = muscle aches (myalgias)
Repatha/prasugrel = flu-like symptoms
What is the main purpose of a cardioversion?
Cardioversion is a procedure that can be done either with an electrical shock (electrical cardioversion) or with medication (pharmacological cardioversion) to treat abnormal heart rhythms.
Cardioversion is typically a planned procedure, but can sometimes be done in emergency situations if the arrhythmia is causing severe symptoms.
Why is this medication dose hyphenated?
losartan-hydrochlorothiazide 50-12.5 mg
This is called a "combination" medication, meaning the medication contains two different types of drugs that work together to lower blood pressure (in this case- an ARB and a diuretic to manage high blood pressure)
ex: Entresto 24-26, 49-51, 97-103
There are advantages and disadvantages to combination medications!
Provides relief from anginal chest pain
Nitroglycerin is a vasodilator, meaning it widens blood vessels. This widening makes it easier for blood to flow through the vessels, reducing the heart's workload and increasing blood and oxygen supply to the heart. It can drastically drop BP (and consequently have large rebound reactions)
What lab do we use to see how thick or thin someone's blood is on warfarin?
INR (international normalized ratio)
Name the brand name of atorvastatin and rosuvastatin!
atorvastatin = Lipitor
rosuvastatin = Crestor
Name one antiarrhythmic medication!
Flecainide
Amiodarone
Sotalol
Tikosyn
Multaq (dronedarone)
Furosemide (Lasix) impacts your potassium. Does it increase or decrease potassium levels?
Furosemide = decreases potassium (this is why many patients take potassium and furosemide together!)
Spironolactone = potassium sparing (helps the body retain potassium -> hyperkalemia)
Electrolyte imbalance = arrhythmias, cardiac arrest, organ failure, etc.
Which is which! clonidine vs colchicine
clonidine = lowers BP
colchicine = gout
c(lo)nidine- the "lo" can remind you it is to lower BP!
What does DAPT stand for?
Dual antiplatlet therapy
Dual Antiplatelet Therapy, is a treatment that combines two antiplatelet medications, typically aspirin and a P2Y12 inhibitor like clopidogrel, prasugrel, or ticagrelor. It's used to prevent blood clots after certain heart procedures and in individuals with atherosclerotic cardiovascular disease. DAPT helps to reduce the risk of heart attack, stroke, and other thrombotic events by inhibiting platelet aggregation, which is a key step in blood clot formation.
Meaning, sometimes patients will be one more than one blood thinner so be on the lookout!
Which is which! prasugrel vs praluent
Prasugrel = Anti-platelets (clot prevention)
Praluent = LDL (cholesterol lowering)
What is a loading dose?
A loading dose with an antiarrhythmic medication is an initial, higher dose given at the beginning of treatment. The purpose is to rapidly achieve a desired therapeutic concentration of the drug in the body, which allows for faster control of the arrhythmia.
Although loading doses can be common for other medication types, we often see them in clinic for antiarrhythmics. Expect changing doses in these medications! (amiodarone, tikosyn, sotalol)
What is a doppler machine? What does it look at?
A Doppler machine is a medical device that uses sound waves (ultrasound) to measure blood flow through blood vessels. Doppler ultrasound can even detect the direction and speed of blood flow, which helps diagnose circulation issues like deep vein thrombosis (DVT) or arterial blockages.
It can be found in the closet at West, the MA desk at East, and in the MA station in LC. Don't forget about it for our venous providers!