cardiovascular agents power point

SA node - sinoatrial node

Na & Ca enter a cardiac cell, irritate the cell & cause contraction

Return of the cell to resting after depolarization; caused by K ions

The volume of blood expelled from the heart in one minute

• The amount of blood ejected from the left ventricle with each heart beat
• ( CO = SV x HR )

• (PAC)
• Preload-the volume of blood in the L ventricle before it contracts.
• Afterload-the resistance against which the L ventricle must pump in order to get blood into the systemic circulation
• Contractility-force of contrction

• CHF
• Angina Pectoris
• Cardiac Dysrhythmias

• Heart unable to pump adequately
• Weak enlarged geart muscle
• Blood backs up into the lungs & peripheral tissue
• L side failure --> pulmonary
• R side failure --> peripheral congestion

• Acute cardiac pain from inadequate bliid flow through coronary arteries --> anoxia --> pain
• May occur with exertion, stress, or extreme cold
• Usually transient (lasting 3-5 minutes)
• Subsides when precipitating factor relieved

• Deviation from normal HR and rhythm: bradycardia, tachycardia, irregular HR
• Named by site of origin: atrial, ventricular, nodal
• Atrial dysrhythmia: prevent proper filling of ventricles resulting in lower CO
• Ventricular dysrhythmia-results in lower or absent CO: life threatening

• Treatment of CHF
• Atrial fibrillation
• Flutter

• Raise force of contraction
• Lower HR
• Lower conduction

• GI: anorexia, N & V, diarhea
• CV: badycardia, PVC's
• EENT: blurred vision, haloes
• Electrolyte: lower K

• Administer: with food
• Monitor: AP for one ful minute. Hold if <60 bpm and report
• Monitor for hypokalemia: muscle weakness, arrhythmias. higher K in diet
• High Risk For Toxicity

• 1.bradycardia, dysrhythmias, headaches, nausea and vomiting, visual illusions: green and yellow haloes, confusion\delirium
• 2. Digibind (binds with digoxin)
• 3.Monitor serum digitalis levels:
• A.Therapeutic range:
• I. 0.5 - 2.0 nanograms\ml
• B.*Very narrow:high risk for toxicity

• 1. used to treat angina pectoris
• 2. categories:(NBC)
• - Nitrates
• - Beta Blockers
• - Calcium Channel Blockers
• -(watching NBC on tv relieves heart pain)

• Nitrates:
• 1. lower cardiac oxygen demands by lower preload and afterload. Vasodilatation of collateral coronary vessels
• 2. nitroglycerin (Nitrostat)
• 3. store tablets in glass container in cool, dark place\ SL - offer sips of water first\ May repeat dose q 5 min up to 3X\ transdermal patch - wear gloves

• Nitrates:
• 1. tachycardia(monitor pulse)
• 2. hypotension(monitor BP, move slowly)
• 3. headache, dizziness(avoid alcohol)
• 4. weakness(monitor safety)

block beta 1 receptor site thereby blocking the release of epiniphrine and norepinephrine resulting in lower oxygen demand, lower HR and lower BP

• atenolol (Tenormin)
• propranolol (Inderal)

• Nitrates
• Beta blockers
• Calcium channel blockers

• SE ( nursing interventions )
• 1. hypotension(monitor BP, arise slowy)
• 2. bradycardia(monitor pulse)
• 3. bronchspasm(assess lung sounds
• 4. impotence(warn client)

lower oxygen demand by lowering cardiac contractility and workead; relaxes coronary arteries

• diltiazem(Cardizem)
• verapamil(Calan)
• nifedipine(Procardia)

• 1.headache (report)
• 2.dysrhythmias (monitor pulse)
• 3.hypotension, dizziness (monitor BP,arise slowly)
• 4.flushing, rash (report)

To treat cardiac dysrhythmias

• Class I: sodium channel blockers
• Class II: Beta blockers
• ClassIII: drugs that prolong repolarization
• Class IV: Ca channel blockers

• Action of SCB:
• Lower Na influx to cardiac cells then Lowers conduction velocity
• Lower automaticity
• Raises repolarization

• lidocaine (xylocaine)
• procainamide (pronestyl)

To block beta 1 receptors blocking epinephrine and norepinephrine release to lower HR and Bp and lower conduction automaticity

propranolol(Inderal)

• Action- prolongs repolarization
• Common drugs:
• bretylium (Bretylol)
• amiodarone HCL (Cordarone)

• Action: lower oxygen demand by lowering carkeac contractility and workliad; relaxes coronary arteries
• Common drugs:
• verapamil (Calan)
• dilitiazem (Cardizem)

• Bradycardia (monitor pulse)
• Dysrhythmias (monitor EKG)
• Orthostatic hypotinsion (monitor Bp, arise slowly)
• Dizziness (monitor safety, avoid alcohol)
• Anorexia, nausea (take with food)
• Vomiting, diarrhea (report)
• Rash, flushing,, pruritis (report)