Comprehensive Cardiology and Pharmacology: Anticoagulants, Rhythms, and Heart Failure

Anticoagulants

Prevent new clots

Heparin

An anticoagulant used to prevent blood clots.

Warfarin

An anticoagulant that helps prevent blood clots.

DOACs

Direct oral anticoagulants.

P Wave

Atrial depolarization.

PR Wave

AV conduction.

QRS Wave

Ventricular depolarization.

T Wave

Ventricular repolarization.

Sinus Bradycardia

Heart rate < 60.

Sinus Tachycardia

Heart rate > 100.

Sinus Arrhythmia

Irregular but normal P waves.

ACE Inhibitors

Captopril, Enalapril, Benzapril.

Beta-blockers

Propranolol, Atenolol, Metoprolol.

Calcium Antagonists

Verapamil, Diltiazem, Nifedipine.

Diuretics

Remove excess fluid.

Loop Diuretics

Furosemide.

Thiazide Diuretics

Hydrochlorothiazide.

Potassium-sparing Diuretics

Spironolactone.

Statins

Lower LDL cholesterol and stabilize plaque.

Antiplatelets

Prevent platelet aggregation.

Pentoxifylline

Improves RBC flexibility and lowers blood viscosity.

Cilostazol

Improves walking distance in PAD.

Congestive Heart Failure

Heart can't pump enough blood, fluid backs up.

Mitral Valve Prolapse

Valve bulges into atrium with regurgitation.

Coronary Artery Disease

Atherosclerosis leads to plaque narrowing arteries.

What do ACE Inhibitors do?

Lower peripheral vascular resistance.

What are ACE Inhibitor side effects?

Dizziness, cough, orthostatic hypotension

What are Beta-blockers?

Lower HR, lower force of contraption

What are Beta-blockers side effects?

bradycardia, Lower BP, lethargy, depression

Calcium antagonists lower ….

Oxygen

Calcium antagonist side effects:

Lower BP, bradycardia, headache, nausea, constipation, edema

Diuretics Side effects:

hypokalemia: loop, thiazide

Hyperkalemia: K-sparing

dehydration

Diuretics education:

Daily weights, Monitor K, Give in morning, Asses lung sounds and edema

Anti Anxiety meds:

Lorazepam, Alprazolam

What do cardiac pt take anti anxiety meds?

Reduces sympathetic stimulation, lowers HR and BP

Anti anxiety meds risks:

Sedation, resp. depression, dependence

Proton Pump Inhibitors Meds:

omeprazole, pantoprazole

What do Proton pump inhibitors do?

Decrease stomach acid

Why cardiac pt’s get Proton pump inhibitors?

Stress ulcer prevention, prevent GI bleed with antiplatelets

What do statins do?

Lower LDL cholesterol, stabilize plaque

Statins meds:

Atorvastatin, Rosuvastatin

Side effects of statins?

muscle pain, liver toxicity

Monitor what in statins?

AST/ALT, report muscle weakness

Antiplatelets meds:

Aspirin, Clopidogrel

Antiplatelets do what?

Prevents platelet aggregation

What are Antiplatelets used for?

Coronary artery disease, stroke prevention, after stents

Pentoxiifyiline does what?

Improves RBC flexibility, Lowers blood viscosity, improves microcirculation

What is Pentoxifylline used for?

PAD, Claudication

Cilostazol does what?

Improves walking distance in PAD

Cilostazol meds:

Antiplatelet, vasodilator

Cilostazol is contraindicated in?

heart failure

Thrombocytes do what?

Dissolve clots

Major risk of thrombocytes?

Bleeding

Anticoagulants do what?

Prevent new clots

Anticoagulant meds?

Heparin, warfarin, DOACs

P wave:

Atrial Depolarization

PR wave:

AV conduction

QRS Wave:

Ventricular depolarization

T wave:

Ventricular repolarization

RA Lead:

Right chest

LA lead:

Left chest

Rl lead:

Right lower

LL lead:

Left lower

V1 lead:

4th intercostal right sternum

Normal Sinus Rhythm:

HR - 60-100, regular, P before QRS

Sinus Bradycardia:

HR <60

Sinus Tachycardia

HR > 100

Sinus Arryhthmia:

Irregular but normal P wave

What is CVI?

valve failure - blood pooling - edema

Symptoms of CVI:

Brown discoloration, warm, edema , venous ulcers (ankles)

CVI Risk factors:

Smoking, diabetes, HTN, Hyperlipidemia, age

CVI treatments:

Exercise therapy, smoking cessation, Antiplatelets, pentoxifylline, cilostazol, compression stockings

CVI priority teachings:

Foot care, walking program, smoking cessation

CHF Risk factors:

MI, HTN, CAD, diabetes

CHF treatments:

diuretics, ACE inhibitors, Beta blockers, low sodium diet, fluid restriction, oxygen

CHF plan of care:

Daily weights, Strict I&O, oxygen, Elevate HOB, monitor lungs

Mitral Wave Prolapse manifestations:

Chest pain, palpitations, fatigue, dizziness

Mitral Valve Prolapse teaching?

Avoid stimulants, beta blockers, report worsening symptoms

Mitral Wave Prolapse prevention:

Dental hygiene, Antibiotics before procedures

Coronary Artery disease is what?

Atherosclerosis - plaque - narrowed arteries - ischemia

Coronary Artery Disease progression:

Fatty steak - plaque - rupture - clot - occlusion

Primary Prevention for CAD:

Diet, exercise, no smoking

Secondary preve ntion for CAD:

Statins, BP control

Tertiary prevention for CAD:

Stents, CABG

Screening for CAD:

Lipid panel, BP, A1C, stress test

Teaching for CAD:

Low fat diet, exercise, stress control, smoking cessation, weight loss

Nitrates do what?

Dilate coronary arteries

PCi opens…

blocked artery

Stent does?

Keeps artery open

CAPG does:

bypasses blockage