Cardiovascular Risk Factors and Common Medications

Vocabulary practice flashcards covering coronary artery disease risk factors, cardiovascular drug classes (diuretics, vasodilators, beta-blockers, CCBs, ACE inhibitors, ARBs, statins), and GLP-1 agonists.

ACSM Age Risk Factor for CAD

A positive risk factor defined as men aged $\ge 45$ years and women aged $\ge 55$ years.

Negative CAD Risk Factor

High-density lipoprotein (HDL) cholesterol greater than $60\,mg/dL$, which removes one positive risk factor from the total count.

Primary Heart Health Medication Groups

The three major medication categories improving heart health: medications that lower blood pressure, medications that lower cholesterol, and medications that prevent blood clots.

Diuretics

A class of drugs (e.g., hydrochlorothiazide [HCTZ], furosemide [Lasix]) commonly called 'water pills' that lower blood pressure by increasing urination and reducing blood volume.

Hypokalemia Risk with Diuretics

The depletion of potassium ($K^+$)—an essential mineral for muscle contraction—requiring patients to increase dietary intake of potassium-rich foods such as fruits, vegetables, and beans.

Signs of Low Potassium ($K^+$)

Clinical symptoms including dry mouth/increased thirst, muscle cramps, tiredness/weakness, irregular heartbeat, and nausea that must be reported to a physician.

Nitroglycerin (NTG)

A vasodilator that treats and prevents chest pain (angina) and lowers blood pressure by dilating coronary arteries, reducing tension, decreasing vasospasm, and dilating systemic vessels.

Fast-Acting vs. Long-Acting NTG

Sublingual Nitrostat tablets are fast-acting to stop acute angina attacks, whereas Nitro-Dur transdermal patches and oral Imdur/Isordil are long-acting formulations used for prevention.

Sublingual (SL) NTG Protocol

At onset of angina, sit or lie down and place $1$ tablet under the tongue for $3\text{--}5\text{ minutes}$; if pain persists, repeat with a $2^{\text{nd}}$ tablet; if pain continues, take a $3^{\text{rd}}$ tablet and immediately call 911.

Sublingual NTG Storage Guidelines

Must be kept away from heat, light, and moisture in its original tightly capped amber glass container (or cool, dry place) and replaced every $6\text{ months}$.

NTG Contraindications and Drug Interactions

Must never be combined with erectile dysfunction drugs (Viagra, Levitra, Cialis) or alcohol due to the danger of intense low blood pressure, severe hypotension, and syncope.

Beta-Blockers

A medication class (e.g., atenolol [Tenormin], metoprolol [Lopressor], propranolol [Inderal]) that blocks adrenaline on cardiac beta receptors to reduce heart rate, lower blood pressure, and diminish myocardial $O_2$ demand.

Beta-Blocker Heart Rate Precaution

The clinical rule requiring pulse measurement prior to administration; the medication should not be taken if the heart rate is below $50\text{ bpm}$.

Beta-Blocker Rebound Effect

A dangerous spike in blood pressure and heart rate caused by abruptly discontinuing beta-blocker therapy rather than tapering off under medical supervision.

Calcium Channel Blockers (CCBs)

Agents such as verapamil (Calan), amlodipine (Norvasc), and diltiazem (Cardizem) that prevent vasoconstriction, lower total peripheral resistance (TPR) and afterload, and decrease cardiac workload.

ACE Inhibitors

Angiotensin-converting enzyme inhibitors (e.g., lisinopril [Zestril]) that block the conversion of angiotensin I to angiotensin II to decrease TPR; frequently causes a chronic cough as a side effect.

Angiotensin Receptor Blockers (ARBs)

Medications such as losartan (Cozaar) and irbesartan (Avapro) that block angiotensin II from binding to vascular receptors, preventing vasoconstriction.

Statins

Lipid-lowering drugs (e.g., simvastatin [Zocor], atorvastatin [Lipitor]) that decrease LDL and triglycerides, potentially raise HDL, and require monitoring for muscle soreness and liver enzyme elevations.

Rhabdomyolysis (Statin-Induced)

A severe breakdown of muscle tissue signaled by muscle soreness during statin therapy, requiring liver function tests (LFTs) and clinical evaluation.

Semaglutide

A GLP-1 receptor agonist administered weekly via subcutaneous injection that curbs appetite, yielding an average of $15\%$ body weight loss compared to $2.4\%$ with placebo.

GLP-1 RA Mechanisms of Action

Actions triggered by GLP-1 receptor activation: decreased appetite in the brain, induced insulin secretion and inhibited glucagon in the pancreas, and delayed gastric emptying in the stomach.

Semaglutide Qualification Criteria

Prescription threshold requiring a body mass index (BMI) of $30+$ or $27+$ in the presence of specific weight-related conditions.

Pre-Endoscopy GLP-1 Holding Protocol

A clinical policy requiring patients to discontinue GLP-1 agonists for $1\text{ week}$ prior to endoscopy to prevent retained gastric contents and avoid sedation-related pulmonary aspiration.