Pharmacology Cardio and respiratory

therapy goals for cardiovascular disease

therapy goals for cardiovascular disease

1: minimize cardiac damage including the stretch of myocardial fibers

2: removal/prevention of edema

3: improve cardiac output

4: regulate heart rate and rhythm

5: improve oxygenation of blood

6: decrease risk of thromboembolism

why is it important for us to know cardiac anatomy and physiology

looking at an echo

looking at EKGs

important for client education

ECG

what is the P wave

depolarization and subsequent contraction of the atrial muscles

what is the PR interval

the flat line that immediately follows the P wave

it occurs at the AV node to allow the atria to finish contracting before the ventricles contract

Depolarization of the ventricles is represented by what

QRS complex

In which part of the ECG do the ventricles relax

T wave

During depolarization or contraction what moves into the cell

sodium

during repolarization or relaxation what moves out of the cell

potassium

After repolarization, sodium and potassium ions are located on the “wrong” side of the cell. The ___________ works to reestablish order.

sodium potassium pump

why is it important to understand depolarization and repolarization

­Cardiac medications can effect depolarization and repolarization of the heart either directly or indirectly as a side effect

what are the main three ions that are involved in the depolarization and repolarization of the heart

sodium

potassium

calcium

what branches does the autonomic nervous system have

parasympathetic

sympathetic (epinephrine and norepinerphrine)

the sympathetic branch is often referred to as

“fight or flight”

the parasympathetic branch is often referred to as the

rest and restore system

rest and digest

what does the sympathetic nervous system do

­Increase the heart rate, elevates blood pressure*,* causes constriction of small peripheral arterioles , decrease perfusion , dilate arterioles , increase blood flow, decrease activity of the GI tract, dilates bronchioles, and dilates pupils.

what are the two neurotransmitter hormones that inhibit the sympathetic system

epinephrine and norepinephrine

they bind to adrenergic receptors

Medications that mimic the effect of epinephrine and norepinephrine are called

adrenergic agonists

medications that bind to the receptors but do not cause a sympathetic response are called

adrenergic antagonists

what are the types of adrenergic receptors

alpha 1

alpha 2

beta 1

beta 2

beta 1 receptors are located where

in the heart

what do beta 1 receptors do

•They increase the heart rate, the strength of contraction and the speed at which the depolarization wave travels through the heart.

Beta 1’s Bring the Beat

stimulation by norepinephrine or adrenergic agonists can result in

tachycardia

beta 2 receptors are located where

smooth muscle surrounding the blood vessels of the heart and terminal bronchioles in the lungs

when beta 2 receptors are stimulated they cause

vasodilation of skeletal muscle and heart

bronchodilation

alpha 1 receptors cause smooth muscle surrounding blood vessels in the skin and GI to

contract (vasoconstriction)

what happens when the parasympathetic nervous system is stimulated

­Slows heart rate, increases blood flow to the GI tract, and decreases the diameter of the bronchioles.

what are cholinergic receptors

primary receptors for the parasympathetic nervous system

what is the primary neurotransmitter for the parasympathetic system

acetylcholine

what are some types of cholinergic receptors

Muscarinic

-increase GI stimulation, slow HR, cause pupil constriction

what are the parasympatholytics

atropine and glycopyrolate

block acetylcholine from reaching receptor

what do anticholinergics do

increase HR, decrease secretions, decrease GI motility, pupil dilation

what is ectopic focus

another area of the myocardium begins to depolarize outside of the normal sequence or faster than the SA node

can be the result of damaged myocardial cells. may allow sodium to leak into the cell and cause rapid spontaneous depolarization

if the ectopic focus is located in the ventricles you may see what

premature ventricular contraction

A series of uncoordinated ventricular quivers is known as _______ and is rapidly fatal

ventricular fibrillation

arrythmias located above the ventricles are

supraventricular

SA node

atria

AV node

arrythmias located in the ventricles are called

ventricular arrythmias

unifocal PVCs

multifocal PVCs

V-tach

V-fib

drugs to treat class I ventricular arrhythmias

No channel blockers

drugs to treat class II arrhythmias

beta blockers

drugs to treat class III arrhythmias

K channel blockers

drugs to treat class IV arrhythmias

Ca channel blockers

which beta blocker will we use first to see if they will work

Esmolol

what should we do with animals who have been on beta blockers for a long time

wean them off slowly

who should we be cautious with using beta blockers in

CHF patients

in ___ breeds potassium blockers can control _____

boxer

ventricular cardial myopathy

sotalol interacts with what

glucose levels

be mindful in diabetic patients

what are the three principles of respiratory therapeutics

control secretions

control reflexes

maintaining normal airflow to aleveoli

_________ is responsible for baseline tone of mild bronchoconstriction

of  the respiratory system

parasympathetic nervous system

what in the respiratory system is the sympathetic nervous system involved with

•β2 adrenergic mediated bronchodilation

•α1 mediated bronchoconstriction

what does copage mean

to hit the sides of the rib cage after nebulization to break up mucus

what is the cough reflex

There is a stimuli that signals the Larynx, trachea, and bronchi ---afferent nerves (sensory nerves) transmit the signal to the cough center located in the medulla ----efferent nerves (motor nerves) transmit a motor impulse back to the laryngeal and respiratory muscles

cough reflex

stimuli goes to the

larynx trachea bronchi

the efferent nerves send a signal to the

laryngeal and respiratory muscles