Pharmacology and Anatomy in Cardiology

Definitions:
- Selective Beta Blockers: Act primarily on the heart (e.g., metoprolol).
- Nonselective Beta Blockers: Act on both heart and lungs, can impair lung function (e.g., bronchoconstriction).
Nursing Considerations:
- Monitor heart rate and systolic blood pressure before administration.
- Hold if heart rate < 60 BPM or systolic BP < 100 mmHg.
- Do not stop abruptly.
Clinical Considerations:
- Nonselective beta blockers should not be given to patients with asthma or COPD due to potential bronchoconstriction.

Mechanism of Action: Reduces calcium influx, causing smooth muscle relaxation.
Adverse Effects:
- Can cause edema, specifically lower extremity edema due to vasodilation.
Example: Amlodipine.
Nursing Considerations: Monitor blood pressure and heart rate.

Nursing Considerations:
- Monitor potassium levels.
- Administer in the morning to avoid nocturia.

Types: ACE inhibitors and ARBs.
Monitoring:
- Potassium and blood pressure monitoring.
ACEs can cause angioedema; transition to ARBs if this occurs.
Mechanism of Action:
- ACE inhibitors prevent conversion of angiotensin I to angiotensin II.
- ARBs block the receptor sites of angiotensin II.

Notable Drugs: Digoxin and nitroglycerin.
Important Concepts: Understand preload and afterload.
Digoxin toxicity: Hypokalemia increases risk; monitor signs of toxicity and hold if apical heart rate < 60.

Mechanism of Action: Block LDL production in the liver.
Considerations:
- Administer at bedtime (except for some).
- Monitor liver function tests.
- Caution with grapefruit juice.

Increases HDL but can cause flushing; premedicate with aspirin to reduce flushing.

Types: Familiarize with Direct Oral Anticoagulants (DOACs) and differences from warfarin and heparin.
Monitoring for Heparin:
- Watch for heparin-induced thrombocytopenia (HIT); platelet counts should be monitored.

Clinical Presentation: Symptoms include intermittent claudication, pallor, and diminished pulses.
Patient Positioning: Legs down to promote blood flow.
Management Goals: Encourage walking to promote collateral circulation despite pain.

Aneurysms: Weakening of the vessel wall.
- Types: Aortic dissection vs. abdominal aortic aneurysm (AAA).
- Ruptured AAA: High mortality risk; prompt identification and treatment required.
Signs and Symptoms in Dissection: Sudden ripping or tearing pain, often in the chest or back.
Management: Aggressive blood pressure control; IV antihypertensives may be initiated.

Cyanotic vs. Acyanotic:
- Cyanotic: Poor oxygenation, typically affecting blood flow to the lungs (e.g., Tetralogy of Fallot).
- Acyanotic: Adequate oxygenation.

Defects:
- Ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and aorta positioned over both ventricles.
Management: Need for patent ductus arteriosus to maintain blood flow to lungs, which can be maintained with medications (e.g. prostaglandins).

Sinus Bradycardia and Sinus Tachycardia: Distinction is made based on heart rate and symptoms.
Atrial Fibrillation: Unorganized rhythm; patient may show risk for clotting due to stasis in the atrium.
Ventricular Tachycardia: Two classifications based on the presence of a pulse; interventions differ accordingly.

Definition: ST-elevation myocardial infarction signaling potential myocardial injury.

Constant emphasis on understanding underlying mechanisms and nursing considerations for various medications and clinical conditions. Encourage continuous revision and engagement with provided content for successful examination outcomes.