intervention goals for pts with high risk of developing CVD

improve cholesterol levels
get active
quit smoking
manage stress
achieve&maintain healthy wt
control high BP

recommendations for lipid management in pts with high risk of developing CVD

lifestyle modifications
dietary therapy
mod/high dose of statin therapy

drugs for lipid management in pts with high risk of developing CVD

antihyperlipidemics:
-HMG-CoA reductase inhibitors (statins)
-bile acid sequestrants
-nicotinic acid
-fibric acid derivatives

HMG-CoA reductase inhibitors (statins)
what
ex
adverse effects

inhibit reductase from making cholesterol
atorvastatin (lipitor)
iovastatin (mevacor)
simvastatin (zocor)
GI distress, constipation
inc liver enzymes
rhabdomyolosis

bile acid sequestrants
what
ex
adverse effects

bind to bile acids, fats, and lipids --> causes them to be excreted
cholestyramine
GI distress
constipation
dec absorption of other drugs

nicotinic acid
what
ex
adverse effects

lowers blood lipids
crystaline
niaspan
Gi distress
flushing, itching, tingling
hyperglycemia

fibric acid derivates
what
ex
adverse effects

inc cholesterol excretion
dec triglyceride production
inc HDL
gefibrozil (lopid)
fenofibrate (tricor)
GI distress
constipation
dec absorption of other drugs

recommendations for pts with HTN

lifestyle modifications
drugs
diet
consistent moderate exercise

drug Tx for pts with HTn

ACE inhibitors
beta blockers
diuretics
calcium channel blockers

ACE inhibitors
what
ex
adverse

vasodilators
diuretics
enalapril (vasotec)
isinopril (zestril)
captopril (capoten)
hypotension
headache
nausea
cough

beta blockers
what
ex
adverse

dec sympathetic tone
dec vascular tone
vasodilate
atenolol (tenormin)
metoprolol (lopressor)
propanolol (inderal)
hypotension
dizzy
weak
fatigue

diuretics
what
ex
adverse

dec vascular volume
dec pressure
bumetanide (bumex)
furosemide (lasix)
HCTZ
hypotension
electrolyte imbalance

calcium channel blockers
what
ex
adverse

dec influx of calcium into muscle
vasodilation
diltiazem (cardizem)
verapamil (calan, isoptin)
nifedipine
hypotension
dizzy
lighteheaded
nausea
peripheral edema

drug tx for pts with ischemic heart disease

sublingual nitroglycerin to relieve angina
beta blockers
calcium channel blockers or long-acting nitrates can be added if just beta blockers doesn't work

tx for pts with an MI

exercise
aspirin
beta blockers 3 years post
do NOT use dipyridamole (persantine)

drugs for CAD

nitroglycerin
anticoagulants
thrombolytics
cardiotonics

nitroglycerin
what
ex
adverse

dec vascular tone
dilates coronaries
constricts veins
nitro
isordil
hypotension
dizzy
headache

anticoagulants
what
ex
adverse

inhibits clot formation
aspirin
heparin
coumadin
plavix
xarelto
lovenox
pradaxa
hemorrhage
bruising

thombolytics
what
ex
adverse

lysis of existing clots
streptokinase
urokinase
tPA
bleeding

cardiotonics
what
ex
adverse

inc force of contraction
inc Q and SV
digoxin
lanoxin
toxicity
scooping of ST at rest
elongates QRS
headache

drugs for valvular disease

diuretics
anticoagulants
antiarrhytmics
ACE inhibitors
cardiotonics
antibiotics

drugs for dysrhythmias

anticoagulants
beta blockers
calcium channel blockers
antiarrythmics

antiarrythmics
what
ex

alters the action potential of cardiac muscle
quinidine (cardioquin)
procainamide (procanbid)
norpace
cordarone

Tx CHF

diet
lifestyle changes
exercise
drugs

drug Tx for CHF

cardiotonics: milrinone
diuretics
ACE inhibitors
nitrates
digoxin
potassium
aspirin
calcium antagonists

what is milrinone

Used in the short term management of heart failure
inc force of contraction
inc SV and Q
vasodilate vessels (decrease afterload)
Adverse effects: hypotension, angina, headache, dysrrhythmia, hypokalemia