Transcript heart
Cardiovascular Drugs Review Clotting 2 • Back in the Game strives to markedly improve your life. Pain relief is usually the first step. The second is a comprehensive rehabilitation program. It is our mission to return our patients to their homes, their jobs, or back to their chosen activities as quickly and safely as possible. We continuously ask ourselves the 3 question, "how can we best serve Cardiovascular Drugs • Medications that affect heart and blood vessels • Anticoagulants Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Categories • • • • • Cardiac glycosides Antiarrhythmic agents Antihypertensives Vasodilators lipid agents Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Categories • • • • • • • • Vasoconstrictors Anticoagulants Platelet inhibitors Thrombolytic agents Vasoconstrictors Anticoagulants Platelet inhibitors Thrombolytic agents Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Cardiac Glycosides • • • • • Strengthen the heartbeat Congestive heart failure Digoxin or digitalis Digitalization Monitoring apical pulse – namely atrial fibrillation Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Digitalis • Toxic side effects • increased intracellular amounts of Ca2+ ions+ • usually given by mouth, but can also be given by IV injection in urgent situations • Contraindications or extreme caution • Interactions • Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Antiarrhythmic Agents • Suppress various types of arrhythmias • Need for accurate and timely reporting of vital signs and observations • Alert for signs of hypotension and bradycardia Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Antiarrhythmic Agents • • • • • • • Adrenergic blockers Calcium channel blockers Disopyramide Lidocaine Procainamide Quinidine Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Antihypertensives • • • • Lower blood pressure Definition Prescribed on trial basis Monitor VS and observe for side effects • Common side effects is hypotension – Postural hypotension Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Initial Therapy Options • Thiazide diuretics – Good first choice and cost effective • The members of this class of diuretics are derived from benzothiadiazine. They work by inhibiting reabsorption of sodium (Na+) and chloride (Cl−) ions from the distal convoluted tubules in the kidneys by blocking the thiazide-sensitive Na+-Cl− symporter. Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Therapy Options • Calcium channel blockers – Hypertension with diabetes or coronary risk • Beta-adrenergic blockers – Hypertension with angina, postmyocardial infarction, and certain arrythmias Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Antihypertensives (See next slide) • ACE inhibitors – Decrease vasoconstriction • Angiotensin receptor blockers – Similar to ACE inhibitors as they block vasoconstriction, but at different sites Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. 15 Coronary Vasodilators • Treat angina by dilating blood vessels • Ischemia • Angina pectoris – Obstruction or constriction of coronary arteries Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Angina Treatment • • • • • • Nitroglycerin Isosorbide (Isordil, Sorbitrate) Side effects Contraindications or extreme caution Interactions Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Antilipemic Agents • Elevated blood cholesterol – Risk factor for coronary heart disease • • • • LDL VLDL HDL Therapeutic lifestyle changes Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Antilipemic Agents • • • • • Statins Bile acid sequestrants Nicotinic acid (Niacin) Fibric acid derivatives (Fibrates) Cholesterol absorption inhibitor Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Vasoconstrictors • Adrenergic in action • Constrict blood vessels – Increase blood pressure • Side effects • Precautions Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Anticoagulants • Prevent formation of clots or decrease the extension of existing clots • Do not dissolve clots • Observe closely for bleeding complications Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Coumarin Derivatives • Administered orally • Interfere with vitamin K • Antidote – Vitamin K • Used for long-term therapy • Blood tests to determine dosage • Interactions Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Heparin • Types – Standard and low molecular weight • Standard – Intra – venously or subcutaneous oldest drugs currently still in widespread clinical use Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Heparin • LMW – Subcutaneous only • Acts on thrombin – Inhibiting action of fibrin in clot formation • How to administer Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Heparin • • • • • • IV administration is immediate acting Dilute flushing Interactions Side effects Contraindications Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Platelet Inhibitor Therapy • • • • Decrease platelet clumping Dipyridamole (Persantine) Aspirin Clopidogrel (Plavix) – important in aggregation of platelets and cross-linking by the protein fibrin Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Thrombolytic Agents • Dissolve clots (fibrinolysis) after they have formed • IV in less than 6 hours after MI or CVA • Bleeding – Most serious complication Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. Colony Stimulating Factors • • • • • • Stimulates more red blood cells Uses Epoetin alfa (Epogen or Procrit) Darbepoetin alfa (Aranesp) Filgrastim (Neupogen) Side effects Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR. • • • Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it." PHYSICIAL THERAPY We believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent reinjury. At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game. 29