Cardiovascular Drugs

Review Clotting

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• 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 question, "how can we best serve your health needs?" The answer is always the same: a commitment to excellence in everything we do. Excellence is what we value most. As such, our staff is continuously upgrading their knowledge base in order to give you the best. We employ a variety of advanced techniques designed to restore normal strength, motion, flexibility, and reduce pain. Back in the Game focuses on comprehensive care for joints, muscles, bones, and nerves.

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Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR.

Cardiovascular Drugs

• Medications that affect heart and blood vessels

• Anticoagulants

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, post-

myocardial 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.

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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 THERAPYWe 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 re-injury.

• 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.

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