Drugs affecting hemodyanamics

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Anonymous
ID:
241246
Filename:
Drugs affecting hemodyanamics
Updated:
2013-10-17 16:24:01
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pharm
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hemo drugs
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  1. Homeostasis
    Cardiac Output

    Cardiac Output = HR X SV

    • Volume of blood pumped per minute Preload the pool
    • amount of stretch created by the volume Afterload the pipes
    • Resistance to outflow
    • Contractility the pump
    • Heart rate and rhythm
  2. Mechanical Control
    • Valves & Myocardium
    • Vessels
    • Calcium channels control muscle contraction in vessels (tunica media)
    • Starling’s Law
    • force of contraction is determined by stretch
    • Within limits-if too much stretch the actin and myosin bonds can’t link, too little they can’t slide together very far
  3. Autonomic
    • Control Reflex Activation of SNS and PNS Vasomotor Cente
    • rMedulla oblongata
    • Heart rate
    • Baroreceptors
    • Aortic arch
    • Carotid arteries
    • Vena Cava (Bainbridge reflex)
    • Vessel size
  4. Humoral Control
    Neurohormones

    • Catecholamine
    • Norepinephrine (a)
    • increased vascular resistance (BP)Epinephrine (a & b)
    • increase heart rate, vasoconstriction, contractility and bronchodilation
  5. Humoral Control

    Hormones
    • Renin-Angiotensin-Aldosterone
    • Renin produced by decrease in renal BP
    • Acts directly to save Na+ (and H2O)Converts angiotensinogen to angiotensin I
    • Angiotensin I + Angiotensin Converting Enzyme (ACE) = Angiotensin II
    • Angiotensin II
    • Strong vasoconstrictor
    • Release of aldosterone
  6. Cardiac Output = Metabolic
    • LifeProvides for:
    • Delivery of
    • OXYGEN
    • Nutrients
    • Biological elements
    • To carry on metabolic processes
    • Removal of
    • Metabolic waste (toxic elements)
    • Debris (non-toxic)
  7. Problems with the Pump
    • Valve Problems
    • Stenotic or regurgitant
    • Wall problems
    • Structural problems
    • congenitalacquired
    • Post MI
    • akinetic
  8. Heart Failure
    • 5 million Americans
    • Heart failure (CHF)
    • Unable to pump enough blood to meet needs    cardiac output
    • SNS
    • RAA
    • Remodeling
  9. Dysrhythmias
    • Bad electricity
    • Bad pumping
    • Bad perfusion
  10. Atherosclerosis
    • Damage to vessels
    • Lipid deposits
    • Injury
    • Plaque build up
    • Foam cells
    • Inflammatory process
    • Plaque rupture
    • ACS
  11. Acute Coronary Syndrome
    • Chest Pain
    • SOB
    • Diaphoresis
    • N/V
    • ECG changes
    • ST-segment  elevation
    • Abnormal Q wave
  12. Blood Pressure Regulation
    • Baroreceptors
    • ANS response to BP changes
    • sympathetic response can oppose treatment that decreases with time
    • RAAS-renal indirect response
    • Renal Regulation
    • Direct action
    • dec GFR with Dec BP-saves H2O
  13. Blood Pressure Regulation
    • Natriuretic peptides
    • A-atrial, B-brain ventricles
    • Reduce blood volume
    • Diuresis & 3rd spacing
    • Dilate arterioles & veins in response to BP
    • C-vascular endothelium
    • vasodilation
    • They get overwhelmed by HF progression
  14. Classification of Blood Pressure
    • Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (Seventh Report)
    • Normal: 120/80
    • Pre-hypertension: SBP 120-139 or DBP 80-89
    • Hypertension: Stage 1 SBP 140-159 or SBP 90-99
    • Hypertension: Stage 2 SBP>160 or DBP>100

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