1 NP Practice 1-2 Questions
2 Birth Control Contraindications 1-2 Questions
3 Treatment of CHF 5-15 Questions
• Know First Line Treatment in
... [Show More] CHF
• Side Effects of Diuretics
• Side Effects of Ace Inhibitors
4. Treatment of Hypertension 5-6 Questions
• Know First Line Treatment in Hypertension
• Side Effects of Diuretics
• Side Effects of Ace Inhibitors
5. Treatment of Fungal infections 3-5 Questions
• Know How to Treat Various Fungal Infections
• Common Uses
6. Treatment of Abnormal Heart Rhythms 4-5 Questions
• Know Treatment of Arrhythmia
7. Treatment of Depression& Anxiety 4-5 Questions
8. Treatment of Parkinson 4-5 Questions
• Know Treatment of Parkinson Disease
9. Treatment of Alzheimer’s 4-5 Questions
10. Treatment of Acne 1-2 Questions
11. Clotting Factor in Vitamin K1-2 Questions
CONGESTIVE HEART FAILURE (CHF): *Refer to your CHF PowerPoint Slides
• EPIDEMIOLOGY:
o Most common cause of hospitalization over 65 years of age.
o Afflicts more than 2 million Americans annually.
o 900,000 hospitalization per year.
o PROGNOSIS: Poor
▪ Untreated, 82% of men die within 6 years of onset.
▪ Untreated, 67% of women die within 6 years of onset.
▪ Treated, mortality was reduced to 40%
Causes: Myocardial Infarction, hypertension, coronary artery disease, Hyperthyroidism,
Beriberi, anemia, arteriovenous shunts.
• HEMODYNAMIC PROPERTIES: Consequences of CHF
o Subnormal Cardiac Output > decreased exercise tolerance, tachycardia,
pulmonary edema, cardiomegaly
o Neurohumoral Reflexes: Reflex tachycardia, increased sympathetics, increased Renin.
o Myocardial Hypertrophy occurs, to maintain cardiac performance.
▪ Ventricular dilation helps to maintain cardiac output to an extent (due to Starling's Law), but past a certain point it can no longer help.
o Factors affecting cardiac performance:
▪ Higher preload: due to increased blood volume and venous tone.
▪ Higher afterload: due to hypertension, increased arterial tone.
▪ Lower contractility > lower inotropic state
▪ Higher heart rate, due to reflex tachycardia
o Edema: Especially pulmonary edema, but also peripheral. Results from decreased Cardiac Output, by two mechanisms:
▪ Decreased CO ------> impaired venous return > higher capillary
hydrostatic pressure
▪ Decreased CO ------> decreased renal perfusion > activate renin
angiotensin system RAS > aldosterone causes higher Na+ and fluid
retention.
• TREATMENT:
o CARDIAC GLYCOSIDES: See CHF PowerPoint Slides :
o MECHANISM: Inhibit Na+/K+-ATPase Pump > increased intracellular Na+
in myocardium ------> decreased expulsion of Ca+2 in myocardium >
tonically higher levels of [Show Less]