Cardiovascular Renal

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  Drugs Afecting the Cardiovascular and Renal Systems RNSG 1301 Fall 2013 Wilhelmina Rich MSN, RN Brief physiologic review   Circulatory System  Parasympathic vagus nerve  Sympathetic actions  Regulation of arterial pressure   AP = PR x CO   ANS  renin-angiotensin-alosterone  !ineys  Natriuretic peptiesBrief physiologic review   ran#-Starling mechanism  Cariac output = stro#e volume x $R   %yocarial contractility    Cariac preloa  Cariac afterloa Antilipemic agents Treat conditions associated with excess cholesterol in the blood stream &he goo' (a an ugly lipis  Chylomicrons   )ery low ensity lipoproteins *)+,+  +ow ensity lipoprotein *+,+  $igh ensity lipoprotein *$,+  Antilipemic Agents, Chapter 32  &riglyceries . cholesterol are the two primary forms of lipis in the (loo  &riglyceries are an energy source' . are store in aipose tissue  Cholesterol is primarily use to ma#e steroi hormones' cell mem(ranes' . (ile aci  &he liver is the ma/or organ where lipi meta(olism occurs   Antilipemic rugs are use to lower high levels of lipis within (loo  &reatment0   ,rugs  +ifestyle changes  %a/or classes of rugs0  $%1-CoA reuctase inhi(itors  Bile aci se2uestrants  Niacin  i(ric aci erivatives  Cholesterol a(sorption inhi(itor 34etia5  HMG-CoA Reductase nhibitors  6statins7  8nhi(it $%1-CoA en9yme to ecrease cholesterol concentration in the (loo stream 3 ↓ cholesterol  production 5  Common %eication0  Ator!astatin 3+ipitor5  Sie :ffects0 18 istur(ance' ↑  liver en9yme levels  ile Acid #e$uestrants   Bile acis release in intestine →  liver releases cholesterol to (in to (ile acis →  increase (ining leas to ecrease a(sorption in intestine 3 ↓ cholesterol absorption 5  Common %eication0 Cholest%ramine  3;uestran5  Sie :ffects0 18 istur(ance' ↑  liver en9yme levels  i(ric Aci ,erivatives - 1emfi(ro9il . clofi(rate synthesis of )+,+- 1enerally well tolerate- 18 complaints most common s<e  Nicotinic aci niacinvitamin B > -  :ffective in treating most hyperlipiemias - )arious effects at ifferent oses - ew patients can tolerate continue use0 flushing' itching' peptic ulcer' ia(etic intolerance General &atient 'ducation &oints (or Antilipemia  Sie :ffects  %uscle pain' other unexplaine pain  18 upset' constipation   ?ellow iscoloration of s#in  ,ecrease sex rive
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