Download Table 26.2 (continued)

The Pharmacy Technician
FOUNDATIONS AND PRACTICES
Chapter 26
The Cardiovascular,
Circulatory, and Lymph
Systems
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 26.1
The heart.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Anatomy of the Heart
• Composed of four chambers: two upper
•
•
•
and two lower
Atria—top two chambers
Ventricles—bottom two chambers
Septum—divides heart into right and left
sides
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Valves of the Heart
• Tricuspid valve—located between the right
•
•
•
atrium and the right ventricle
Pulmonary valve—located between the
right ventricle and the pulmonary artery
Mitral or bicuspid valve—located between
the left atrium and the left ventricle
Aortic valve—located between the left
ventricle and the aorta
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Layers of the Heart
• Pericardium—fluid-filled sac that
surrounds and protects the heart
– Permits free movement of the heart during
contraction
• Endocardium—innermost wall layer;
•
covers the inside surface of the heart
Myocardium—surrounds heart and causes
chamber contractions
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 26.2
Blood flow through the heart.
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Function of the Heart
• Provides oxygenated blood throughout the
•
•
body by a pumping mechanism
Oxygenated blood deposits materials
necessary for growth and nourishment
Receives from tissues the waste products
resulting from metabolism
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hypertension
• Sustained elevation of systemic arterial
•
blood pressure
Symptoms include:
–
–
–
–
Severe headache
Chest pain
Irregular heartbeat
Fatigue
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Hypertension (cont.)
• Pharmaceutical treatment includes
diuretics, vasodilators, ACE inhibitors,
beta blockers, and calcium channel
blockers
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Congestive Heart Failure
• Heart pumps out less blood than it
•
receives
Results in weakened and enlarged heart
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Congestive Heart Failure (cont.)
• Symptoms of CHF include:
–
–
–
–
–
–
–
Upright posture or leaning forward
Anxiety and restlessness
Cyanotic and clammy skin
Persistent cough
Rapid breathing
Fast heart rate
Edema of the lower limbs
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Congestive Heart Failure (cont.)
• Pharmaceutical treatment includes cardiac
glycosides, diuretics, vasodilators, ACE
inhibitors, beta-adrenergic blockers, and
phosphodiesterase inhibitors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Coronary Artery Disease
• Occurs when there is insufficient blood
•
flow to the heart
Can lead to:
–
–
–
–
–
–
Angina
Heart attack
Arrythmias
Stroke
Pulmonary embolism
Heart failure
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Coronary Artery Disease (cont.)
• Pharmaceutical treatment includes platelet
aggregation inhibitors, anticoagulants,
tissue plasminogen activators, and
thrombin inhibitors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cardiovascular Pharmaceuticals
• Antiarrhythmic drugs—restore normal
•
rhythm patterns but do not cure the cause
of the irregular heartbeat
Cardiac glycosides—used to increase the
force of myocardial contraction, without
causing an increase in the consumption of
oxygen
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Cardiovascular Pharmaceuticals (cont.)
• Diuretics—used to eliminate excess
•
sodium and water via the urinary tract
Vasodilators—allow more blood to exit the
heart, preventing or mitigating congestion;
lower blood pressure
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cardiovascular Pharmaceuticals (cont.)
• Angiotensin-converting enzyme inhibitors
•
(ACE inhibitors)—lower high blood
pressure; thought to reshape the heart;
prevent the body from producing natural
vasodilators
Angiotensin II receptor blockers—similar
to ACE inhibitors; block the body’s natural
vasodilators
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cardiovascular Pharmaceuticals (cont.)
• Beta-adrenergic blockers—used to block
•
•
cells from receiving natural
vasoconstrictors
Antiadrenergic agents—interfere with the
manufacture of vasoconstrictors at nerve
endings
Platelet aggregation inhibitors—reduce the
ability of the blood to coagulate
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cardiovascular Pharmaceuticals (cont.)
• Anticoagulants—prevent clots from
•
forming or existing clots from getting
bigger
Tissue plasminogen activators—break
down blood clots by reversing the clotting
order and interfering with the synthesis of
various clotting factors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Cardiovascular Pharmaceuticals (cont.)
• Thrombin inhibitors—inactivate bound
•
thrombin by binding to the enzyme and
blocking its interaction with its substrates
of fibrin
Antihyperlipidemics—help prevent the
progression of coronary artery disease by
lowering plasma lipid levels
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Anticoagulants
• Do not thin out the blood
• Prevent clots from forming
• Prevent existing clots from getting bigger
• Cannot dissolve existing blood clots
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Warfarin
• Oral drug of choice
• Works by preventing the synthesis of
clotting factors II, VII, IX, and X
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Warfarin (cont.)
• Used in the long-term prevention or
management of venous thromboembolic
disorders, including:
– Deep vein thrombosis
– Pulmonary embolism
– Clotting associated with atrial fibrillation and
prosthetic heart valves
• Vitamin K may be used as an antidote
when too much warfarin has been given
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Heparin
• Parenterally administered drug of choice
• Works by inactivating clotting factors IX, X,
•
XI, and XII
Used prophylactically to:
–
–
–
–
Prevent and treat deep vein thrombosis
Prevent and treat pulmonary embolism
Treat thrombophlebitis
Prevent clotting during cardiac and vascular
surgery
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Heparin (cont.)
• The only antidote for heparin overdose is
protamine sulfate
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.2
Antiarrhythmic Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.2 (continued)
Antiarrhythmic Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.2 (continued)
Antiarrhythmic Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.2 (continued)
Antiarrhythmic Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.3
Thiazide Diuretics
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.4
Loop Diuretics
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.5
Potassium Sparing Diuretics
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.7
Peripheral Vasodilators
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.8
Coronary Vasodilators
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.9
Angiotensin-Converting Enzyme Inhibitors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.9 (continued)
Angiotensin-Converting Enzyme Inhibitors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.9 (continued)
Angiotensin-Converting Enzyme Inhibitors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.10
Angiotensin II Receptor Blockers (Angiotensin II Antagonists)
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.11
Nonselective Beta-Adrenergic Blocking Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Table 26.12
Selective Beta-Adrenergic Blocking Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.13
Antiadrenergic Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.14
Antiplatelet Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.15
Comparison of Antiplatelet Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.15 (continued)
Comparison of Antiplatelet Agents
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.16
Anticoagulants
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.17
Thrombolytics and Tissue Plasminogen Activators
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.18
Thrombin Inhibitors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cholesterol and Triglycerides
• HDL—high-density lipoproteins or “good”
•
•
cholesterol
LDL—low-density lipoproteins or “bad”
cholesterol
Triglycerides—a form of energy stored in
adipose and muscle tissues
– Often measured to depict fat ingestion and
metabolism
– Can be used to assess CAD risk factors
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.19
Total Cholesterol Levels
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.20
High-Density Lipid (HDL) Levels (Good Cholesterol)
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.21
Low-Density Lipid (LDL) Levels (Bad Cholesterol)
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Table 26.22
Triglycerides
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Lymphatic System
• Complex system of lymph organs, nodes,
•
•
ducts, tissues, vessels, and capillaries
Transports lymph fluid to the circulatory
system
Cardiovascular and lymphatic systems
work in tandem
– Joined by a capillary system through which
lymph and blood move
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Lymphatic System (cont.)
• Lymphatic system supports the immune
system by:
–
–
–
–
Filtering out organisms that cause disease
Producing specific white blood cells
Manufacturing antibodies
Distributing fluids and nutrients throughout
the body
– Draining excess fluids and protein so that
tissues do not swell or become inflamed
The Pharmacy Technician: Foundations and Practices
Mike Johnston, Karen Davis, and Jeff Gricar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.