Aacn Cmc Exam Latest Update

AACN CMC What percentage of ventricular filling is passive and what percentage is atrial kick? - Passive - 75% Atrial kick -- 25-35% What 3 components make up stroke volume? - Preload Afterload Contractility Uses of beta blockers - HTN Classic angina (Coronary artery obstruction) Ventricular and Supraventricular arrhythmia's ACS Heart failure Hypertrophic cardiomyopathy Clinical effects of beta blockers - Decreased heart rate Decreased contractility Decreased automaticity Decreased conduction velocity Decreased renin release (kidneys) Cardioselective beta blockers - Block Beta 1 receptors N-AMEBA Nebivolol Atenolol Metoprolol** Esmolol Bisoprolol** Acebutolol **are usually used in patients with CHF with co-morbid COPD, asthma Alpha/Beta Blockers - Labetalol -- HTN emergencies Carvedilol -- Heart failure nonselective beta blockers - Block Beta 1 and Beta 2 blockers Propranolol Sotalol Timolol Nadolol Oxprenolol Penbutolol Pindolol Effects of CCBs - Heart -- Decreased heart rate Decreased conduction velocity Decreased contractility Blood vessels -- Coronary vasodilation (prevent vasospasm) Peripheral vasodilation (after load reduction) Uses of CCBs - HTN - dihydropyridines -pines Angina (vasospasm and classic) Arrhythmias (diltiazem) Hypertrophic cardiomyopathy If you suspect a beta blocker or CCB overdose, how do you differentiate? - Check a blood sugar Tend to have hyperglycemia with CCB overdose What is the role of the kidney is heart failure? - Juxtaglomerular cells on the afferent arteriole release renin when renal blood flow is reduced What are the effects of ACE and ARBs? - preload and afterload reduction due to venous and arterial vasodilation What is the aldosterone blocker? What are the unwanted side effects? - spironolactone -- indicated for HF and HTN Potassium sparing diuretic effect androgen and progesterone so it can cause sexual dysfunction, gynecomastia, menstrual problems and breast pain eplerenone -- most selective aldosterone blocker that does not have unwanted side effects as above What are the P2Y12 inhibitors? What are their indications? - Clopidogrel (Plavix) -- Recent MI or Stroke. STEMI, UA, NSTEMI managed medically or PCI or with CABG Prasugrel (Effient) -- STEMI, UA, or NSTEMI managed with PCI.. NOT for medical management Ticagrelor (Brilinta) -- STEMI, UA, NSTEMI managed medically or with PCI