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Chapter 6 Drugs for Cardiovascular Arrhythmias and Hypertension

Chapter 6 Drugs for Cardiovascular Arrhythmias and Hypertension. Hank Gathers hypertrophic cardiomyopathy Flo Hyman Marfan’s syndrome Jim Fixx atherosclerotic coronary artery disease Darryl Kile atherosclerotic coronary artery disease. “Pistol” Pete Maravich abnormal coronary arteries

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Chapter 6 Drugs for Cardiovascular Arrhythmias and Hypertension

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  1. Chapter 6 Drugs for Cardiovascular Arrhythmias and Hypertension

  2. Hank Gathers • hypertrophic cardiomyopathy • Flo Hyman • Marfan’s syndrome • Jim Fixx • atherosclerotic coronary artery disease • Darryl Kile • atherosclerotic coronary artery disease

  3. “Pistol” Pete Maravich • abnormal coronary arteries • Len Bias • illegal drugs • High School versus College Athlete • Changing cardiovascular development

  4. Arrhythmias • “Irregular heart action caused by physiological or pathological disturbances in the discharge of cardiac impulses from the sinoatrial node or their transmission through conductive tissue of the heart.”

  5. Arrhythmias • Medications control arrhythmias and assist the heart in maintaining a normal rhythm • Device-based techniques • Implantable pacemakers or defibrillators • Can result in syncope, fatal in certain sports • Table 6-1, pg 82

  6. Arrhythmias • Common Forms of Arrhythmias • Table 6-2,pg 83

  7. Arrhythmia Medications • Four subclassifications • Class I Sodium channel blockers • Class II β-adrenergic blockers • Class III Potassium channel blockers • Class IV Calcium channel blockers

  8. Adverse Effects • Lethargy • Fatigue • Bradycardia • Orthostatic hypotension • Cold extremities • Rashes, pruritus, headache, nausea, diarrhea, swelling, behavioral disturbances, disorientation

  9. Adverse Effects(cont.) • Despite the purpose of reducing arrhythmias one of the most common side effects of the anti arrhythmic drugs is the increase in rhythm disturbances.

  10. Antiarrhythmic Drug Interactions • Table 6-3, pg 85

  11. Device Therapy • Pacemakers – first implanted (1958) • Implantable cardioverter defibrillators (ICD) – (1980) • Not common in athletes

  12. Hypertension • Hypertension is the “pressure in the pipes” • Diet, stress, genetics, etc. • Approximately 24% of population • Females have higher rates • BP > 140 mm Hg • on three separate occasions • Essential hypertension • No known cause • Secondary hypertension • Diagnosable cause

  13. BP Classifications • Normal <120/<80 • Prehypertension 120–139/80–89 • Hypertension • Stage 1 140–159/90–99 • Stage 2 >160/>100 • Stage 3 Physician’s care

  14. Monitor variables that can affect BP • Salt and intake of high-sodium and high-fat foods (PJ) • Alcohol • Over-the-counter stimulants - caffeine/cold medication • Diet pills • Smoking or chewing tobacco • Cocaine or anabolic steroids

  15. Medications for Hypertension • Diuretics • Calcium channel blockers • ACE Inhibitors • Angiotensin II blockers • Beta blockers • Alpha-blockers

  16. Adverse Effects • Diuretics • Orthostatic hypotension • Dehydration – electrolyte imbalance • ACE inhibitors • Cough • Beta blockers • Bradycardia, fatigue, dizziness • Alpha-blockers • Tachycardia/orthostatic hypotension

  17. Hypertension in the Athlete/Active Population • Table 6-6, pg 88

  18. What to Tell the Athlete • Page 88

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