Week 7 Topic 1 Cardiovascular Medications

1. HM734 Exercise Testing and Prescription 1 Week 7 Topic 1Cardiovascular Medications Prof. Warren Payne

2. HM734 Exercise Testing and Prescription 2 What causes angina pectoris? Imbalance between demand for oxygen by the heart and supply of oxygen to the heart

3. HM734 Exercise Testing and Prescription 3 Estimate of Oxygen Uptake by the Heart Myocardial VO2 (MVO2) = SBP x HR (Double Product or Rate Pressure Product)

4. HM734 Exercise Testing and Prescription 4 Control of Angina Pectoris Need to ensure that: MVO2 (demand) is reduced to match supply or MVO2 is met by increasing supply Demand and supply controlled by HR and SBP

5. HM734 Exercise Testing and Prescription 5 Control of Demand and Supply Dilate Reduce volume Reduce pumping rate

6. HM734 Exercise Testing and Prescription 6 Medications to Control Demand and Supply Dilate Nitrates Reduce volume Diuretics Reduce pumping rate ? Blockers

7. HM734 Exercise Testing and Prescription 7 Medications to Control Demand and Supply Dilate Nitrates Angiotensin Converting Enzyme (ACE) Inhibitors Ca++ Channel Blockers Reduce volume Diuretics Reduce pumping rate ? Blockers Reduce pumping force Ca++ Channel Blockers ? Blockers

8. HM734 Exercise Testing and Prescription 8 Mechanisms of Action:Dilators Nitrates Reduce Ca++ availability by increasing Ca++ uptake by sarcoplasmic reticulum ACE Inhibitors Reduce the production of the potent vasoconstrictor, angiotensin

9. HM734 Exercise Testing and Prescription 9 Mechanisms of Action: Volume Reducers Diuretics Affect the loop of Henley to reduce water reabsorption by the kidneys

10. HM734 Exercise Testing and Prescription 10 Mechanisms of Action:Rate Reducers ? Blockers Block the effect of adrenergic stimulation on heart rate and contractility

11. HM734 Exercise Testing and Prescription 11 Mechanisms of Action:Pumping Force Reducers Ca++ Channel Blockers Reduce the influx of Ca++ during a cardiac action potential. Reduce contractility and increases smooth muscle compliance.

12. HM734 Exercise Testing and Prescription 12 Effect of Medications on Resting and Exercise HR, BP, ECG and Exercise Capacity

13. HM734 Exercise Testing and Prescription 13 Effect of Medications on Resting and Exercise HR, BP, ECG and Exercise Capacity

14. HM734 Exercise Testing and Prescription 14 Effect of Medications on Resting and Exercise HR, BP, ECG and Exercise Capacity

15. HM734 Exercise Testing and Prescription 15 Effect of Medications on Resting and Exercise HR, BP, ECG and Exercise Capacity

16. HM734 Exercise Testing and Prescription 16 Effect of Medications on Resting and Exercise HR, BP, ECG and Exercise Capacity