PATHOPHYSIOLOGY

Predisposing Factors Age Gender

Persistent increase of blood glucose

Metformin Increases utilization of glucose Decrease hepatic glucose

Hyperglycemia

Sitagliptin Increases insulin release Lactulose Stool softener, preventing the client from doing Valsava maneuver Furosemide Inhibits reabsorption of sodium and chloride

Increase blood viscosity Increase blood pressure

Captopril Blocks ACE from converting angiotensin 1 to angiotensin 2, decreasing blood pressure

Injury to endothelial wall Plaque formation in the endothelium

Simvastatin Decreases serum cholesterol and LDL

Atherosclesrosi s Rupture of plaque

Clopidogrel Inhibit platelet aggregation Enoxaparin Inhibit thrombus and clot formation

Complete thrombosis in coronary arteries

Decrease coronary tissue perfusion

Diminished myocardial oxygenation

Anaerobic metabolism

Increased lactic acid production (Lactic acidosis) Angina

Isosorbide mononitrate Relaxes vascular smooth muscle, decreasing venous return, arterial BP, reduces left ventricular workload and decreases myocardial O2 consumption

Tissue necrosis Myocardial infarction