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SP18: Pharm MT3 > Cardiac Pharm > Flashcards

Cardiac Pharm Flashcards

1
Q

What are the two main problems that can cause heart failure?

A
  1. Heart cant fill with enough blood

2. Heart cant pump with enough force

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2
Q

T/F: In diastolic heart failure, the heart cannot pump enough blood out of the ventricles due to weakened heart muscles.

A

False

Diastolic - stiff muscle cant relax, heart doesn’t fill

Systolic - weakened heart cant pump, not enough blood pumped out

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3
Q

T/F: Diastole = filling, systole = pumping

A

True

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4
Q

What class of heart failure involves symptoms at rest?

A

Class IV (severe)

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5
Q

How does cardiac muscle differ from skeletal muscle?

A

Ca++ influx activates ryanodine receptors on sarc reticulum leading to more Ca++ release

Things happen more slowly to allow heart to fill

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6
Q

__________ alter the force or energy of muscular contractions.

A

Inotropic drugs

Negative - weaken the force

Positive - increase the strength

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7
Q

_____________ may change the heart rate by affecting nerves controlling the heart, or by changing the rhythm produced by the SA node.

A

Chronotropic drugs

Positive - increase HR

Negative - decrease HR

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8
Q

Cardiac glycosides, B-adrenergic receptor agonists, and bipyridines are all _______________ used to treat CHF.

A

Positive inotropic drugs

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9
Q

How does digoxin work?

A

It is a cardiac glycoside - blocks Na/K ATPase

Internal Na increases -> slows down removal of Ca from the cell

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10
Q

T/F: Diuretics (mainly loop) are the mainstay in CHF treatment.

A

True

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11
Q

T/F: B1-adrenergic receptor agonists are the first line of defense against CHF.

A

False

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12
Q

T/F: Bipyridines are safe drugs to treat CHF.

A

False

They are available but not favored for treatments

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13
Q

T/F: All beta-blockers are good for treating CHF.

A

False

Only some, mechanisms not really known

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14
Q

Along with their role in helping fluid retention, ___________ can also have some other positive effects on CHF.

A

diuretics

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15
Q

____________ are shown to help in supplementation to other meds especially in the A.A. Population.

A

Vasodilators

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16
Q

What is the difference between a stable and unstable angina?

A

Stable - fixed plaque

Unstable - unstable plaque, could throw a clot

17
Q

What is the result of taking nitrates/nitrites?

A

Prodrugs that spontaneously produce nitric oxide

18
Q

What is the end result of nitrous oxide release?

A

Relaxation of smooth muscle -> vasodilation -> more blood to the heart

19
Q

What is the most common adverse effects of nitroglycerin?

A

Vasodilation causes headaches

20
Q

T/F: The use of viagra with nitroglycerin is contraindicationed.

A

True

Will cause extreme hypotension

21
Q

What is the rationale for using beta blockers or calcium channel blockers to treat angina?

A

Lower cardiac output so the heart doesn’t need as much oxygen

22
Q

What are the three types of drugs used to treat angina pectoris?

A
  1. Nitrates - vasodilation
  2. Calcium blockers - vasodilation and cardiac depressants
  3. Beta-blockers - cardiac depressants
23
Q

__________ coordinate cardiac muscle contraction.

A

Electrical signals

24
Q

Basically, the sum total of action potentials traveling through the heart creates the _________.

A

EKG

25
Q

The electrical signal starts at the _________, and travels through the __________.

A

SA node; AV node

26
Q

What is an atrioventricular block?

A

A type of arrhythmia where the conduction between atria and ventricles is blocked/slowed

27
Q

What is the diagnostic tool for a primary AV block?

A

PR interval lengthened beyond 0.2 seconds

28
Q

What constitutes a 3rd degree AV block?

A

Impulse from SA node does not reach ventricles

29
Q

How would an atrial fibrillation look on an EKG?

A

Tiny irregular fibrillation between heart beats and beats are erratic

30
Q

What are the four classes of anti-arrhythmic drugs?

A

Class I - block Na+ channel
Class II - Beta blockers
Class III - prolong action potential and prolong refractory period
Class IV - Ca+ channel antagonists

31
Q

Why is dosage so important for anti-arrhythmia drugs?

A

Obviously can’t stop or make drastic changes to heart function - just tweak

32
Q

T/F: Beta blockers can diminish both Na and Ca currents

A

True

33
Q

What will be the effect of blocking the K+ channel?

A

Prolonged ventricular action potential

34
Q

What phase of the action potential will class I drugs affect?

A

Phase 0

They will block Na+ channels thus altering the depolarization speed

35
Q

What phase of the action potential will class II drugs act on?

A

Phase 4

Beta-blockers prolong AV conduction

36
Q

Which phase of the action potential do class III compounds affect?

A

Phase 3

K+ channel blockers slow down repolarization

37
Q

What phase of the action potential do class IV drugs act on?

A

Phase 2

Ca+ channel blockers slow conduction by increasing the refractory period

SP18: Pharm MT3 (7 decks)

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