CHF

Question 1

Class 1 anti-arrhythmics

Answer 1

Sodium Channel Blocks
a - procainamide
B- Lidocaine, Mexiletine
c - none listed

Question 2

Class 2 Anti-arr

Answer 2

Beta Blockers
b1 - atenolol
B1- esmolol (expensive, IV)

Question 3

Function of beta blockers in heart dz

Answer 3

Heart dz desensitizes the myocardium to sympathetic tone and does not listen to b receptors anymore.
B blockers allow them to regain sensitivity

Question 4

Class 3 anti-arr

Answer 4

Potassium channel blockers
Sotalol
Amiodarone

Question 5

What is special about amiodarone? What are its SE

Answer 5

Has all 4 class effects
SE: pulmonary fibrosis in humans, liver toxicity

Question 6

Class 4 anti-arr

Answer 6

Calcium channel blockers - diltiazem, amlodipine

Question 7

What is special about diltiazem

Answer 7

Has nodular and vascular properties

Question 8

Loop diuretics

Answer 8

Furosemide, Torsemide

Question 9

How do Loop diuretics work

Answer 9

inhibits Na/K/2cl channels
25% of Na+

Question 10

Distal convoluted diuretics

Answer 10

Thiazides

Question 11

How do thiazides work

Answer 11

inhibits na/cl channel - 10-15% of Na+

Question 12

Direct aldosterone blocker; works at the collecting ducts - 10-15% of Na+; potassium sparing diuretic that works on distal renal tubules

Answer 12

spironolactone

Question 13

T/F: Carbonic anhydrase inhibitors are used often in CHF medications

Answer 13

False - not commonly used as the kidney often becomes resistent to it

Question 14

Venous vasodilator; ointment; reduces preload from the peripheral pooling of blood and decreased venous return to the heart

Answer 14

Nitroglycerine

Question 15

Mixed vasodilator; metabolized by the kidney; prevents formation of AGII by competing with AGI for ACE

Answer 15

Enalapril - 0.5 mg/kg q12h

Question 16

mixed vasodilator; Metabolized by the liver
Works by inhibiting the conversion of AGI to AGII by inhibiting ACE

Answer 16

Benazepril - 0.5 mg/kg q12h

Question 17

Arterial vasodilator; SSAO inhibitor that alters calcium metabolism in the sm, thereby interfering with ca movement and preventing the initiation and maintenance of the contractile state

Answer 17

Hydralyzine

Question 18

Positive inotrope; increases concentration of calcium within the myocardium; mild b2 and a1 adrenergic effects

Answer 18

Dopamine/Dobutamine and digoxin

Question 19

Positive inotrope ; PDE III inhibitor and increasing intracellular calcium sensitivity in the cardiac contractile apparatus

Answer 19

pimobendan

Question 20

Goals of CHF Treatment (5)

Answer 20

Decrease preload
Decrease afterload
Decrease myocardial o2 consumption
Increase contractility
control arr

Question 21

What drugs decrease preload

Answer 21

vasodilators and diuertics

Question 22

what drugs decrease afterload

Answer 22

vasodilators and diuretics

Question 23

what drugs increase contractility

Answer 23

digoxin and pimo

Question 24

what drugs control VTs?

Answer 24

SPAM
Sotalol
Procainamide
Amiodarone
Mexilitine

Question 25

What drugs control SVT

Answer 25

BCD Beta blockers Calcium channel blockers Digoxin

Question 26

how do u decrease myocardial o2 demand

Answer 26

decrease HR and wall stress

Question 27

Bernoullis eq

Answer 27

P=4v^2

Question 28

What does it mean if the MR velocity is different/increased

Answer 28

Either LV pressure is increased or LA pressure is decreased

Question 29

What does a HIGH MR velocity indicate

Answer 29

Stenosis

Question 30

What does a normal Mr number in the face of heart change indicate

Answer 30

hypertension

Question 31

What does it mean if the MR velocity decrease?

Answer 31

Either LV pressure decreased or LA pressure increased

Question 32

What cardiac conditions indicate a decreased Mitral velocity

Answer 32

DCM

Question 33

What cardiac conditions indicate an increase in tricuspid regurg velocity

Answer 33

Pulmonic stenosis or pulmonary hypertension coming out fast on echo = pulmonic stenosis