CVD, BONE METABOLISM, DIABETES, HERBALS Flashcards Preview

PA 2307- Mod 8 > CVD, BONE METABOLISM, DIABETES, HERBALS > Flashcards

Flashcards in CVD, BONE METABOLISM, DIABETES, HERBALS Deck (33)
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1

what are pacemaker cells of the heart

they have instable membrane potentials that allow them to reach threshold and generate action pot spontaneously

2

what movements maintain cardiac cell (3)

1. constant diffusion of na and k down their gradiants
2. 3 Na out for 2 k in
3. ca out 3 NA in

3

what are the 5 (0+4) phases of ventricular action pot

0-depolarization (NA open)
1-rapid repolarization (na close k open n close)
2-plataue (ca open)
3-final repolarization (ca close, k open)
4-spontaneous depolarization (sod permeability increases)

4

What effect do catecholamines have on the heart

positive chronotropic effect
(increase levels of cAMP)

5

what effect does parasympathetic stim have on the heart

stim of muscarinic receptors cause reduced level of cAMP that produces an increase in outward K current (hyperpolarization)= decrease in pacemaker activity

6

what effect that ca have on non pacemaker cells

increase in intracellular ca= increase contraction strength

7

what is peripheral edema indicative of

heart failure

8

what are the cardiovascular consequenses of heart failure

increase venous pressure
increase sympathetic activity
increased renin, aldosterone etc

9

what is digitalis glycosides and how does it work

used for heart failure to have positive iontropic effect

inhibits na/k atpase pump with results in increase of intrcellular sodium conc= greater activation of contractile pros and less ca leaving

10

does digoxin affect skeletal mm

no just increases force and velocity of myocardial contraction

11

what is the cardiac side effects of digitalis glycosides

dose related arrhythmias
-premature atrial and ventricular contractions

12

what are the extracardiac toxicity of digitalis glycosides

most GIT
-vommiting due to stim of chemoreceptor trigger zone

13

What is the antidote for digitalis toxicity

administer potassium iv to decrease the slope of phase 4
or lidocaine
(the spontaneous depolarization portion)

14

What do class I anti arrhythmic drugs do

slow down rate of phase 0 (and 4) by blocking membrane sodium channels
--cause decrease in excitability + conduction velocity

15

What do class II anti arrhythic drugs do

B-adrenergic receptor antagonists- depress phase 4 depolarization by competing w catecholamine stim

16

what do class III anti arrhythmic durgs do

prolong the action potential with a consequent increase in the absolute and effective refractory period

17

What do call IV anti arrhytmic drugs do

Decrease inward current carried by calcium (in sa node decreases rate of phase 4 spontaneous depolarization)

18

what is the net calcium absorbtion when taken orally

15-40%

19

what is essential for calcium absorbtion

bile

20

effects of calcitonin

inhibits rate of bone turnover, increases exretion of sodium, pot and phosphate

21

what is raloxifene and what are its effects and the bioavailability

Selective estrogen receptor modulator (produces agonist effects)
only 2% oral bioavailability

22

How do bisphosphonates work and what is the oral bioavailability

10% bioavailability

-inhibit bone resorption by cellular effects on osteoclasts (inhibis recruitment, differentiation and activity)

23

what does flouride do

incorporated into bone as hydroxyfluroapatite which is resistant to resorption

24

What receptors do insulin bind to

binds to specific tyrosine kinase receptors to initatiate a series of enzyme reactions that impact on glucose homeostasis

25

What do sulfonylureas do

oral hypoglycemic drug

-act by binding to ATP dependent potassium channels in pancreatic B cells which accumulates calcium stimming release of insulin

26

what do glitinides do

oral hypoglucemic drug

same mechanism of sulfonylureas but quicker and shorter action

27

What do thiazolidinediones do

oral hypoglycermic drug

act as insulin sensitizers to regulate the expression of specific genes in adipocytes improving insulin sensitivity of mm and liver

28

what doe biguanides do

oral hypoglycermic drug
they act directly on mm to increase glucose uptake and utalization

29

what doe sglt2 inhibitors do

inhibit glucose resorbtion in prox tubule

30

what % of diabetics get diabetic neuropathy

50% of pts w type 1/2 DM

31

What is diabetic retinopathy

leading cause of new blindness in persons 25-74

32

what is diabetic nephropathy

persistent albuminuria, progressive decline in GFR and elevated BP

33

What is neuropathic arthropathy

jt deteriots