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Alan's lecture - Pharmacology > CVS1 > Flashcards

CVS1 Flashcards

1
Q

the SA node is the pacemaker. TRUE OR FLASE?

A

TRUE

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2
Q

There is a delay in the action potential at the AV node. TRUE OR FALSE?

A

TRUE

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3
Q

Where is the cardiovascular centre located?

A

In the medulla oblangata

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4
Q

In the medulla oblaganta there Baroreceptors, parasympathetic and sympathetic receptors. TRUE OR FLASE?

A

TRUE

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5
Q

If the cardiovascular centre detetcts low BP what system is turned on?

A

Sympathetic nervous system

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6
Q

If the cardiovascular centre detetcts high BP what system is turned on?

A

Parasympthetic nervous system

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7
Q

What occurs in the SA node when BP is low?

A
  • CV centre activates the sympathetic nerous system
  • Noradrenaline binds to B1
  • Increase in pacemaker current
  • This leads to an increase in slope phase 4 of action potential
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8
Q

What occurs in the AV node when sympathetic system is activated due to low BP?

A
  • Noradrenaline binds
  • Increase in ca2+ current
  • Increase in slope phase 0 of action potential
  • Also increases velocity conductivity
  • Increase in contractitlity of myocytes
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9
Q

What occurs in the SA node in parasynthetic nervous system when BP is high?

A
  • Ach binds to muscarinic receptors which slows depolisation
  • Opens K+ channels
  • Inhibits Na+ channel from opening which slows down slope of phase 4 of the action potential
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10
Q

What occurs in the AV node in the parasympathetic nervous system when BP is high?

A
  • Ach binds to muscarinic receptors

- This slows down conduction velocity which slows slope phase 0 of action potential

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11
Q

Baroreceptors send afferent fibres to the cardiac ocntrol centre (medulla). TRUE OR FALSE?

A

TRUE

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12
Q

What are the two types of baroreceptors?

A
  • carotid

- aortic

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13
Q

What occurs when BP is high with Baroreceptors?

A
  • Baroreceptors stimulate parasympathetic outflow which causes SA node to stop firing
  • Parasympathetic outflow inhibits sympathtic nervou system from inducing vasoconstriction
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14
Q

The parasymthpathetic NS has no direct effect with vasodilation. TRUE OR FLASE?

A

TRUE

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15
Q

What occurs when BP is low with Baroreceptors?

A
  • Baroreceptors stimulate sympathetic outflow which causes an increase in SA node firing
  • Sympathetic nervous system increases vasoconstriction which increases venous return and hence increases cardiac output
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16
Q

what is heart failure?

A
  • When the output of the heart is insufficient to meet the needs of the body
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17
Q

What can heart failure come from?

A
  • Insufficient cardiac output from reduced left ventricular contractility
  • Inadequate venous return which can come from inadequate diastolic relaxation
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18
Q

What are some symptoms of HF?

A
  • Tachycardia (compasates)
  • Shortness of breath, tiredness
  • Oedema
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19
Q

What are the possible underlting causes of HF?

A
  • Coronary artery diseas
  • Arrythmias
  • Hypertention
  • Myocardial disease
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20
Q

What are the causes of acute left ventricular failure?

A
  • Inadequate output - pulmonary oedema

- Inadequate output - can lead to increased venous returne - which increases exacerbations

21
Q

what are the treatment options of acute left ventricular failure to reduce venous return?

A
  • Diuretics
  • glycerol tinitrate
  • opioid analgesics
22
Q

what is the generic treatment for cardiogenic shock HF?

A
  • dobutamine - increases organ perfusion
23
Q

what is chronic HF?

A
  • It is a myocardium disease caused by excess load due to e.g hypertention
24
Q

What are some treatment options for chronic HF?

A
  • ACE inhibitors - first line reduces after load
  • Diuretics - furisemide - reduces preload
  • Paradoxically B1 antangonists
  • Digoxin (positive ionotrope)
25
What is the treatment goal for HF?
To reduce compensatory mechanism triggred by vasoconstriction, fluid rentention and increased cardiac output
26
Cardiac glycosides inhibit Na+/K+ ATPase which leads to an increase in cardiac contractility. TRUE OR FALSE?
TRUE
27
B1 agonists also lead to an increase in cardiac/force of contraction. TRUE OR FALSE?
TRUE
28
Digoxin is an example of a positive inotrope. TRUE OR FALSE?
- TRUE
29
cardiac glycosides were formally isolated from foxglove. TRUE OR FALSE?
TRUE
30
Cardiac glycosides have multiple effects, they block the Na+/K+ATPase in neurons in the CNS and PNS. TRUE OR FALSE?
TRUE
31
what are some side effects of cardiac glycosides e.g digoxin?
- Narrow therapeutic window - Cuases arrythmias due to AV block - slows down SA node - Neurological effects - confusion
32
What are the cautions with digoxin?
- Hypokaleamia - increases toxicity of digoxin | - Hypotheriodism
33
what are the contranidications of digoxin?
- Heart block
34
What are the drug intrecations with digoxin?
- Diuretics - Antibiotics - B antangonist increase AV conduction - B antangonist and Ca2+ chanel blockers btoh decrease contractility
35
Thyroid hormones increase renal blood flow and GFR. true or false?
true
36
Hypothyrodism increases GFR which promotes toxicity induced by digoxin. true or false?
false
37
K+ inhibits digoxin from bidning to Na+/K+ ATPase, when a patient has hypokaleamia this inhibition increases which makes digoxin more potent because less digoxin is binding to the Na+/K+ ATPase. TRUE OR FALSE?
TRUE
38
B1 - increases heart rate and contractility B2 - vascular smooth muscle dilation/ relaxation/ GI tract relaxation B3 - lilpolysis (adipose tissue) A1 - vascular smooth muscle constriction a1 and a2 - for liver and pancrese - gluconeogenesis True or false?
true
39
Provide an example of a sympathomimetic inotrope drug?
- Dubamine - used in acute emergency / can cause receptor down regulation which is the opposite of what we are trying to do - Dopamine - doesnt cross the BBB/ it a NT but it is also a B1 agonist
40
Provide an example of a PDE inhibitor?
- Enoximone
41
Enoximone is a selective PDE 3 found in smooth and caridiac muscle , it increases cAMP which causes arterial vasodilation. TRUE OR FLASE?
- TRUE
42
What are some benefits of enoximone?
- Increases cardiac output | - Does not down regulate receptors
43
Enoximone can cause arrythmias - close monioring with ECG needed/ not for chronic therapy. TRUE OR FALSE?
TRUE
44
what does Hydrazaline do?
- causes relaxation of cardiac smooth muscle
45
Hydrazaline - is not widely used because it causes quick tolerance and reflex tachycardia. TRUE OR FALSE?
TRUE
46
Sacubitril - inhibits neprilysin. TRUE OR FALSE?
TRUE
47
What is neprilysin?
it is an endopeptidase that degrades ANP, BNP nd CNP
48
Valsartan is an angiotension recpetor blocker. TRUE OR FALASE?
TRUE
49
Valsartan blocks vasoconstriction induced by angiotensin 2. TRUE OR FALSE?
TRUE

Alan's lecture - Pharmacology (16 decks)

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