Exam 3 Linger CIS pharm Flashcards Preview

Year 2 CV > Exam 3 Linger CIS pharm > Flashcards

Flashcards in Exam 3 Linger CIS pharm Deck (30):
1

What are the cardio drugs WITHOUT positive ionotropic effects. can have negative

diuretics
ACEI
ARB
vasodilators
beta adrenergic R blockers
Natriuretic peptide

2

which class of diuretics are the most efficacious for reducing volume overload?

loop diuretics

3

what are the loop diuretics

furosemide, bumetanide, tosemide, ethacrynic acid

4

how do loop diuretics work

inhibit luminal Na/K Cl cotransporter in TAL of Henle
dec intracell K, dec back diffusion of K.
dec reabsorption Ca and Mg. Inc diuresis

5

what are indications for furosemide and ethacyrnic acid

edema, heart failure, HTN, Acute renal failure, hypercalcemic states

6

prescribed furosemide and additional agent to control BP and edema
reaction is swollen tongue and nagging cough
what most likely caused it

ACEI "-pril"

7

why do ACEI cause cough and angioedema

blocks inactivation of bradykinin

8

which R do ARBs work on

AT1

9

CHF patient is stable on furosemide and losartan
thir drug is prescribed to improve survival in patients wit HF
Sx may initially get worse but dramatic improvement after 3-6 mo Therapy
which drug was most likley prescribed

beta blocker
like metoprolol

10

describe effects of high and low dose beta blockers

high can antagonize supportive effects of catecholamines and worsen HF

low can slow herat rate, increase Ejection fraction and decrease mortality

11

what are sprionolactone and plerenone

aldosterone antagonist

12

when are aldosterone antagonists used

on top of ACEI or ARB
not by itself

13

Patient develops palpitations and has presence of third Heart sound S3
has paroxysmal atrial tachycardia with block at toxic concentrations

digoxin

14

what type of drug is digoxin

cardiac glycosid

15

what are clinical indications for cardiac glycosides

heart failure, a fib and shock

16

how do cardiac glycosides work

inhibit membrane bound NaK ATPase and increase myocardial contractility

17

does digoxin have effect on mortality

no

18

how does digoxin effect Ca

increased intracell Ca so pumped into Sarcoplasmic Reticulum because cannot leave cell (concentration gradient gone from blocked Na/K ATPase

19

Why does digoxin have many adverse effects

Na/KATPase in every part of body
main areas affected are GI and neuro

20

how does digoxin change action potential

brief prolongation of action potential followed by shortening

21

loking at action poetnetials of cardiomyocytes you see oscillatory depolarizing afterpotentnials following normally evoked action potentnials.
what drug toxicity could cause this

digoxin

22

how does digoxin change sympathetic tone

therapeutic levels decreases sympathetics and increases parasympathetics
toxic levels increases sympathetics

23

how does digoxin affect AV node at therapeutic doses

decreases conduction velocity and increases refractory period

24

how does hyperkalemia effect figosxin

reduce the effects because hyperkalemia inhibitis abnomral cardiac automaticity

25

which drug an potentiate toxic effects of digoxin

furosemide from hypokalemia and hypomagnesia

26

what are the bipyridines

inamrinone and milrinone

27

how do bipyridines work

prolong relaxation though do increase contractility

28

when are bipyrdines worked

acute HF, very short term use
usually used in hospital setting

29

how do bipyridines work

inhibit PDE3 which degrades cAMP

30

which drugs increase mortality

ACEI
ARBs
Beta blockers
aldosterone antagonists (after MI)
hydralazine with nitrate (african americans)