HF3

Question 1

what is the mechanism of action of clonidine

a. direct dilation of arterioles
b. selectively block alpha1 receptors
c. reduce sympathetic outflow from vasomotor centers in the brainstem
d. prevent the release of NE from peripheral postganglionic sympathetic neurons

Answer 1

c. reduce sympathetic outflow

Question 2

which are the predominant initial effects of B1 antagonists

a. decrease HR and decrease FOC
b. decrease HR and decrease PVR
c. decrease PVR and decrease preload
d. decrease preload and decrease CO

Answer 2

a. decrease in HR and decrease in FOC

Question 3

what is the most likely adverse effect of a drug that causes direct vasodilation of arterioles

Answer 3

tachycardia

Question 4

list 4 groups known as preload reducers

Answer 4

1. diuretics
2. aquaretics
3. aldosterone antagonists
4. venodilators

Question 5

what are diuretics effects on symptoms of HF and hypertrophy

Answer 5

decreases symptoms and decreases hypertrophy

Question 6

which is an antidiuretic hormone antagonist:

a. acetazolamide
b. conivaptan
c. eplerenone
d. triamterene

Answer 6

b. conivaptan

Question 7

name two aquaretics

Answer 7

conivaptan (IV)

tolvaptan (PO)

Question 8

what are the effects of auqaretics?

Answer 8

increase urine output, increase sodium concentration, decrease HF symptom,s, and effect BP

Question 9

list two aldosterone antagonists that decrease preload

Answer 9

spironolactone and eplerenone

Question 10

what is the MOA of aldosterone antagonists

Answer 10

decrease Na/ K exchange in collecting duct;

decreasing sodium and water reabsorption

Question 11

what should be monitored when taking spironolactone?

Answer 11

potassium

Question 12

list the venodilators.

what is there MOA

Answer 12

NTG
sodium nitroprusside
increase venous capacitance

Question 13

what do venodilators do to venous return to heart and O2 demand

Answer 13

decrease venous return

decrease O2 demand

Question 14

does sodium nitroprusside effect the arterial side or venous side more in a normal heart?
in HF?

Answer 14

in normal heart venouse side

in HF arterial side

Question 15

list 3 afterload reducing groups

Answer 15

ACEI/ ARB
Beta blocker
Vasodilators

Question 16

what is the MOA of ACEIs and ARBs on preload side?

Answer 16

blocks aldosterone

Question 17

what is the MOA of ACEIs and ARBs on afterload side

Answer 17

blocks angio II’s vasoconstriction

Question 18

how does angio II have a slow pressor response

Answer 18

aldosterone release

Question 19

how does angio II have a rapid pressor response

Answer 19

altered SVR

Question 20

other than decrease afterload and preload what hemodynamic effect does ACEI’s and ARBs have?

Answer 20

decrease remodeling and decrease hypertrophy

Question 21

why does BB use seem paradoxical in HF?

Answer 21

they can cause drop in CO initially (bad).

over long term, have decreased mortality do to

Question 22

what all is decreased by BBs in HF?

Answer 22

decreased:
HR
renin
apoptosis
tachyarrhythmias

Question 23

BBs stop tachycardia caused from what in HF

Answer 23

neurohumoral mechanism

Question 24

when should BB’s not be used for HF

Answer 24

acute situation

Question 25

list two vasodilators used in afterload reduction

Answer 25

Nesiritide | BiDil

Question 26

what is in BiDil

Answer 26

hydralazine and ISDN

Question 27

name a synthetic brain natriuretic peptide? | what is it's MOA

Answer 27

Nesiritide | MOA = vasodilation by binds to GC receptor on vascular smooth muscle

Question 28

what is brain naturetic peptide

Answer 28

a marker of HF

Question 29

what does nesiritide do by binding to GC receptor?

Answer 29

increase cGMP leading to relaxation | also gives diuresis

Question 30

what needs to be monitored with nesiritide

Answer 30

renal fxn and BP

Question 31

where does BiDil work? arterial or venous

Answer 31

both hydralazine = arterial ISDN = venous

Question 32

what is beneficial about BiDil

Answer 32

decreases mortality (especially in AA pts)

Question 33

what is a problem with BiDil

Answer 33

TID

Question 34

what are the inotropic agents for HF

Answer 34

cardiac glycosides beta agonists PDE inhibitors

Question 35

what is digoxins effects on electrolytes

Answer 35

increases Na at Na/K ATPase pump, increases Ca at Na/Ca exchanger

Question 36

how does digoxin increase FOC

Answer 36

increases intracellular Ca

Question 37

how is digoxin eliminated

Answer 37

renally

Question 38

at what crcl is digoxin contraindicated

Answer 38

ClCr less than 50

Question 39

which should have a lower renin level of digoxin: for HF or for arrhythmia

Answer 39

for HF

Question 40

what happens to ejection fraction with digoxin tx?

Answer 40

increases (more blood flow to organs)

Question 41

what is a conduction problem with digoxin

Answer 41

slows conduction to AV node; can cause arrhythmias