HF4 Flashcards Preview

Pharmacology II > HF4 > Flashcards

Flashcards in HF4 Deck (30)
Loading flashcards...
1

what effect does hyperkalemia have on digoxin?
what effect does hypokalemia have

hyperkalemia = less benefits of digoxin
hypokalemia = digoxin toxicity

2

what are the adverse effects of digoxin

muscle weakness
agitation
vision problems
fatigue
anorexia
nausea and vomiting

3

what should be used for digoxin toxicity treatment

digoxin immune fab (digibind)

4

what category is amiodarone's interaction with digoxin?
what should be done if taken together

category D
decrease digoxin dose by 1/3 to 1/2

5

what is the interaction category of verapamil and digoxin?
what should be done if taken together

category C
monitor closely (can increase digoxin conc.)

6

what category interaction is spironolactone and digoxin?
what should be done if taken together

category C
monitor closely (can increase digoxin conc.)

7

what category interaction is quinidine and digoxin?
what should be done if taken together

category D
decrease digoxin dose by 1/4 to 1/2

8

what is the MOA of beta agonists in HF (3 steps)?

1. activates adenylyl cyclase which produces cAMP
2. cAMP activates protein kinase
3. phosphorylation of L type Ca channel increases Ca conc.

9

what are two B agonists for HF

Dopamine
Dobutamine

10

what is increased by B agonists

increases:
inotropic = FOC
chronotropic = HR
lusitropic = relaxation rate

11

what beta adrenergic agonist is used for short term treatment of severe, refractory chronic HF

Dopamine

12

why is dopamine only used short term?

increase in oxygen demand due to tachycardia

13

what are the adverse effects of dopamine

tachycardia
arrhythmias

14

what do low doses of dopamine do

cause vasodilation in periphery by binding to receptors on KIDNEYS
also causes diuresis

15

what do intermediate doses of dopamine do?

cause vasodilation via B2 receptors and increase HR and FOC via B1 receptors

16

what do high doses of dopamine do

cause vasoconstriction throughout body via alpha1 receptors

17

what does high doses of dopamine do to hemodynamics

increase afterload and SVR

18

what receptor is effected the most by both enantiomers of dobutamine

beta1 effected most

19

what enantiomer of dobutamine is an alpha1 antagonist

+ enantiomer

20

what enantiomer of dobutamine is an alpha1 agonist

- enantiomer

21

what are the hemodynamic effects of dobutamine

increase SV and increase CO

22

what are some adverse effects of dobutamine

angina
tachycardia

23

why do b-agonists development create tolerance

receptor down regulation

24

what is the MOA of phosphodiesterase inhibitors in HF?

inhibit breakdown of cAMP, causing phosphorylation of L-type Ca channel, increasing Ca conc

25

what PDE inhitors are used for HF?

PDE-3s:
inamrinone
milrinone

26

what is the hemodynamic effects of PDE inhibitors

increase FOC
decrease afterload
decrease preload

27

why are PDE inhibitors used short term only

long term linked to increased mortality

28

what are some adverse effects of PDE inhibitors

ventricular arrhythmias
thrombocytopenia
N and V
increased LFTs

29

what PDE inhibitor is preferred?
why

milrinone
inamrinone has 10% incidence of thrombocytopenia

30

increased preload leads to what type of symptoms

congestive symptoms