ORGANOTROPIC AGENTS - Drugs used for treatment of heart failure

Question 1

Normally involved in the pathogenesis of heart failure

Answer 1

• A cardiac lesion that impairs cardiac output
• An increase in peripheral vascular resistance
• An increase in sodium and water retention

Question 2

Not Normally involved in the pathogenesis of heart failure

Answer 2

A decrease in preload

Question 3

All of the following are compensatory mechanisms that occur during the pathogenesis of congestive heart failure

Answer 3

• An increase in ventricular end-diastolic volume
• An increase in the concentration of plasma catecholamines
• Increased activity of the renin-angiotensin-aldosterone system

Question 4

The following are not compensatory mechanisms that occur during the pathogenesis of congestive heart failure

Answer 4

An increase in vagal tone

Question 5

All of the following are recommended at the initial stages of treating patients with heart failure

Answer 5

• Reduced salt intake
• ACE inhibitors
• Diuretics

Question 6

The following are not recommended at the initial stages of treating patients with heart failure

Answer 6

Verapamil

Question 7

The following agents belong to cardiac glycosides

Answer 7

• Digoxin
• Strophantin K
• Digitoxin

Question 8

The following agent do not belong to cardiac glycosides

Answer 8

Amrinone

Question 9

The non-glycoside positive inotropic drug is

Answer 9

Dobutamine

Question 10

Sugar molecules in the structure of glycosides influence

Answer 10

Pharmacokinetic properties

Question 11

Aglycone is essential for

Answer 11

Cardiotonic action

Question 12

Derivative of the plant Foxglove (Digitalis)

Answer 12

Digoxin

Question 13

True or False. They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca++ in myocardial cells

Answer 13

TRUE

Question 14

True or False. They cause a decrease in vagal tone

Answer 14

FALSE

Question 15

True or False. Children tolerate higher doses of digitalis than do adults

Answer 15

TRUE

Question 16

True or False. The most frequent cause of digitalis intoxication is concurrent administration of diuretics that deplete K+

Answer 16

TRUE

Question 17

True or False. An important action of digitalis is to increase vagal tone.

Answer 17

TRUE

Question 18

True or False. Digoxin is thought to increase intracellular concentrations of calcium in myocardial cells by indirectly slowing the action of the sodium-calcium exchanger.

Answer 18

TRUE

Question 19

Compare the half-life of digoxin and the half-life of digitoxin

Answer 19

Digitoxin is greater than digoxin

Question 20

True or False about cardiac glycosides. They inhibit the activity of the Na+/K+-ATPase

Answer 20

TRUE

Question 21

True or False about cardiac glycosides. They decrease intracellular concentrations of calcium in myocytes

Answer 21

FALSE

Question 22

True or False about cardiac glycosides. They increase vagal tone

Answer 22

TRUE

Question 23

True or False about cardiac glycosides. They have a very low therapeutic index

Answer 23

TRUE

Question 24

True or False about cardiac glycosides. Digoxin is a mild inotrope

Answer 24

TRUE

Question 25

True or False about cardiac glycosides. Digoxin increases vagal tone

Answer 25

TRUE

Question 26

True or False about cardiac glycosides. Digoxin has a longer half-life than digitoxin

Answer 26

FALSE

Question 27

True or False about cardiac glycosides. Digoxin acts by inhibiting the Na+/K+ ATPase

Answer 27

TRUE

Question 28

The most cardiac manifestation of glycosides intoxication is

Answer 28

- Atrioventricular junctional rhythm - Second-degree atrioventricular blockade - Ventricular tachycardia

Question 29

The manifestations of glycosides intoxication are

Answer 29

- Visual changes - Ventricular tachyarrhythmias - Gastrointestinal disturbances

Question 30

For digitalis-induced arrhythmias the following drug is favored

Answer 30

Lidocaine

Question 31

In very severe digitalis intoxication the best choice is to use

Answer 31

Digibind (Digoxin immune fab)

Question 32

True or False about cardiac glycoside-induced ventricular tachyarrhythmias. Lidocaine is a drug of choice in treatment

Answer 32

TRUE

Question 33

True or False about cardiac glycoside-induced ventricular tachyarrhythmias. Digibind should be used in life-threatening cases

Answer 33

TRUE

Question 34

True or False about cardiac glycoside-induced ventricular tachyarrhythmias. They occur more frequently in patients with hyperkalemia than in those with hypokalemia

Answer 34

FALSE

Question 35

True or False about cardiac glycoside-induced ventricular tachyarrhythmias. They are more likely to occur in patients with a severely damaged heart

Answer 35

TRUE

Question 36

This drug is a selective beta-1 agonist

Answer 36

Dobutamine

Question 37

Tolerance to this inotropic drug develops after a few days

Answer 37

Dobutamine

Question 38

This drug inhibits breakdown of cAMP in vascular smooth muscle

Answer 38

Amrinone

Question 39

This drug is useful for treating heart failure because it increases the inotropic state and reduces afterload

Answer 39

Amrinone

Question 40

This drug acts by inhibiting type III cyclic nucleotide phosphodiesterase

Answer 40

Milrinone

Question 41

True or False about inhibitors of type III phosphodiesterase. They raise cAMP concentrations in cardiac myocytes

Answer 41

TRUE

Question 42

True or False about inhibitors of type III phosphodiesterase. They reduce afterload

Answer 42

TRUE

Question 43

True or False about inhibitors of type III phosphodiesterase. They show significant cross-tolerance with beta-receptor agonists

Answer 43

FALSE

Question 44

True or False about inhibitors of type III phosphodiesterase. They are associated with a significant risk for cardiac arrhythmias

Answer 44

TRUE

Question 45

The following drugs are used in the treatment of severe congestive heart failure

Answer 45

- Digoxin - Dobutamine - Dopamine

Question 46

The following drug are not used in the treatment of severe congestive heart failure

Answer 46

Verapamil

Question 47

Drugs most commonly used in chronic heart failure are

Answer 47

- Cardiac glycosides - Diuretics - Angiotensin-converting enzyme inhibitors

Question 48

True or False about angiotensin converting enzyme (ACE) inhibitors. They act by inhibiting the ability of renin to convert angiotensinogen to angiotensin I.

Answer 48

FALSE

Question 49

True or False about angiotensin converting enzyme (ACE) inhibitors. Enalapril is a prodrug that is converted to an active metabolite

Answer 49

TRUE

Question 50

True or False about angiotensin converting enzyme (ACE) inhibitors. They reduce secretion of aldosterone

Answer 50

TRUE

Question 51

True or False about angiotensin converting enzyme (ACE) inhibitors. They can produce hyperkalemia in combination with a potassium-sparing diuretic

Answer 51

TRUE

Question 52

The following effects of ACE inhibitors may be useful in treating heart failure

Answer 52

- They decrease afterload - They reduce reactive myocardial hypertrophy - They increase myocardial beta-1 adrenergic receptor density

Question 53

The following effect of ACE inhibitors may be not useful in treating heart failure

Answer 53

They increase circulating catecholamine levels

Question 54

True or False about the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of heart failure. They improve hemodynamics by decreasing afterload

Answer 54

TRUE

Question 55

True or False about the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of heart failure. They can increase plasma cholesterol levels

Answer 55

FALSE

Question 56

True or False about the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of heart failure. They may slow the progression of heart failure by preventing myocardial and vascular remodeling

Answer 56

TRUE

Question 57

True or False about the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of heart failure. They are effective first-line agents in the treatment of chronic heart failure

Answer 57

TRUE