ORGANOTROPIC AGENTS - Drugs used for treatment of heart failure Flashcards Preview

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Flashcards in ORGANOTROPIC AGENTS - Drugs used for treatment of heart failure Deck (57):
1

Normally involved in the pathogenesis of heart failure

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

2

Not Normally involved in the pathogenesis of heart failure

A decrease in preload

3

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

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

4

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

An increase in vagal tone

5

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

- Reduced salt intake
- ACE inhibitors
- Diuretics

6

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

Verapamil

7

The following agents belong to cardiac glycosides

- Digoxin
- Strophantin K
- Digitoxin

8

The following agent do not belong to cardiac glycosides

Amrinone

9

The non-glycoside positive inotropic drug is

Dobutamine

10

Sugar molecules in the structure of glycosides influence

Pharmacokinetic properties

11

Aglycone is essential for

Cardiotonic action

12

Derivative of the plant Foxglove (Digitalis)

Digoxin

13

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

TRUE

14

True or False. They cause a decrease in vagal tone

FALSE

15

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

TRUE

16

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

TRUE

17

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

TRUE

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.

TRUE

19

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

Digitoxin is greater than digoxin

20

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

TRUE

21

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

FALSE

22

True or False about cardiac glycosides. They increase vagal tone

TRUE

23

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

TRUE

24

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

TRUE

25

True or False about cardiac glycosides. Digoxin increases vagal tone

TRUE

26

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

FALSE

27

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

TRUE

28

The most cardiac manifestation of glycosides intoxication is

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

29

The manifestations of glycosides intoxication are

- Visual changes
- Ventricular tachyarrhythmias
- Gastrointestinal disturbances

30

For digitalis-induced arrhythmias the following drug is favored

Lidocaine

31

In very severe digitalis intoxication the best choice is to use

Digibind (Digoxin immune fab)

32

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

TRUE

33

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

TRUE

34

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

FALSE

35

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

TRUE

36

This drug is a selective beta-1 agonist

Dobutamine

37

Tolerance to this inotropic drug develops after a few days

Dobutamine

38

This drug inhibits breakdown of cAMP in vascular smooth muscle

Amrinone

39

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

Amrinone

40

This drug acts by inhibiting type III cyclic nucleotide phosphodiesterase

Milrinone

41

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

TRUE

42

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

TRUE

43

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

FALSE

44

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

TRUE

45

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

- Digoxin
- Dobutamine
- Dopamine

46

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

Verapamil

47

Drugs most commonly used in chronic heart failure are

- Cardiac glycosides
- Diuretics
- Angiotensin-converting enzyme inhibitors

48

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

FALSE

49

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

TRUE

50

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

TRUE

51

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

TRUE

52

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

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

53

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

They increase circulating catecholamine levels

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

TRUE

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

FALSE

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

TRUE

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

TRUE

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