Pharmacology: cardiac rate, force and BP

Question 1

sympathetic NS innervation in the heart

Answer 1

NA and adrenaline activate B1-adrenoceptors (Gs)

Question 2

parasympathetic NS innervation in the heart

Answer 2

ACh activates M2 muscarinic receptors (Gi)

Question 3

examples of beta agonists

Answer 3

dobutamine
adrenaline
NA

Question 4

effect of beta agonists

Answer 4

increase rate and force of cardiac output

Question 5

what is adrenaline (alpha/beta agonist) used in?

Answer 5

cardiac arrest

anaphylactic shock

Question 6

what is dobutamine used in?

Answer 6

heart failure (less tachycardia than other agonists)

Question 7

examples of beta antagonists

Answer 7

propranolol
atenolol
bisoprolol

Question 8

effect of beta antagonists

Answer 8

during exercise rate and force is significantly reduced

Question 9

when are beta antagonists used?

Answer 9

excessive sympathetic during emotion
AF and SVT
angina
heart failure (start low, go slow)
hypertension (?)

Question 10

adverse of beta antagonists

Answer 10

bronchospasm
bradycardia
hypoglycaemia
fatigue 
cold extremities

Question 11

example of a non-selective muscarinic ACh receptor antagonists

Answer 11

atropine

Question 12

mechanism of action of non-selective muscarinic ACh receptor antagonists

Answer 12

increase HR (more pronounced in athletes)

Question 13

when are non-selective muscarinic ACh receptor antagonists used?

Answer 13

bradycardia

anti cholinesterase poisioning

Question 14

example of a cardiac glycoside

Answer 14

digoxin

Question 15

mechanism of action of digoxin

Answer 15

blocks Na+/K+ ATPase (causes membrane to depolarise slightly)

Question 16

when is digoxin used?

Answer 16

heart failure

Question 17

adverse of digoxin

Answer 17

yellow vision

Question 18

calcium sensitizers

Answer 18

levosimendan
increases Ca2+
decompensated heart failure

Question 19

inodilators

Answer 19

amrinone and milrinone
increases contractiltiy
acute heart failure

Question 20

two classes of drugs used in relax vascular smooth muscle

Answer 20

organic nitrates

CCBs

Question 21

two example of organic nitrates

Answer 21

GTN

ISMN

Question 22

mechanism of action of organic nitrates

Answer 22

dilation of collaterals increasing coronary blood flow (improved perfusion of the ischeamic zone)

Question 23

when are organic nitrates used?

Answer 23

angina

pulmonary oedema

Question 24

adverse of organic nitrates

Answer 24

headaches
reflex tachycardia (beta blocker)
formation of methaemoglobin
hypotension
tolerance

Question 25

examples of CCBs

Answer 25

verapamil amlodipine diltiazem

Question 26

mechanism of action of CCBs

Answer 26

reduce rate, force and SVR

Question 27

when are CCB's used?

Answer 27

hypertension angina SVT, AF

Question 28

adverse of CCB's

Answer 28

flushing ankle oedema hypotension

Question 29

what drug to avoid in heart failure?

Answer 29

verapamil

Question 30

two classes of drug that block the RAAS

Answer 30

1. ACEI | 2. ARB

Question 31

mechanism of action of aliskiren

Answer 31

renin inhibitor, decreasing BP

Question 32

example of an ACEI

Answer 32

lisinopril

Question 33

mechanism of action of ACEI

Answer 33

blocks angiotensin I to angiotensin II blocking aldosterone production and inactivates bradykinin

Question 34

when are ACEI used?

Answer 34

hypertension heart failure MI

Question 35

adverse of ACEI

Answer 35

dry cough hypotension hyperkalaemia angioedema

Question 36

example of an ARB

Answer 36

losartan

Question 37

mechanism of action of ARBs

Answer 37

block angiotensin II on AT1 receptors, but doesn't inhibit bradykinin

Question 38

when is ARBs used?

Answer 38

hypertension heart failure MI

Question 39

what are both ACEI and ARB contradicted in?

Answer 39

bilateral renal artery stenosis | pregnancy

Question 40

potassium channel opens

Answer 40

minoxidil and nicorandil hyperpolarisation used as last resort in hypertension and angina adverse: reflex tachycardia and salt and water retention

Question 41

alpha1-adrenoceptors

Answer 41

prazosin and doxazosin vasodilation prostatic hyperplasia and hypertension adverse: postural hypertension