10 Integrated Cardiac Pharmacology Flashcards

1
Q

where is the ANS cardiac control center in the CNS?

A

rostral ventrolateral medulla(RVLM)

nucleus tractus solitarius(NTS)

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2
Q

what type of pressure are baroreceptors sensitive to?

A

pulse pressure

if the pulse pressure decreases, but mean pressure is the same, baroreceptor rate of discharge will still decrease

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3
Q

autonomic predominance in vasculature

A

sympathetic is the only innervation

vasoconstriction in arterioles and venules

cholinergic vasodilation in skeletal muscle arterioles

no PSYMP INNERVATION; M3 receptors in endothelium are not connected to nerves

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4
Q

stimulation of vagal c fibers arises from where?

effect?

A

atria, ventricles, great veins, pulmonary arteries, alveoli capillaries

bradycardia, hypotension, brief apnea- bezold-jarisch reflex

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5
Q

during exercise how is the sympathetic vasoconstriction of exercising muscle overcome to allow required perfusion

A

local vasodilators

stimulation of cholinergic vasodilatory fibers

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6
Q

dynamic whole body exercises affect the TPR how?

A

drop!

baroreceptors are not triggered

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7
Q

stages of valsalva maneuver

A

strain

  1. increased MAP, decreased HR(compensatory)
  2. decreased CO/MAP(less return), increased HR(compensatory)

release

  1. transient MAP decrease, CO is restored
  2. MAP ramp up w/compensatory drop in HR
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8
Q

cause of neurocardiogenic syncope

A

cardioinhibitory - increased PSYMP tone, bradycardia

vasodepressor - decreased sympathetic tone, hypotension

mixed - both HR and BP depressed

widely accepted theory: vagal afferents affect NTS to mediate these presentations

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9
Q

potential triggers for neurocardiogenic syncope

A

pain

visual stimuli

noxious stimuli

excessive standing(pooling)

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10
Q

exacerbation of neurocardiogenic syncope

treatment?

A

dehydrtation

anxiety

exogenous catecholamines

treatment: drink water, eat salt, shift weight while standing

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11
Q

tilt table test

A
  • Pt lays horizontal and strapped down
  • HR, ECG, BP recorded
  • Table elevated to 70/80 deg
  • Room darkened
  • If no syncope after 20 min, isoproterenol is administered IV for 20 min(increase HR, decrease BP)
  • Test considered negative if no event @ 40m
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