adrenergic 2

Question 1

Beta blocker, which is the most selective?

Answer 1

nebivolol

Question 2

Beta blocker: which patients do you give it to?

Answer 2

1. Mild to severe symptoms of heart failure.
2. Systolic dysfunction of the left ventricle (EF<40%)
3. Receiving treatment with an ACE inhibitor and a diuretic
4. Any age and either sex.
5. CAD or nonischemic dilated cardiomyopathy.
6. Diabetic and nondiabetic
7. COPD without reactive airway disease.

Question 3

use of 1 of 3 BB are proven to

Answer 3

reduce mortality. They are
bisoprolol, carvedilol, sustained release metoprolol succinate

These are recommended for all pt with current or prior symptoms of HFrEF to reduce morbidity and mortality

Question 4

mechanism of neprilysin

Answer 4

degrades BNP to inactive fragments. BNP typically help against heart failure

Question 5

Digoxin excretion

Answer 5

renally

Question 6

Digoxin half life

Answer 6

1. age, renal, cardiac function dependent

2. 38 hours

Question 7

when should Digoxin be considered

Answer 7

1. HF with reduced systolic function

2. HF with preserved systolic function

Question 8

Digoxin toxicity causes

Answer 8

1. hypokalemia
2. hypercalcemia
3. hypomagnesemia

Question 9

Digoxin: hypokalemia caused by

Answer 9

Results in increased digoxin binding increasing its therapeutic and toxic effects.

Question 10

Digoxin: hypercalcemia caused by

Answer 10

Digoxin enhances Ca+2 absorption into cardiac myocytes, which is one of the ways it increases inotrophy.
This can also lead to Ca+2 overload and increased susceptibility to digitalis-induced arrhythmias.

Question 11

Digoxin: hypomagnesemia caused by

Answer 11

Can sensitize the heart to digitalis-induced arrhythmias (includes any arrhythmia except supraventricular tachydysrhythmias).

Question 12

digoxin can be beneficial in pt with

Answer 12

HFrEF to decrease hospitalizations for HF

Question 13

Milrinone is a

Answer 13

1. phosphodiester type 3 inhibitor
2. found in vasculature and myocyte.
3. This causes a rise in cAMP and rise in Ca, so this can lead to increase in force of contraction but also increase afterload because it increases vasoconstriction because it also effects the vessels.

Question 14

inotropic therapy drugs

Answer 14

1. dobutamine

2. milrinone

Question 15

dobutamine mechansim

Answer 15

1. B-1agonist to increase contractility,

2. slight peripheral vasodilation

Question 16

dobutamine indications

Answer 16

ADHF short-term management - “Cold & wet”

Question 17

dobutamine half life

Answer 17

2 minutes

Question 18

dobutamine is recommended if

Answer 18

hyportensive

Question 19

dobutamine side effects

Answer 19

1. Angina,
2. Tachyarrhythmia,
3. Cardiac Dysrhythmia