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Pharm II > Cardiac Glycosides, Antianginals, and Antidysrhythmics > Flashcards

Cardiac Glycosides, Antianginals, and Antidysrhythmics Flashcards

1
Q

normal value of ANP

A

20-77

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2
Q

more sensitive than ANP for diagnosing HF

A

BNP

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3
Q

normal range for BNP

A

less than 100 pg/mL

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4
Q

nonpharm measures to treat HF

A

2 g/day of salt
decrease alcohol intake
limit fluid intake
avoid smoking
lose weight
decrease sat fat
mild exercise (walking, biking)

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5
Q

agents used in HF

A

glycosides, phosphodiesterase inhibitors, vasodilators, ACE inhibitors, ARBs, diuretics, spironolactone, nesiritide, some beta blockers

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6
Q

cardiac glycoside

A

digoxin

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6
Q

3 effects of digitalis on the heart

A

positive inotropic (increase contractility)

negative chronotropic (decrease HR)

negative dromotropic (decreases conduction of heart cells)

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7
Q

cardiac glycosides are also used to correct what

A

a-fib and a-flutter

accomplished by negatove chronotropic and negative dromotropic effects

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8
Q

therapeutic serum lvl for dig for dysrhythmias

A

0.8-2.0 ng/mL

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9
Q

therapeutic serum lvl for dig for HF

A

0.5-1.0 ng/mL

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10
Q

symptoms of dig toxicity

A

anorexia, diarrhea, N/V, bradycardia, dysrhythmias, headaches, malaise, blurred vision, visual illusions (white, green, or yellow halos around objects), confusion, and delirium

older adults more at risk

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11
Q

antidote for dig

A

digoxin-immune Fab (digibind)

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12
Q

what increases the effect of digoxin at its myocardial cell site of action, resulting in dig toxicity

A

hypokalemia (low K+)

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13
Q

what can interact with dig

A

diuretic, cortisone (hypokalemia), and antacids (decrease absorption)

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14
Q

this drug group inhibits the enzyme PDE, which promotes a positive inotropic response and vasodilation

A

phosphodiesterase inhibitors

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15
Q

a phosphodiesterase inhibitor (admin IV no longer than 48-72 hrs)

need to be on EKG bc dysrhythmias may result

A

milrinone lactate (high alert)

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16
Q

decrease venous blood return to the heart and result in a decrease in cardiac filling, ventricular stretching (preload), and oxygen demand on the heart

A

vasodilators

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17
Q

dilate venules and arteriole, which improves renal blood flow and decreases blood fluid volume

A

ACE inhibitors

-pril

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18
Q

for pts who cannot tolerate ACE inhibitors

A

ARBs

-sartan

19
Q

first-line drug treatment in reducing fluid volume

A

diuretics

20
Q

potassium sparing diuretic

A

spironolactone

21
Q

an ANP that inhibits ADH by increasing sodium loss; effect is achieved by promoting vasodilation, natriuresis, and diuresis

A

nesiritide

22
Q

a combo of hydralazine (for BP) and isosorbide dinitrate (a dilator) has been approved to treat HF especially in who

A

african americans

23
Q

new med that regulates vascular tone and contraindicated in pregnancy

A

vericiguat

24
Q

a condition of acute cardiac pain caused by inadequate blood flow to the myocardium due to either plaque occlusions within or spasms of the coronary arteries

A

angina pectoris

25
Q

types of angina

A

classic (stable)- predictable with stress or exertion

unstable (preinfarction)- frequently with progressive severity, unpredictable

variant (prinzmetal)- during rest caused by vessel spasm

26
Q

types of antianginal drugs

A

nitrates, beta blockers, and CCBs

27
Q

first agents used to relieve angina

generalized vasodilation and can cause hypotension

A

nitrates

decreases preload and afterload

28
Q

used for variant angina

A

nitrates and CCBs

29
Q

side effects of nitrates

A

headaches, hypotension, dizziness, flushing, weakness, faintness

taper dose to prevent myocardial ischemia

reflex tachycardia if given too rapidly

30
Q

decrease the effects of the sympathetic nervous system by blocking the action of the catecholamines, epi and norepi, thereby decreasing the heart rate and blood pressure

A

beta blockers

31
Q

selective beta 1 blocker (cardioselective)

A

atenolol and metoprolol (A BEAM)

32
Q

nonselective beta blocker side effects

A

bronchospasm, agitation, dizziness, drowsiness, confusion, cool extremities, and ED (with propranolol)

33
Q

relax coronary artery spasm and relax peripheral arterioles, decreasing cardiac oxygen demand.

negative inotropic and decrease afterload, and peripheral resistence, and they reduce the workload of the heart which decreases the need for oxygen

A

CCBs

check LFTs

calcium activates myocardial contraction, increasing the workload of the heart and the need for more oxygen

34
Q

side effects of CCBs

A

headache, hypotension, dizziness, and flushing of skin

reflex tachycardia can occur as a result of hypotension

check LFTs

35
Q

what IV med can decrease the effects of heparin

A

nitro

36
Q

defined as any deviation from the normal rate or pattern of the heartbeat

rates that are too slow, too fast, or irregular

A

cardiac dysrhythmia

37
Q

4 classes of antidysrhythmics

A

I sodium channel blockers
II beta blockers
III drugs that prolong repolarization
IV CCBs

38
Q

slow conduction and prolong repolarization (quinidine, procainamide, disopyramide)

A

Class IA

39
Q

slow conduction and shorten repolarization (lidocaine, mexiletine HCl)

A

Class IB

40
Q

prolong conduction with little to no effect on repolarization (flecainide)

A

Class IC

41
Q

reduce calcium entry
decrease conduction velocity, automaticity, and recovery time (refractory period)

A

Class II beta blockers

42
Q

prolong repolarization during ventricular dysrhythmias

prolong action potential duration

A

Class III (emergency treatment of ventricular dysrhythmias) (amiodarone)

43
Q

block calcium influx
slow conduction velocity
decrease myocardial contractility (negative inotropic)
increase refraction in AV node

A

Class IV CCBs

44
Q

all antidysrhythmic drugs are potentially _____

A

prodysrhythmic

Pharm II (16 decks)

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