Cardiac Glycosides, Antianginals, and Antidysrhythmics

Question 1

Occurs when the heart muscle does not pump blood as well as it should

Answer 1

Congestive heart failure

Question 2

Drugs that inhibit the sodium-potassium pump, which results in an increase in intracellular sodium

Answer 2

Cardiac glycosides

Question 3

Action that increased myocardial contraction stroke volume

Answer 3

Inotropic

Question 4

An action that decreases conduction of heart cells

Answer 4

Dromotropic

Question 5

Cardiac dysrhythmia with rapid uncoordinated contractions of the atrial myocardium

Answer 5

Atrial fibrillation

Question 6

Medicines that relieve the symptoms of angina pectoris

Answer 6

Antianginal drugs

Question 7

Peripheral vascular resistance

Answer 7

Afterload

Question 8

Agents used for the treatment of stable and variant angina pectoris, certain dysrhythmias, and hypertension

Answer 8

Calcium channel blockers

Question 9

The first agents used to relieve angina

Answer 9

Nitrates

Question 10

Amount of blood in the ventricles of the heart at the end of diastole

Answer 10

Preload

Question 11

Lack of blood supply to the heart muscle

Answer 11

Myocardial Ischemia

Question 12

Drugs that restore the cardiac rhythm to normal

Answer 12

Antidysrrhythmic drugs

Question 13

Any deviation from the normal rate or pattern of the heartbeat

Answer 13

Cardiac dysrhythmia (arrhythmia)

Question 14

Return of cell membrane potential to resting after depolarization

Answer 14

Repolarization

Question 15

When sodium and calcium enter the cardiac cell and myocardial contraction occurs

Answer 15

Depolarization

Question 16

Drugs that decrease the effects of the sympathetic nervous system by blocking the action of the catecholamines, epinephrine, and norepinephrine - caused a decrease in heart rate and blood pressure

Answer 16

Beta blockers

Question 17

Nonpharmacological treatment for heart failure includes:

Answer 17

Limiting salt to <2g/day (1 tsp). Limiting alcohol to 1 drink/day or less. Restricting fluid intake. Quitting smoking. Decreasing saturated fat intake. Mild exercise.

Question 18

Which lab is typically used to diagnose HF?

Answer 18

Brain natriuretic peptide (BNP)

Question 19

How do cardiac glycosides affect heart function?

Answer 19

1. Positive inotropic (increase myocardial contractility)
2. Negative chronotropic (decrease heart rate)
3. Negative dromotropic (decrease conduction)
4. Increase stroke volume (increase cardiac output)

Question 20

What is the therapeutic level of Digoxin?

Answer 20

0.8-2.0 ng/mL

Question 21

What are the symptoms of digoxin toxicity?

Answer 21

Nausea, vomiting, diarrhea, blurred vision, green or yellow halo, headache, confusion, delirium, bradycardia, PVCs, cardiac dysrhythmias

Question 22

What medication can we give for Digoxin toxicity?

Answer 22

Digoxin immune fab

Question 23

True or False: Hypokalemia will increase the likelihood of digoxin toxicity.

Answer 23

True

Question 24

Drugs that interact with digoxin include:

Answer 24

Diuretics, cortisone, and antacids

Question 25

Milrinone lactate (Primacor) is an example of a:

Answer 25

Phosphodiesterase inhibitor

Question 26

Phosphodiesterase inhibitors work by:

Answer 26

1. Causing a positive inotropic effect. 2. Increasing stroke volume. 3. Promoting vasodilation

Question 27

What effects do vasodilators and arteriolar dilators have on preload and afterload?

Answer 27

Vasodilators decrease preload. Arteriolar dilators decrease afterload.

Question 28

Besides cardiac glycosides and phosphodiesterase inhibitors, what other drugs do we use to treat HF?

Answer 28

ACE inhibitors, ARBs, Diuretics, and Beta Blockers

Question 29

What are the different types of angina?

Answer 29

Classic (stable), Unstable (preinfarction), and Variant (Prinzmetal, vasospastic)

Question 30

Describe class angina

Answer 30

Occurs with predictable stress or exertion

Question 31

Describe unstable angina

Answer 31

Occurs frequently with progressive severity unrelated to activity; unpredictable

Question 32

Describe variant angina

Answer 32

Occurs during rest; caused by vasospasm

Question 33

What are nonpharmacological ways to control angina?

Answer 33

Avoiding heavy meals, smoking, extreme weather changes, strenuous exercise, emotional upset, and alcohol.

Question 34

How do nitrates work?

Answer 34

They promote vasodilation and decrease preload and afterload.

Question 35

What are the most common side effects of nitrates?

Answer 35

Headache and hypotension

Question 36

Why do we usually give nitro sublingual?

Answer 36

Due to its extensive 1st pass metabolism

Question 37

How do beta blockers help heart failure?

Answer 37

Decrease force of myocardial contraction and heart rate, which decreases the workload of the heart.

Question 38

Are atenolol and metoprolol selective or nonselective beta blockers?

Answer 38

Selective

Question 39

Verapamil, nifedipine, and diltiazem are examples of:

Answer 39

Calcium channel blockers

Question 40

How do calcium channel blockers affect the heart?

Answer 40

They relax coronary arteries, cause a negative inotropic effect, thus reducing cardiac workload and oxygen demand.

Question 41

Which calcium channel blocker is most likely to cause hypotension?

Answer 41

Nifedipine

Question 42

What patient education should be provided regarding administration of nitroglycerin?

Answer 42

Take sublingual nitro if chest pain occurs per prescribers instructions. Take the first dose while sitting or lying down. If chest pain is not relieved, call 911.

Question 43

The 4 classes of antidysrhythmic drugs are:

Answer 43

1. Sodium channel blockers 2. Beta blockers 3. Drugs that prolong repolarization 4. Calcium channel blockers

Question 44

Quinidine, Flecainamide, lidocaine, and procainamide are examples of:

Answer 44

Sodium channel blockers

Question 45

Amiodarone is an example of:

Answer 45

A drug that prolongs repolarization

Question 46

Which 2 types of drugs used to treat dysrhythmias have similar effects on the heart?

Answer 46

Beta blockers and calcium channel blockers