Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology -- Test #3 > Cardiac Ischemia > Flashcards

Cardiac Ischemia Flashcards

1
Q

How does dilation of veins/decreasing prelaod affect heart blood flow

A

Less Oxygen consumption and improved myocardial perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does dillation of the arteries/decreasing afterload affect the heart

A

Decrease leads to lower Oxygen consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Two broad strategies utilized to improve myocardial ischemia?

A

Agents increasing O2 supply and agents decreasing O2 demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Examples of agents that increase O2 supply to heart

A

Vasodilators (like Ca entry blockers), Statins, Antithrombotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Examples of agents that help decrease heart O2 demand

A

Beta blockers
Organic Nitrates
Ca entry blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Agents used to treat Stable and Variant Angina

A

Organic Nitrates
calcium Channel Blockers
Beta-Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Primary effect of organic nitrates in Angina

A

Marked dilation of veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can Organic Nitrate resistance be avoided?

A

Brief periods (several hours) without the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do Calcium channel blockers help with angina?

A

Decreased Ca diminishes trigger for contraction

Dilation of arteries, decrease in afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the role of beta-blockers in Angina

A

Block epinephrine stimulation of the myocardium
Negative inotropic and chronotropic effect
Lower HR increases Perfusion
OVERALL – Lower Oxygen demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SA and aV nodal automaticity is caused by…

A

HCN2/4 channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HR is increased by…

A 
Hypokalemia
Beta agonists
Fiber stretch
Acidosis
Injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do beta adrenergic antagonists slow the HR

A

Inhibit HCN conductance, hyperpolarizing the membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Small molecule used to modify HCN?

A

Ivabradine (Procoralan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does Ivabradine work?

A

Selective blocker of HCN

Approved for patients WHO CAN’T take beta-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What combination therapy is particularly effective in stable angina?

A

Organic Nitrates + Beta adrenergic antagonists

17
Q

Combination therapy used for stable angina refractory of organic nitrate/beta-blocker combination

A

Calcium channel blockers + beta blockers

18
Q

Which CCB should you use?

A

Use DHP because it doesn’t inhibit the heart

19
Q

Combination used for severe vasospastic or stable angina, but NOT for angina+HF

A

CCB + Organic Nitrates

20
Q

What to try if none of the double therapies work?

A

Triple therapy. Bitch.

21
Q

Beta blocker, Nitrates, Diltiazem, DHPs, Verapamil.

Who causes hypotension, flushing, headaches?

A

Nitrates and DHPs

22
Q

Beta blocker, Nitrates, Diltiazem, DHPs, Verapamil.

Who causes LV dysfunction

A

beta blockers, Verapamil, Diltiazem

23
Q

Beta blocker, Nitrates, Diltiazem, DHPs, Verapamil.

Who causes major Brady + AV block

A

beta blocker ad Verapamil

24
Q

Beta blocker, Nitrates, Diltiazem, DHPs, Verapamil.

Which is heavily associated with GI distress?

A

Verapamil

25
Q

Beta blocker, Nitrates, Diltiazem, DHPs, Verapamil.

Which one is a bronchoconstrictor

A

beta blockers

26
Q

Effect of Ranolazine?

A

Inhibits late Na current
Typically in Cardiac Ischemia, the late Na current would lead to Na overload. This would trigger Ca overload. Elevated Calcium would trigger mechanical and electrical disruptions.

27
Q

What is Ranolazine used for?

A

To prevent anginal attacks

NOT to terminate currently active ones

28
Q

Risks of Ranolazine?

A

Can cause Dizziness

May cause lengthening of QT interval

29
Q

Three factors that promote plaque instability

A

Large Lipid Pool
Thin Fibrous Cap
Inflammation

30
Q

List some strategies to stabilize lipid plaques

A

Reduce LDL, Increase HDL
Inhibit MMPs, Inflammation
Inhibit Cholesterol crystallization

31
Q

Two drugs that are used in stents

A

Paclitaxel

Sirolimus

32
Q

What is Paclitaxel

A

Stent drug that binds microtubules and stablizes polymerization

33
Q

What is sirolimus?

A

A stent drug macrolide that binds FKB12 and inhibits mTOR to stop cell cycle progression.

34
Q

Net effect of stent drugs?

A

Present restenosis by inhibiting smooth muscle cell proliferation

Pharmacology -- Test #3 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions