Cardio Drugs 1

Question 0

Essential for activity of cardiac glycosides

Answer 0

Lactone ring and steroid nucleus

Question 1

Drugs with + inotropic effects

Answer 1

Digitalis glycosides
Bipyridines
Adrenoreceptor stimulants

Question 2

Remove glycone in cardiac glycosides

Answer 2

Dec activity

Inc toxicity

Question 3

Cardiac glycosides moa

Answer 3

Improve inotropic- Inhibit na-k atpase
Neg chronotropic- inc refractoriness, slow depolarization
Dec cns sympa outflow
Arteriolar and venous vasoconstriction

Question 4

C.g. Toxicity

Answer 4

Narrow therapeutic window
Dec k- favor digoxin binding
Dec mg- ca acts as synergistically
Inc ca- sensitizes heart
Quinidine- competes with digigoxin

Question 5

Amiodarone, antibiotics,renal failure, product formulation effects with cg

Answer 5

Interacts with digoxin
Destroy enteric bacteria inactivating digoxin
Impair excretion of digoxin
Modify bioavailability of digoxin

Question 6

Ssx of toxicity cg

Answer 6

Nausea, vomiting, diarrhea
Headache, visual distirbances, confusion, delirium
Wof: arrythmias in pedia- first sign

Question 7

Management of digoxin toxicity

Answer 7

Discontinue
Anti arryhtmics
Potassium
Monitoring- renal function test, serum digoxin levels, clinical status

Question 8

Bipyridine derivatives

Answer 8

Amirinone and milrinone- vasodilation
Selective inhibition of phosphodiesteras III
Given to pt with chf- inc co, dec pulmo capillary and peri v.r
Moa- inc force contract, reduce preload and afterload

Question 9

Sympatomimetic amines moa

Answer 9

B1- inc contraction, inc hr
B2- bronchodilation, vasodilation, dec gi tone
A1- vasoconstriction, contraction of urinary and gi sphincter

Question 10

Sympatomimetic amines inotropic agents

Answer 10

Dobutamine- b1 selective agonist, improve myocardial fxn in chf
Side effects- inc hr bp, ventricular ectopic activity, phlebitis
Dopamine- non-selective adrenergic agonist
Low- inc renal blood flow, high- vasoconstrict

Question 11

Nitrates and nitrites forms

Answer 11

Amyl nitrite- extremely volatile
Nitroglycerin- moderately volatile
Isosorbid dinitrate/mononitrate- solid compounds
For acute and recurrent angina

Question 12

N and n moa

Answer 12

Release edrf for vasodilation
RELAXES ALL smooth muscles
No direct effect on cardiac and skeletal

Question 13

Side effects n and n

Answer 13

Headache, apprehension, dizziness
Hypotension, tachy, palpitation
Low nitrate regimen - 10-12 hts withdrawal, no dose later than 7

Question 14

Most common treatment for MI

Answer 14

Vasodilators

Question 15

For pulmonary artery htn

Answer 15

Endothelin receptor blocker

Question 16

Ca channel blocker

Answer 16

Muscle contraction
Diphenylalkylamine, benzothiazepine,dihydropyridine
Moa- dec trans membrane calcium current
Warning- neg inotropic verapamil- worsen chf

Question 17

Treatment of angina

Answer 17

Nitrites: amyl nitrite
Nitrates: nitroglycerin and isosorbide
Beta blockers- propanolol
Ca antagonists: verapamil, nifedipine