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Pharm > Cardio X > Flashcards

Cardio X Flashcards

1
Q

What is the significance of a ST depression?

A

Ischemia

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2
Q

What does a narrow pulse pressure indicate?

A

Ischemia

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3
Q

Do you use lidocaine prophylactically?

A

No

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4
Q

What is the frank starling mechanism?

A

The more preload there is, the more contractility there is to expell the load

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5
Q

What is the preload?

A

Tension deveoped on the walls of the ventricles before is starts to contract

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6
Q

What is the effect of increasing preload on stroke volume?

A

Increases

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7
Q

What is the effect of increasing afterload on stroke volume?

A

Decreased

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8
Q

What is the anrep phenomenon?

A

Increasing after load, will increase contractility

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9
Q

What is the Bowditch phenomenon?

A

increase in HR will be related with increase contractility

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10
Q

Increases in contractility are reflected on a SV/EDV cure how: shifts along the curve, or shifts of the curve?

A

Shifts of the curve

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11
Q

What is the effect of contractility on the need d(EDV)/dSV?

A

smaller

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12
Q

What is the end result of all hearts diseases?

A

Cardiac remodeling (hypertrophy etc) and heart failure

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13
Q

What are the drugs that are used to counteract the decrease in CO d/t heart failure?

A

Inotropic agents

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14
Q

What are the drugs that are used to stop the SANS activation that is caused by cardiac failure?

A

Beta blockers

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15
Q

What are the two ways in which beta blockers help in heart failure?

A

Decrease SANS activation

Decrease renin secretion

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16
Q

What are the two things in heart failure that leads to elevated cardiac filling pressure?

A

Vasoconstriction

Na and water retention

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17
Q

Which division of the ANS activates renin secretion?

A

SANS

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18
Q

Which of the aldosterone inhibitors prevents cardiac remodeling?

A

Spironolactone

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19
Q

What is the effect or ARBs on vasoconstriction?

A

Decreases

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20
Q

What is stage A of the ACC/AHA classification system for heart failure?

A

High risk for developing HF

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21
Q

What is stage B of the ACC/AHA classification system for heart failure?

A

Asymptomatic HF (pre-HF)

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22
Q

What is stage C of the ACC/AHA classification system for heart failure?

A

Symptomatic HF

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23
Q

What is stage D of the ACC/AHA classification system for heart failure?

A

Refractory, end stage HF

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24
Q

Which stage of HF: HTN

A

A

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25
Q

Which stage of HF: CAD

A

A

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26
Q

Which stage of HF: DM

A

A

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27
Q

Which stage of HF: family h/o cardiomyopathy

28
Q

Which stage of HF: previous MI

29
Q

Which stage of HF: LV systolic dysfunction

30
Q

Which stage of HF: Asymptomatic valvular disease

31
Q

Which stage of HF: Known structural heart disease

32
Q

Which stage of HF: SOB and fatigue

33
Q

Which stage of HF: reduced exercise tolerance

34
Q

What are Tran’s three groupings of HF pts?

A

Before the heart (peripheral edema)

At the heart (HTN)

Decreased CO

35
Q

What are the two drugs that are indicated for stage A HF?

A

ACEI or an ARB

36
Q

What are the three drugs that are indicated for stage B HF?

A

ACEI/ARB and beta blocker

37
Q

When and in what stage are diuretics indicated for HF pts?

A

C, if there is fluid retention

38
Q

When and in what stage are aldosterone antagonists indicated for HF pts?

A

C

Symptomatic LVD/most MI

39
Q

When and in what stage are hydralazine and nitrates indicated for HF pts?

A

C

Symptomatic HF

40
Q

When and in what stage are ARB and ACEIs (together) indicated for HF pts?

A

C

Symptomatic HF

41
Q

When and in what stage is digoxin indicated for HF pts?

A

Symptomatic HF, atrial fibrillation

42
Q

Why are ACEI and ARBs indicated for all HF pts?

A

Decrease cardiac remodeling

43
Q

What are the drugs used to treat type B HF pts?

A

regular meds + positive inotropes

44
Q

What will diuretics do to the ventricular filling pressure needed for each level of stroke volume?

A

Shift along cardiac output curve to a lower value (decreases volume without increasing contractility)

45
Q

What will Inotropic agents do to the ventricular filling pressure needed for each level of stroke volume?

A

Shift the curve up (more output at the same ventricular pressure)

46
Q

What will vasodilators do to the ventricular filling pressure needed for each level of stroke volume?

A

Shift curve up and to the left (more output at less ventricular pressure)

47
Q

What are the two effects of the beta adrenergic receptor activation in the heart on Ca?

A

Increase release, but also increase sequestration

48
Q

What happens to the pattern of myocardial contraction with Ca release via cAMP from beta adrenergic stimulation?

A

Increase slope (rate of contraction)

Increase peak (max contraction force)

Increase rate of relaxation

49
Q

What is lusitropy? What effects do beta receptors activation have on this?

A

ability of the heart to relax

Increases

50
Q

True or false: heart relaxation is an active process

51
Q

What is the MOA of amrinone?

A

Increases myocardial cAMP

52
Q

What is the MOA of milrinone?

A

Increases myocardial cAMP

53
Q

What is the MOA of isuprel?

A

B1 receptor agonist

54
Q

What is the MOA of dobutamine?

A

B1 receptor agonist

55
Q

What is the MOA of dopamine on the heart?

A

B1 receptor agonist

56
Q

What is the MOA of epi on the heart?

A

B1 receptor agonist

57
Q

Ca interaction with what protein is responsible for the increased peak and rate of heart contraction?

58
Q

What are the four practical approaches to increasing myocardial contractility?

A
  1. Increase cytosolic Ca
  2. Increase myocardial cAMP
    3 Agonism of B1
  3. Increase B1 receptor
59
Q

What is the MOA of digoxin?

A

Inhibits Na/K exchanger, which inhibits Ca from leaving the cell d/t increase [Na] and subsequent/indirect inhibition of Na/Ca exchanger

60
Q

What is the effect on EDV and ESV with digoxin?

61
Q

What is the effect on pulmonary and systemic venous pressure with digoxin?

62
Q

What is the interaction of the vagus nerve and digoxin?

A

Dig increases vagal tone (decreases AV conduction)

63
Q

What happens to the PR interval with dig?

64
Q

What happens to the QT interval with dig?

65
Q

What happens to coronary flow with dig?

66
Q

Is dig pro or antiarrhythmic?

67
Q

What is the EKG finding of pts on dig?

A

ST depression

Pharm (73 decks)

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