Cardiovascular Agents 2

Question 1

Drugs for the Treatment of Congestive Heart Failure

Answer 1

1. VASODILATORS
2. ACE INHIBITORS
3. DIURETICS
4. BETA STIMULATORS
5. CARDIOTONIC DRUGS

Question 2

Produce relaxation of the vascular smooth muscle, decreasing peripheral resistance and reducing blood pressure

They cause reflex tachycardia that occurs when BP drops

Answer 2

VASODILATORS

Question 3

Nitrates that act to directly relax vascular muscle tone and cause decrease in blood pressure with pooling of blood in the veins.

Answer 3

VASODILATORS

Question 4

Are employed to decrease the blood volume, which decreases the venous return and the blood pressure. The results are decreased preload and decreased afterload.

Answer 4

DIURETICS

Question 5

These agents affect the intracellular calcium levels in the heart muscles leading to increased contractility.

Answer 5

CARDIOTONIC DRUGS

Question 6

This will stimulate the beta receptors in the sympathetic nervous system, increasing the myocardial contraction, called positive inotropic effect.

Answer 6

BETA STIMULATORS

Question 7

These are agents extracted from the foxglove plant. These are available in oral and parenteral preparations

Answer 7

CARDIAC GLYCOSIDES

Question 8

Agents that block the conversion of angiotensin I to angiotensin II. The result is blockage of the vasoconstriction and decreased blood volume. The afterload will be decreased.

Answer 8

ACE INHIBITORS

Question 9

Example of Cardiotonic Drugs

Answer 9

1. CARDIAC GLYCOSIDE
2. PHOSPHODIESTERASE INHIBITORS

Question 10

The myocardium will contract forcefully that results to increased cardiac output and increased blood flow. This effect is called ______

Answer 10

POSITIVE INOTROPIC EFFECT

Question 11

This effect causes the heart rate to slow down due to the decreased rate of cellular repolarization. May also cause bradycardia.

Answer 11

NEGATIVE CHRONOTROPIC EFFECT

Question 12

Examples of cardiac glycosides

Answer 12

1. Digoxin
2. Digitoxin
3. Ouabain

Question 13

Used to treat severe hypertension

Answer 13

VASODILATORS

Question 14

Example of vasodilators

Answer 14

• Hydralazine
• Minoxidil
• Diazoxide
• Sodium Nitroprusside

Question 15

It acts directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilation and drop in BP

Answer 15

VASODILATORS

Question 16

One of the adverse effect of vasodilators which may occur with nitroprusside

Answer 16

CYANIDE TOXICITY

Question 17

They INCREASE levels of calcium inside the cell by inhibiting the Sodium-Potassium pump

Answer 17

CARDIAC GLYCOSIDES

Question 18

Digitalis is also called ____

Answer 18

DIGOXIN

Question 19

T / F:

Cardiac glycosides cause more calcium to accumulate inside the cell during depolarization

Answer 19

TRUE

Question 20

Clinical uses of cardiac glycosides

Answer 20

• Congestive heart failure
• Dysrhythmias

Question 20

Cardiac glycosides are not given to patients with?

Answer 20

ELECTROLYTE IMBALANCE:

• Hypokalemia
• Hypomagnesemia
• Hypercalcemia

Question 21

Antidote for digitalis toxicity & cardiotoxicity:

Answer 21

Digitalis toxicity:
- DIGOXIN IMMUNE (Ovine, Digibind)

Cardiotoxicity:
- Phenytoin
- Lidocaine

Question 22

Drug-Drug interactions of cardiac glycosides

Answer 22

Can INCREASE effects of digitalis: Verapamil, Amniodarone, Quinidine, quinine, erythromycin, tetracyclines

Can INCREASE risk of toxicity & arrhythmias: Potassium-losing diuretics (Furosemide)

Can cause IMPAIRED absorption of digitalis: cholestyramine, charcoal, colestipol

Question 23

What to monitor before administering digitalis?

Answer 23

APICAL PULSE for 1 minute

Question 24

Withhold the administration of digitalis if apical pulse is?

Answer 24

Adults:
- Less than 60
- More than 110

Infants:
- Less than 90

Question 25

Therapeutic level of digitalis in the blood

Answer 25

0.5 - 2.0 nanograms/mL