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Pharmacology Exam 5 > CHF > Flashcards

CHF Flashcards

1
Q

CHF is insufficient ____ _____ associated with increased blood volume and edema

A

cardiac output

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2
Q

This class reduces congestive symptoms

A

diuretics

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3
Q

This class reduces preload and ventricular wall stress (benefit) but can increase RAAS activation

A

diuretics

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4
Q

_____ therapy should be accompanied by dietary salt restriction and lowest dose needed

A

diuretic

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5
Q

This class shows no reduction in mortality except aldosterone antagonists

A

diuretics

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6
Q

____ diuretics work when GFR is low

A

loop

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7
Q

_____ diuretics are ineffective when GFR is low

A

thiazides

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8
Q

Major problem with loop diuretics is _____ depletion

A

K

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9
Q

Diuretic resistance is often seen as CHF progresses due to issues of compliance, _____ in Na+ reabsorption, and decreased _____ perfusion

A

compensation

renal

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10
Q

______ diuretics are used primarily to potentiate the action of loops

A

thiazide

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11
Q

can produce even greater K+ depletion

A

thiazide

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12
Q

Aldosterone antagonists (K+ sparing) inhibit ______ and thus reduce _____

A

remodeling

mortality

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13
Q

aldosterone antagonists can cause ______ (‘lyte abnormality)

A

hyperkalemia

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14
Q

_____ inhibitors decrease production of Ang2, aldosterone and SNS activity

A

ACE

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15
Q

Ang2 levels move toward _____ with sustained use of _____

A

baseline

ACEI’s

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16
Q

clinical efficacy is maintained after prolonged use of ACEIs probably due to _____ related effects

A

bradykinin

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17
Q

High doses of _____ reduce mortality

A

ACEIs

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18
Q

_____ block AT1 but not AT2 receptors

A

ARBs

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19
Q

Maintain beneficial Ang2 effects and avoids Ang2 escape seen with ACEIs

A

ARBs

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20
Q

Alternative for patients intolerant of ACEIs (cough)

A

ARBs

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21
Q

T or F: ARBs reduce mortality

A

true

22
Q

_____ mainly reduce preload and tolerance is an issue when used alone

A

nitrates

23
Q

____ reduces pulmonary and systemic vascular resistance (afterload)

A

hydralazine

24
Q

____ has a moderate direct positive inotropic effect

A

hydralazine

25
Q

Fixed-dose combo of ______ and _______ reduces mortality especially in African-Americans

A

isosorbide

hydralazine

26
Q

These drugs counterintuitively decrease mortality because they reduce contractile force

A

beta blockers

27
Q

_____ _____ prevent cardiac ischemia and consequently unstable tachyarrhythmias

A

beta blockers

28
Q

these drugs inhibit cardiac remodeling and reduce renin secretion

A

beta blockers

29
Q

these reduce cardiac remodeling

A

ACEIs
ARBS
beta blockers

30
Q

ACEI result in elevated bradykinins which can be good and bad - good things include _____ and decreased _____ while bad thing(s) are _____

A

vasodilation
remodeling
cough

31
Q

Cardioselective beta blockers

A

metoprolol
bisoprolol
carvedilol

32
Q

the primary pharmacological effect of ____ is to have a (+) inotropic effect

A

digoxin

33
Q

Use of ____ in CHF therapy is controversial due to toxicity, does not reduce mortality and may decrease survival in women

A

digoxin

34
Q

decreases hospitalization in advanced CHF

A

digoxin

35
Q

Inhibits Na/K-ATPase in myocyte membranes

A

digoxin

36
Q

Hyperkalemia will ____ the inotropic effect of digoxin

A

reduce

37
Q

Hypokalemia will ____ the inotropic effect of digoxin

A

increase

38
Q

_____ will result in an increased digoxin binding and thus increased inhibition of ATPase

A

hypokalemia

39
Q

____ will result in a decreased digoxin binding to the ATPase

A

hyperkalemia

40
Q

hypokalemia promotes ____ overload

A

calcium

41
Q

can produce sinus bradycardia at low therapeutic doses

A

digoxin

42
Q

decreases conduction velocity and prolongs effective refractory period

A

digoxin

43
Q

causes calcium overload at toxic levels

A

digoxin

44
Q

excreted unchanged by the kidney

A

digoxin

45
Q

does not reduce mortality and may actually increase in females

A

digoxin

46
Q

Digoxin _____ ____ is used after an overdose and is an immune complex that sequesters digoxin

A

immune FAB

47
Q

Fatigue and yellow/green halos around objects typically indicate toxicity before cardiac signs appear when using ____

A

digoxin

48
Q

____ and ____ increase potassium and decrease digoxin efficacy

A

ACEIs

ARBs

49
Q

Drugs that reduce mortality in CHF (4)

A

isosorbide-hydralazine
ACEIs/ARBs
Aldosterone antagonists
beta blockers

50
Q

drugs that only relieve symptoms

A

diuretics (loop/thiazide)

digoxin

51
Q

which 2 antiarrhythmics can increase plasma digoxin levels

A

quinidine

verapamil

52
Q

most common warning sign preceding digoxin toxicity

A

nausea/vomiting

anorexia

Pharmacology Exam 5 (8 decks)

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