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PA 2307- Mod 8 > CVD, BONE METABOLISM, DIABETES, HERBALS > Flashcards

CVD, BONE METABOLISM, DIABETES, HERBALS Flashcards

1
Q

what are pacemaker cells of the heart

A

they have instable membrane potentials that allow them to reach threshold and generate action pot spontaneously

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2
Q

what movements maintain cardiac cell (3)

A
  1. constant diffusion of na and k down their gradiants
  2. 3 Na out for 2 k in
  3. ca out 3 NA in
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3
Q

what are the 5 (0+4) phases of ventricular action pot

A

0-depolarization (NA open)
1-rapid repolarization (na close k open n close)
2-plataue (ca open)
3-final repolarization (ca close, k open)
4-spontaneous depolarization (sod permeability increases)

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4
Q

What effect do catecholamines have on the heart

A

positive chronotropic effect

increase levels of cAMP

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5
Q

what effect does parasympathetic stim have on the heart

A

stim of muscarinic receptors cause reduced level of cAMP that produces an increase in outward K current (hyperpolarization)= decrease in pacemaker activity

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6
Q

what effect that ca have on non pacemaker cells

A

increase in intracellular ca= increase contraction strength

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7
Q

what is peripheral edema indicative of

A

heart failure

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8
Q

what are the cardiovascular consequenses of heart failure

A

increase venous pressure
increase sympathetic activity
increased renin, aldosterone etc

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9
Q

what is digitalis glycosides and how does it work

A

used for heart failure to have positive iontropic effect

inhibits na/k atpase pump with results in increase of intrcellular sodium conc= greater activation of contractile pros and less ca leaving

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10
Q

does digoxin affect skeletal mm

A

no just increases force and velocity of myocardial contraction

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11
Q

what is the cardiac side effects of digitalis glycosides

A

dose related arrhythmias

-premature atrial and ventricular contractions

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12
Q

what are the extracardiac toxicity of digitalis glycosides

A

most GIT

-vommiting due to stim of chemoreceptor trigger zone

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13
Q

What is the antidote for digitalis toxicity

A

administer potassium iv to decrease the slope of phase 4
or lidocaine
(the spontaneous depolarization portion)

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14
Q

What do class I anti arrhythmic drugs do

A

slow down rate of phase 0 (and 4) by blocking membrane sodium channels
–cause decrease in excitability + conduction velocity

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15
Q

What do class II anti arrhythic drugs do

A

B-adrenergic receptor antagonists- depress phase 4 depolarization by competing w catecholamine stim

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16
Q

what do class III anti arrhythmic durgs do

A

prolong the action potential with a consequent increase in the absolute and effective refractory period

17
Q

What do call IV anti arrhytmic drugs do

A

Decrease inward current carried by calcium (in sa node decreases rate of phase 4 spontaneous depolarization)

18
Q

what is the net calcium absorbtion when taken orally

A

15-40%

19
Q

what is essential for calcium absorbtion

A

bile

20
Q

effects of calcitonin

A

inhibits rate of bone turnover, increases exretion of sodium, pot and phosphate

21
Q

what is raloxifene and what are its effects and the bioavailability

A

Selective estrogen receptor modulator (produces agonist effects)
only 2% oral bioavailability

22
Q

How do bisphosphonates work and what is the oral bioavailability

A

10% bioavailability

-inhibit bone resorption by cellular effects on osteoclasts (inhibis recruitment, differentiation and activity)

23
Q

what does flouride do

A

incorporated into bone as hydroxyfluroapatite which is resistant to resorption

24
Q

What receptors do insulin bind to

A

binds to specific tyrosine kinase receptors to initatiate a series of enzyme reactions that impact on glucose homeostasis

25
Q

What do sulfonylureas do

A

oral hypoglycemic drug

-act by binding to ATP dependent potassium channels in pancreatic B cells which accumulates calcium stimming release of insulin

26
Q

what do glitinides do

A

oral hypoglucemic drug

same mechanism of sulfonylureas but quicker and shorter action

27
Q

What do thiazolidinediones do

A

oral hypoglycermic drug

act as insulin sensitizers to regulate the expression of specific genes in adipocytes improving insulin sensitivity of mm and liver

28
Q

what doe biguanides do

A

oral hypoglycermic drug

they act directly on mm to increase glucose uptake and utalization

29
Q

what doe sglt2 inhibitors do

A

inhibit glucose resorbtion in prox tubule

30
Q

what % of diabetics get diabetic neuropathy

A

50% of pts w type 1/2 DM

31
Q

What is diabetic retinopathy

A

leading cause of new blindness in persons 25-74

32
Q

what is diabetic nephropathy

A

persistent albuminuria, progressive decline in GFR and elevated BP

33
Q

What is neuropathic arthropathy

A

jt deteriots

PA 2307- Mod 8 (8 decks)

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