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Alan's lecture - Pharmacology > CVS1 > Flashcards

CVS1 Flashcards

1
Q

the SA node is the pacemaker. TRUE OR FLASE?

A

TRUE

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2
Q

There is a delay in the action potential at the AV node. TRUE OR FALSE?

A

TRUE

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3
Q

Where is the cardiovascular centre located?

A

In the medulla oblangata

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4
Q

In the medulla oblaganta there Baroreceptors, parasympathetic and sympathetic receptors. TRUE OR FLASE?

A

TRUE

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5
Q

If the cardiovascular centre detetcts low BP what system is turned on?

A

Sympathetic nervous system

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6
Q

If the cardiovascular centre detetcts high BP what system is turned on?

A

Parasympthetic nervous system

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7
Q

What occurs in the SA node when BP is low?

A
  • CV centre activates the sympathetic nerous system
  • Noradrenaline binds to B1
  • Increase in pacemaker current
  • This leads to an increase in slope phase 4 of action potential
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8
Q

What occurs in the AV node when sympathetic system is activated due to low BP?

A
  • Noradrenaline binds
  • Increase in ca2+ current
  • Increase in slope phase 0 of action potential
  • Also increases velocity conductivity
  • Increase in contractitlity of myocytes
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9
Q

What occurs in the SA node in parasynthetic nervous system when BP is high?

A
  • Ach binds to muscarinic receptors which slows depolisation
  • Opens K+ channels
  • Inhibits Na+ channel from opening which slows down slope of phase 4 of the action potential
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10
Q

What occurs in the AV node in the parasympathetic nervous system when BP is high?

A
  • Ach binds to muscarinic receptors

- This slows down conduction velocity which slows slope phase 0 of action potential

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11
Q

Baroreceptors send afferent fibres to the cardiac ocntrol centre (medulla). TRUE OR FALSE?

A

TRUE

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12
Q

What are the two types of baroreceptors?

A
  • carotid

- aortic

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13
Q

What occurs when BP is high with Baroreceptors?

A
  • Baroreceptors stimulate parasympathetic outflow which causes SA node to stop firing
  • Parasympathetic outflow inhibits sympathtic nervou system from inducing vasoconstriction
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14
Q

The parasymthpathetic NS has no direct effect with vasodilation. TRUE OR FLASE?

A

TRUE

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15
Q

What occurs when BP is low with Baroreceptors?

A
  • Baroreceptors stimulate sympathetic outflow which causes an increase in SA node firing
  • Sympathetic nervous system increases vasoconstriction which increases venous return and hence increases cardiac output
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16
Q

what is heart failure?

A
  • When the output of the heart is insufficient to meet the needs of the body
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17
Q

What can heart failure come from?

A
  • Insufficient cardiac output from reduced left ventricular contractility
  • Inadequate venous return which can come from inadequate diastolic relaxation
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18
Q

What are some symptoms of HF?

A
  • Tachycardia (compasates)
  • Shortness of breath, tiredness
  • Oedema
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19
Q

What are the possible underlting causes of HF?

A
  • Coronary artery diseas
  • Arrythmias
  • Hypertention
  • Myocardial disease
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20
Q

What are the causes of acute left ventricular failure?

A
  • Inadequate output - pulmonary oedema

- Inadequate output - can lead to increased venous returne - which increases exacerbations

21
Q

what are the treatment options of acute left ventricular failure to reduce venous return?

A
  • Diuretics
  • glycerol tinitrate
  • opioid analgesics
22
Q

what is the generic treatment for cardiogenic shock HF?

A
  • dobutamine - increases organ perfusion
23
Q

what is chronic HF?

A
  • It is a myocardium disease caused by excess load due to e.g hypertention
24
Q

What are some treatment options for chronic HF?

A
  • ACE inhibitors - first line reduces after load
  • Diuretics - furisemide - reduces preload
  • Paradoxically B1 antangonists
  • Digoxin (positive ionotrope)
25
Q

What is the treatment goal for HF?

A

To reduce compensatory mechanism triggred by vasoconstriction, fluid rentention and increased cardiac output

26
Q

Cardiac glycosides inhibit Na+/K+ ATPase which leads to an increase in cardiac contractility. TRUE OR FALSE?

27
Q

B1 agonists also lead to an increase in cardiac/force of contraction. TRUE OR FALSE?

28
Q

Digoxin is an example of a positive inotrope. TRUE OR FALSE?

29
Q

cardiac glycosides were formally isolated from foxglove. TRUE OR FALSE?

30
Q

Cardiac glycosides have multiple effects, they block the Na+/K+ATPase in neurons in the CNS and PNS. TRUE OR FALSE?

31
Q

what are some side effects of cardiac glycosides e.g digoxin?

A
  • Narrow therapeutic window
  • Cuases arrythmias due to AV block - slows down SA node
  • Neurological effects - confusion
32
Q

What are the cautions with digoxin?

A
  • Hypokaleamia - increases toxicity of digoxin

- Hypotheriodism

33
Q

what are the contranidications of digoxin?

A
  • Heart block
34
Q

What are the drug intrecations with digoxin?

A
  • Diuretics
  • Antibiotics
  • B antangonist increase AV conduction
  • B antangonist and Ca2+ chanel blockers btoh decrease contractility
35
Q

Thyroid hormones increase renal blood flow and GFR. true or false?

36
Q

Hypothyrodism increases GFR which promotes toxicity induced by digoxin. true or false?

37
Q

K+ inhibits digoxin from bidning to Na+/K+ ATPase, when a patient has hypokaleamia this inhibition increases which makes digoxin more potent because less digoxin is binding to the Na+/K+ ATPase. TRUE OR FALSE?

38
Q

B1 - increases heart rate and contractility
B2 - vascular smooth muscle dilation/ relaxation/ GI tract relaxation
B3 - lilpolysis (adipose tissue)
A1 - vascular smooth muscle constriction
a1 and a2 - for liver and pancrese - gluconeogenesis
True or false?

39
Q

Provide an example of a sympathomimetic inotrope drug?

A
  • Dubamine - used in acute emergency / can cause receptor down regulation which is the opposite of what we are trying to do
  • Dopamine - doesnt cross the BBB/ it a NT but it is also a B1 agonist
40
Q

Provide an example of a PDE inhibitor?

41
Q

Enoximone is a selective PDE 3 found in smooth and caridiac muscle , it increases cAMP which causes arterial vasodilation. TRUE OR FLASE?

42
Q

What are some benefits of enoximone?

A
  • Increases cardiac output

- Does not down regulate receptors

43
Q

Enoximone can cause arrythmias - close monioring with ECG needed/ not for chronic therapy. TRUE OR FALSE?

44
Q

what does Hydrazaline do?

A
  • causes relaxation of cardiac smooth muscle
45
Q

Hydrazaline - is not widely used because it causes quick tolerance and reflex tachycardia. TRUE OR FALSE?

46
Q

Sacubitril - inhibits neprilysin. TRUE OR FALSE?

47
Q

What is neprilysin?

A

it is an endopeptidase that degrades ANP, BNP nd CNP

48
Q

Valsartan is an angiotension recpetor blocker. TRUE OR FALASE?

49
Q

Valsartan blocks vasoconstriction induced by angiotensin 2. TRUE OR FALSE?

Alan's lecture - Pharmacology (16 decks)

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