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Cardio Pharmacology > Drugs Affecting Rate and Force > Flashcards

Drugs Affecting Rate and Force Flashcards

1
Q

Is increased heart rate a positive or negative chronotopic effect?

A

Positive

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2
Q

What is automaticity and does it increase or decrease in sympathetic stimulation of B1 receptors?

A

tendency for non-nodal regions to acquire spontaneous activity, increases

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3
Q

Does cardiac efficiency increase or decrease with sympathetic stimulation?

A

Decrease (with respect to 02 consumption)

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4
Q

When pacemaker potential slope is decreased what happens to heart rate?

A

decreases

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5
Q

In parasympathetic division, which muscarinic cholinoceptors are activated to decrease heart rate?

A

M2

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6
Q

Which type of stimulation (parasympathetic or sympathetic) may cause dysrhythmias to occur in atria?

A

Parasympathetic

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7
Q

What current are pacemaker potentials regulated by?

A

Funny current

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8
Q

What are the channels that mediate the funny current called?

A

HCN gated channels

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9
Q

What mediate HCN gated channels?

A

Hyperpolarization and Cyclic AMP

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10
Q

What does block of HCN channels do to slope of pacemaker potential and heart rate?

A

decreases both

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11
Q

What is an example of a HCN channel blocker and what is it used for?

A

Ivabradine, angina

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12
Q

Describe the steps of excitation contraction coupling in cardiac muscle contraction.

A
  • Ventricular action potential
  • Opening of voltage activated calcium ion channels (mainly L-type)
  • Calcium ion influx into cytoplasm
  • Calcium is released from sarcoplasmic reticulum
  • Cross bridge formation between actin and myosin results in contraction
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13
Q

What happens in excitation contraction coupling to cause relaxation?

A

Repolarization to phase 4, calcium ion channels closed, no calcium ion influx, no calcium released from sarcoplasmic reticulum, cross bridge formation between actin and myosin breaks, resulting in relaxation

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14
Q

Does increased calcium ion sensitivity cause enhanced or reduced contractility and which adrenoceptor is involved?

A

Enhanced, B1

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15
Q

What do Dobutamine, adrenaline and noradrenaline (catecholamines) do to cardiac efficiency?

A

reduce it

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16
Q

What do Dobutamine, adrenaline and noradrenaline (catecholamines) do to force, rate and cardiac output?

A

Increase it

17
Q

What is adrenaline used for clinically?

A 
cardiac arrest (sudden loss of pumping function)
emergency treatment of asthma
anaphylactic shock (life threatening respiratory 		distress and often vascular collapse)
18
Q

What is dobutamine used for clinically and what beta receptor does it act on?

A

acute, but potentially reversible, heart failure (e.g. following cardiac surgery, or cardiogenic shock), B1

19
Q

What does propanolol block?

A

B1 and B2

20
Q

What to metopralol and atenolol block?

A

B1 only

21
Q

What are adverse effects of beta-blockers?

A

bronchospasm, hypoglycaemia, aggregation of heart failure, fatigue, cold extremities, bradycardia

22
Q

What does atropine do?

A

Increases heart rate, no effect on bp

23
Q

Who does atropine have a more pronounced effect in?

A

Athletes

24
Q

What is atropine used for clinically?

A

Reverse bradycardia following an MI, to accompany an analgesia, and in anticholinesterase poisoning

25
Q

With heart failure is ventricular function curve elevated or depressed?

A

depressed

26
Q

What type of drug is digoxin?

A

inotropic

27
Q

Does digoxin enhance or decrease contractility?

A

enhance

28
Q

Where can digoxin be found in nature?

A

Fox gloves

29
Q

In presence of digoxin what happens to Na+/K+ATPase?

A

blocked

30
Q

What happens to storage of calcium ions in the sarcoplasmic reticulum when using digoxin?

A

increases

31
Q

How does digoxin work?

A

Binds to the alpha-subunit of Na+/K+ ATPase in competition with K+

32
Q

In what circumstance may digoxin be dangerously enhanced?

A

Hypokalaemia

33
Q

What does digoxin do to action potential and refractory period?

A

reduce

34
Q

When is refractory period delay particulary useful (the combination of a and b)?

A

heart failure and AF

35
Q

What are 2 of the most serious side effects of digoxin?

A

excessive depression of AV node conduction (heart block)

propensity to cause dysrhythmias

36
Q

What type of drugs are calcium sensitizers e.g. levosimendan?

A

inotropic drug

37
Q

How do calcium sensitizers cause vasodilation?

A

open Katp channels

38
Q

Which class of anti-arrythmic is divided into 3 subclasses?

A

1

Cardio Pharmacology (8 decks)

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