Drugs on the Heart

Question 1

If the ❤️ was an electric pump…

Answer 1

SA node initiates cycle
AV node relays to the ventricle
Purkinje fibres& bundle of his spread implies through the ventricles.

Malfunction- poor pumping / inadequate supply

Lack of coordination of pumping / v fast - turbulence, blood clot, stroke

Question 2

How is coronary artery disease caused

Answer 2

Lifestyle
Genes
Diet

When blood vessels narrow and blood clots against the plaque

Question 3

How can you prevent coronary artery disease

Answer 3

Change lifestyle
Reduce BP
Use statins to reduce cholesterol

Question 4

What is angina

Answer 4

When the ❤️ doesn’t get enough oxygen
The tissues are starved of o2 and this releases potassium&hydrogen protons.
Cardiac ischemia causes the pain

Question 5

What are the symptoms of angina

Answer 5

Crushing pain in the chest. Can be seen to be down the right arm or neck or jaw.

Question 6

How do you treat angina

Answer 6

By reducing the o2 demand or increasing the o2 supply

Question 7

What does glyceryl tritrate (GTN) do

Nitroglycerol

Answer 7

. Reduces Cardiac workout by dilating peripheral b.v.
. ❤️ not have to push as hard, less blood is returned- lower contraction force.
. Increase SA, cardiac blood supply
. Blood is detoured passed the blockage

Question 8

What does atenolol do

Answer 8

. Slows down HR
. Decreases atria beat / forcibility
. Reduces ventricle beat force
. Decrease Cardiac work rate and o2 demand
. Increase disastole allowing more time for blood to flow in.

Question 9

What is the cause of a ❤️ attack

Answer 9

Ischaemia- muscle death.

Plaque builds in artery - blood clot

Question 10

What is a glyceryl titration drug and its action

Answer 10

Propranolol
. Decrease workload and oxygen demand
. Improve blood flow to coronary arteries
. Reduce pain

Question 11

What does a tissue plasminogen activator do

Answer 11

. Clot busting

. Within a few hours is will destroy a clot

Question 12

What is an angioplasty

Answer 12

. A stent that is put into a vessel to re open it

Question 13

What causes ❤️ failure

Answer 13

Heart not efficient at supplying the body.

Can reduce BP to make it easier on the heart or make the heart pump harder.

Question 14

What’s a treatment for heart failure

Answer 14

Digoxin

Question 15

What does digoxin do

Answer 15

. Increase CO as its a positive inotropic agent (increase constriction)
. Stops Sodium and potassium and increased calcium stored. This increases the construction of the force without increasing o2 consumption

Question 16

When do you give digoxin

Answer 16

When there’s heart failure or arterial fibrillation

When sinus rhythm is symptomatic despite ACE / D

Question 17

What are the strengths and weaknesses of digoxin

Answer 17

😊 improves symptoms and exercises tolerance and decreases likelihood of hospitalisation
😔 not a cure

Question 18

What are the four classifications of cardiac Dysthrythmia

Answer 18

.Site of origin - arterioles/ junction/ ventricle
. True arrythmias- very disorganised rhythm
. Tachycardia- hb fast
. Bradycardia- hb slow

Question 19

What are the 5 Dysthrythmic mechanisms

Answer 19

. Ectopic pacemaker- cardiac tissues other than SA node initiates the heart beat.
. Delayed depolarisation- calcium build in cells and cause train action p.
. Re-entry circles- tissue damage/abnormal makes action p travel in circles
. Congenital abnormalities- additional conductory pathways disrupt vent. Signal
. ❤️ block- damage to coronary pathways disrupt AV signals

Question 20

Who’s at risk of a coronary Dysthrythmia

Answer 20

. Coronary artery disease
. ❤️ valve disorder
. Blood chemistry disorder
. Drugs such as beta blockers, stimulants

Question 21

What does an ectopic pacemaker do

Answer 21

Increases sinus rhythm

Question 22

What does aerial ventricular block cause

Answer 22

Depolarised and contraction mean no QRS waves

Question 23

What is ventricular fibrillation

Answer 23

The development ventricular ectopic failure-entry circuits

The AV stop beating co-ordinatidly
No QRS
fatal
Need DC electric shock

Question 24

The classification of treatments

Answer 24

1) sodium channels (lidocaine)
2) B 1 adrenoceptor (atenolol)
3) potassium channels (amidarone)
4) calcium channels (verapamil)
5) other (digoxin)

Question 25

Problems with classification

Answer 25

. Doesn’t account for drugs that have more than one mechanism
. Does date difference between how the dug reacted to healthy and diseased tissue
. Excuses some antidysolic drugs (A receptors)

Question 26

What are the 3 ways to classify antidyrhythmic drugs clinically

Answer 26

1) supraventricular origin (adrenose)
2) superventricular or ventricular origin (propanolol)
3) ventricular origin (lidocaine)

Question 27

What are the four interlinked heart conditions

Answer 27

1) Angina- the ❤️ is temporarily starved of oxygen.
2) Dysthrythmia- rhythm disturbed. (Caused by 1 or 4)
3) Heart attack- deprived of o2. (Caused by 1)
4) Heart failure- not pump blood properly. (Caused by 3)