Heart Failure

Question 1

the most common site of digitalis toxicity outside the heart

Answer 1

GIT

Question 2

What electrolyte imbalances may reduce the digitoxin toxicity

Answer 2

Hyperkalemia and Hypermagnesemia

Question 3

Istaroxime is another inotropic drug that has a similar effectto digitoxin; however it produces less arrhythmia due to what effect?

Answer 3

SR Sequesteration of Calcium ions

Question 4

MOA of Inamrinone and Milrinone

Answer 4

inhibits Phosphodiesterase (isozyme 3), thus increased cGMP and cAMP

Question 5

a drug that sensitizes the troponin system to calcium

Answer 5

Levosimendan

Question 6

other name of Inamrinone

Answer 6

Amirnone

Question 7

cAMP increases contractility or promotes Vasodilation?

Answer 7

BOTH

Question 8

the most common selective B1 agonist used in Px w/ HF

Answer 8

Dobutamine

Question 9

True/False. Dopamine may be used for AHF if there is a need to increase blood pressure

Answer 9

True

Question 10

types of drugs that are 1st line therapies for CHF

Answer 10

Diuretics
ACE inhibitors
Ang receptor antagonist
Aldosterone Antagonist
B-blockers

Question 11

2 major types of Heart failure

Answer 11

Sytolic HF and Diastolic HF

Question 12

a type of heart failure where ejection fraction remains normal

Answer 12

Diastolic HF

Question 13

the cardiac myocyte pump that maintains the free cytoplasmic calcium at a low level

Answer 13

SERCA

Question 14

what inhibits SERCA?

Answer 14

unphosphorylated Phospholamban

if phosphorylated, inhibition to SERCA is removed

Question 15

what is the normal ejection fraction

Answer 15

> 60%

Question 16

the four primary factors of cardiac performance

Answer 16

Preload
Afterload
Contractility
Heart Rate

Question 17

what are the electrical effects of digitalis?

Answer 17

dec AP duration
delayed after depolarization
less negative RMP

Question 18

T/F. low dose admin of Digitalis promotes parasympathomimetic cardioselectivity.

Answer 18

TRUE

Question 19

Phosphodiesterase Inhibitors

Answer 19

Levosimendan
Milrinone
Inamrinone

Question 20

an synthetic form of BNP that is used in Acute HF

Answer 20

Nesiritide

Question 21

orally active competitive inhibitors of endothelin

Answer 21

Bosentan

Tezosentan

Question 22

what are the 4 stages of development of HF (describe each)

Answer 22

Stage A: no Sx; has risk factors
Stage B: Sx on severe exercise
Stage C: Sx during mild exercise
Stage D: Severe Sx at rest

Question 23

Aldosterone Antagonist, Digitoxin, Hydralizine and Nitrites are the DOC in what developmental stage of Chronic Heart Failure?

Answer 23

Stage C

Question 24

what drugs are used at Stage B of CHF? (4)

Answer 24

ACE inhibitors
Ang Receptor Blocker (ARB)
BB
Diuretics

Question 25

diuretics used in CHF

Answer 25

furosemide and thiazides

Question 26

specific ACEI and ARB used in CHF

Answer 26

ACEI: Enalapril
ARB: Losartan

try this nomenclature:
all -ARtAns (losartan,candesartan etc.) 
A=Ang
Rt=receptors
An=Antagonists

:)

Question 27

4 BB that are used in CHF

Answer 27

Metoprolol
Bisoprolol
Nevibolol
Carvedilol

Question 28

Digitalis is usually given before ACEI and ARB. True/False

Answer 28

False.

True if you want to kill the Px :)

Question 29

A Tx for AHF that corrects euvolemic hyponatremia and a V1a and V2 receptor antagonist

Answer 29

Conivaptan

Question 30

selective V2 antagonist

Answer 30

Tolvaptan

Question 31

Divisions of Vasodilators (3)

Answer 31

Venodilator
Arteriolar dilators
non selective vasodilators

Question 32

what type of Vasodilators should be used in the the condition:
Px w/ high filling pressure and whose principal Sx is Dyspnea

Answer 32

Venous Dilators (Nitrates)

Question 33

what type of Vasodilators should be used in the the condition:
Px w/ fatigue due to low left ventricular output

Answer 33

Arteriolar dilator (Hydralazine)