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Pharmocology > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Digoxin

VASOPRESSORS/SHOCK, Cardiac Glycoside, Inodilator

A

Cardiac Glycoside

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2
Q

Milrinone

VASOPRESSORS/SHOCK, Cardiac Glycoside, Inodilator

A

Inodilator

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3
Q

Dopamine

VASOPRESSORS/SHOCK, Cardiac Glycoside, Inodilator

A

VASOPRESSORS/SHOCK

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4
Q

Cardiac Remodeling

Ventricles constrict, hypotrophy, fibrosis, become spherical
or
Ventricles dilate, hypertrophy, fibrosis, become spherical

A

Ventricles dilate, hypertrophy, fibrosis, become spherical

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5
Q

Cardiac Remodeling

◦Increase wall stress and reduce EF
or
◦Decrease wall stress and induce EF

A

◦Increase wall stress and reduce EF

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6
Q

Cardiac Remodeling

UNDERACTIVE Sympathetic Nervous System (SNS)
or
OVERACTIVE Sympathetic Nervous System (SNS)

A

OVERACTIVE Sympathetic Nervous System (SNS)

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7
Q

Cardiac Remodeling

OVERACTIVE Renin Angiotensin Aldosterone (RAAS)
UNDERACTIVE Renin Angiotensin Aldosterone (RAAS)

A

OVERACTIVE Renin Angiotensin Aldosterone (RAAS)

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8
Q

Cardiac Remodling

Baroreceptor?

desensitization or sensitization

A

desensitization

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9
Q

Called water pills, are medications designed to increase the amount of water and salt expelled from the body as urine.

Epinephrine or Diuretic

A

Diuretic

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10
Q

stable/chronic/controlled/home

Decompensated Heart Failure
or
Compensated Heart Failure

A

Compensated Heart Failure

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11
Q

acute/hospitalization/uncontrolled

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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12
Q

Medications designed to prevent worsening

Decompensated Heart Failure
or
Compensated Heart Failure

A

Compensated Heart Failure

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13
Q

heart failure exacerbation

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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14
Q

Diuretics•Vasodilators

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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15
Q

Inotropic Support•Kidneys>Heart

Decompensated Heart Failure
or
Compensated Heart Failure

A

Decompensated Heart Failure

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16
Q

Cardiac Muscle, Contractility

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

INOTROPIC

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17
Q

SA Node, Heart rate

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

CHRONOTROPIC

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18
Q

Conduction Velocity

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

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19
Q

AV node ,bundle of His, Purkinje Fibers

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

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20
Q

+ increase/ - Decrease the FORCE of myocardial contraction (STRENGTH)

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

INOTROPIC

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21
Q

+ increase/ - Decrease the RATE of the heart beat

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

CHRONOTROPIC

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22
Q

+ increases/ - Decrease CONDUCTION of electrical impulses

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

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23
Q

Furosemide

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Loop Diuretics

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24
Q

Carvedilol

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Beta Blockers

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25
Q

Lisinopril

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

ACE-Inhibitors/ARBS

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26
Q

Spironolactone

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Aldosterone Antagonists

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27
Q

Eplerenone

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Aldosterone Antagonists

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28
Q

Valsartan

Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

ACE-Inhibitors/ARBS

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29
Q

Increase Sympathetic and RAAS Activity 2

Carvedilol, Furosemide, Lisinopril, Spironolactone Valsartan, Eplerenone
Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Beta Blockers’
Carvedilol

ACE-Inhibitors/ARBS
Lisinopril
Valsartan

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30
Q

Sodium or water retention

Carvedilol, Furosemide, Lisinopril, Spironolactone Valsartan, Eplerenone
Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Loop Diuretics

Furosemide

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31
Q

Failure to escape from aldorsterone

Carvedilol, Furosemide, Lisinopril, Spironolactone Valsartan, Eplerenone
Beta Blockers, Aldosterone Antagonists, Loop Diuretics, ACE-Inhibitors/ARBS

A

Aldosterone Antagonists
Spironolactone
Eplerenone

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32
Q

treats Heart Failure?

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Cardiac Glycoside

Digoxin

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33
Q

Treats Atrial Fibrillation

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Cardiac Glycoside

Digoxin

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34
Q

Cardiac Glycosides: Digoxin

+ increase or - Decrease the FORCE of myocardial contraction (STRENGTH)
CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

+ INOTROPIC

+ increase the FORCE of myocardial contraction (STRENGTH)

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35
Q

Cardiac Glycosides: Digoxin

+ increase or - Decrease the RATE of the heart beat
CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A
  • CHRONOTROPIC

Decrease the RATE of the heart beat

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36
Q

Cardiac Glycosides: Digoxin

+ increases or - Decrease CONDUCTION of electrical impulses
CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

DROMOTROPIC

Decrease CONDUCTION of electrical impulses

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37
Q

Cardiac Glycosides: Digoxin
Blocking the Na+/K+ ATPase pump

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

+INOTROPIC

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38
Q

Cardiac Glycosides: Digoxin
Parasympathomimetic (causes vagal stimulation) and also increases baroreceptor sensitivity

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

-CHRONOTROPIC

39
Q

Cardiac Glycosides: Digoxin
Cholinergic activation in atria (AV node), less at Purkinje

CHRONOTROPIC, INOTROPIC, DROMOTROPIC

A

-DROMOTROPIC

40
Q

Cardiac Glycosides: Digoxin

(Improved/ Declined) Cardiac Output and (Increased / Decreased) Renal Perfusion= (Increased / Decreased) Urine Production and (increased / decreased) RAAS activation

A

Improved
Increased
Increased
decreased

41
Q

What do a nurse to check before giving Digoxin

Heart rate, Blood pressure, or Both
Sodium, Magnesium, Cholesterol, Calcium, Potassium, Cortisol
Digoxin level or no?

A

Heart Rate
Potassium
Yes Dig Levels to avoid tox

42
Q

Cardiac Glycosides: Digoxin MOA

Digoxin competes with ?

Calcium, Sodium, or Potassium

A

Potassium

43
Q

Cardiac Glycosides: Digoxin MOA
Since Digoxin and Potassium competes with other ranges needs to be normal to avoid Dig Tox?

Sodium, Magnesium, Cholesterol, Calcium, Potassium, Cortisol

A

Magnesium
Calcium
Potassium

44
Q

Cardiac Glycosides: Digoxin MOA
Which results in Dig Tox?

(Hyper/ Hypo- kalema,) (Hyper / Hyper - magnesemia,) (Hyper / Hypo - calcemia)

A

HypoKalema
HypoMagnesemia
HyperCalcemia

45
Q

Cardiac Glycosides: Digoxin MOA
What are Dig Tox Effects

Heart, Muscles, Balancing, GI, GU, CNS, SNS

A

Heart
GI
CNS

46
Q

disturbance to an otherwise normal rhythm

arrhythmia, dysrhythmia

A

dysrhythmia

47
Q

irregular heartbeat

arrhythmia, dysrhythmia

A

arrhythmia

48
Q

A fast heart rhythm with a rate of more than 100 beats per minute

Bradycardia , Tachycardia

A

Tachycardia

49
Q

A slow heart rhythm with a rate below 60 beats per minute.

Bradycardia , Tachycardia

A

Bradycardia

50
Q

Cardiac Glycosides: Digoxin Tox Effect
Heart-

arrhythmia or dysrhythmia
Bradycardia , Tachycardia

A

dysrhythmia

Bradycardia

51
Q

Cardiac Glycosides: Digoxin Tox Effect
Heart-

Can potassium be hyperkalemia or Hypokalemia or both .
If both which is the main concern?

A

Both

Hypokalemia

52
Q

Cardiac Glycosides: Digoxin Tox Effect
GI-

Constipation
Diarrhea
Vomiting
Heartburn
Nausea 
Abdominal Pain
Anorexia
A

Vomiting
Nausea
Anorexia

53
Q

Cardiac Glycosides: Digoxin Tox Effect
CNS related-

Severe headaches.
Strokes
Confusion
Blurred vision
Weakness.
Vision disturbances
Seizures
Fatigue
A

Confusion
Vision disturbances
Fatigue
Blurred vision

54
Q

Cardiac Glycosides: Digoxin Tox Effect
With Vision disturbances-

(yellow or pink) tint, “Melos or Halos)

A

Yellow tint

Halos

55
Q

Cardiac Glycosides: Digoxin Tox Effect

Can Digoxin could cause weight gain or loss?

A

Weight Loss

56
Q

Cardiac Glycosides: Digoxin
Digoxin Normal range=

0.5- 1 ng/ml, 0.5 -2 ng/ml, 0.5 - 3 ng/ml

A

0.5 - 2 ng/ml

57
Q

Cardiac Glycosides: Digoxin

If Digoxin level are tox is there an antedote?

Yes or No

A

Yes

58
Q

Cardiac Glycosides: Digoxin - Which is the Antedote?

Digifind ®- Digoxin unspecific Antibody Fab fragments
Digibind ®- Digoxin specific Antibody Fab fragments
Digibind ®- Digoxin unspecific Antibody Fab fragments
Digifind ®- Digoxin specific Antibody Fab fragments

A

Digibind ®- Digoxin specific Antibody Fab fragments

59
Q

Cardiac Glycosides: Digoxin - Diuretics

Is it true that patient who have heart failure are on Diuretics.

Yes or No

A

Yes

60
Q

Cardiac Glycosides: Digoxin - Diuretics

Low potassium will (Increase or Decrease) the risk for digoxin to (induced or inhibit) dysrhythmias

A

Increase

induce

61
Q

Cardiac Glycosides: Digoxin - ACE-Inhibitors/ARBs

increase K+ and (increase or decrease) digoxin response

A

Decrease

62
Q

Cardiac Glycosides: Digoxin - Drugs/ Food Binding
Bile Acid Sequestrants- ?

Kayexalate, Cholestyramine,

A

Cholestyramine

63
Q

Cardiac Glycosides: Digoxin - Drugs/ Food Binding
Sodium Polystyrene Sulfate- Potassium Binder

Kayexalate, Cholestyramine,

A

Kayexalate

64
Q

Cardiac Glycosides: Digoxin - Drugs/ Food Binding
Kayexalate?

Bile Acid Sequestrants, Sodium Polystyrene Sulfate- Potassium Binder

A

Sodium Polystyrene Sulfate- Potassium Binder

65
Q

Cardiac Glycosides: Digoxin - Drugs/ Food Binding
Do Digoxin bind to ?

Low fiber food (peaches ) or High fiber food (bran)

A

High fiber food - Bran

66
Q

Cardiac Glycosides: Digoxin - Pharmacokinetics

Digoxin requires adjustment in (Hepatic or Renal) impairment?

A

Renal Kidneys

67
Q

Digoxin eliminates through Hepatic or Renal system

A

Renal Kidneys

68
Q

What are the normal potassium levels?

2.5 - 5 mEq/L, 3.5 -4 mEq/L, 3.5 -5 mEq/L

A

3.5 -5 mEq/L

69
Q

Cardiac Glycosides: Digoxin - Nursing Considerations

a. Nurses should assess heart rate after administration
b. Educate patients to check their pulse at home after use
c. Normal range (60-100 bpm)
d. Notify provider if HR>60
e. Notify provider if patient has palpitations
f. Should see improved Urine Output (>30ml/hr)

A

c.
e.
f.

A.. Before
B. Before
d. <60

70
Q

Feel in the blank?
If ? lb weight gain in 1 day
OR ? lb in 1 week
Need to notify provider (developing fluid overload)

A

2

5

71
Q

Which is a Phosphodiesterase 3 Inhibitor

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone - Inodilator

72
Q

Which 3 drugs are a Positive Inotropic Agents

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone - Inodilator

Dopamine- VASOPRESSORS/SHOCK

73
Q

Which deals with PDE3, PDE$, PDE5

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

74
Q

Milrinone- Inodilator
PDE4

CHF, COPD- Theophylline, PENIS- Erectile Dysfunction

A

COPD- Theophylline

75
Q

Milrinone- Inodilator
PDE3-

CHF, COPD- Theophylline, PENIS- Erectile Dysfunction

A

CHF

76
Q

Milrinone- Inodilator
PDE5

CHF, COPD- Theophylline, PENIS- Erectile Dysfunction

A

PENIS- Erectile Dysfunction

77
Q

Milrinone- Inodilator
Sildenafil/Tadalafil

PDE3, PDE4, PDE5,

A

PDE5

78
Q

Milrinone- Inodilator
NITRATES can be mixed with?

PDE3, PDE4, PDE5,

A

PDE5

79
Q

Severe, decompensated HF (late stages)
Bridge to await a heart transplant
Palliative therapy

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

80
Q

VASODILATOR AND POSITIVE INOTROPIC AGENT

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

81
Q

Adverse side effect ?
dysrhythmias (ventricular)- pushing the heart hard!
Hypotension

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

82
Q

CONTRA-INDICATIONS:
Can’t use if MI or dysrhythmia

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

83
Q

What do a nurse to check before giving Milrinone

Heart rate, Blood pressure, or Both

A

Blood pressure

84
Q

Which is IV continuous drip

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

Dopamine- VASOPRESSORS/SHOCK

85
Q

Which is used in the late stages of heart failure

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Milrinone- Inodilator

Dopamine- VASOPRESSORS/SHOCK

86
Q

Which is
Hemodynamic Support
Inotropic Support for Heart Failure

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Dopamine- VASOPRESSORS/SHOCK

87
Q

Dopamine- VASOPRESSORS/SHOCK
DA Renal perfusion (oxygenate kidneys= inc urine output)

Moderate, Low, High

A

Low

88
Q

Dopamine- VASOPRESSORS/SHOCK
(DA+Beta1+Alpha1) (improved blood pressure)

Moderate, Low, High

A

High

89
Q

Dopamine- VASOPRESSORS/SHOCK
Beta (DA+Beta1) (Cardiac Output)

Moderate, Low, High

A

Moderate

90
Q

Adverse side effect ?
dysrhythmias (ventricular)- pushing the heart hard!
Hypertension

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Dopamine- VASOPRESSORS/SHOCK

91
Q

Which has the following Nursing conderations?
DA- urine output, improvement of the AKI/ARF (SCr/BUN down)

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Dopamine- VASOPRESSORS/SHOCK

92
Q

Which has the following Nursing conderations?
Beta- inotropic support

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Dopamine- VASOPRESSORS/SHOCK

93
Q

Which has the following Nursing conderations?
Alpha- BP

Inodilator, Cardiac Glycoside, VASOPRESSORS/SHOCK
Digoxin, Dopamine, Milrinone,

A

Dopamine- VASOPRESSORS/SHOCK

Pharmocology (36 decks)

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