L33 Heart Failure Flashcards
Excitation contract coupling in the heart
Ca influx activate ryanodine receptors,
Ca release from SR
Ca binds troponin, moving tropomyosin, exposing actin
Ionotropic drugs
Negative inonotropes weaken contractions
Positive strengthen contractions
Chonotropic drugs
Change heart rate
Positive ionotropic drugs to treat heart failure
Cardiac glycosides
Beta1 adrenergic rec. agonist
Bipyridines
Cardiac glycoside (Digoxin) mechanism
Blocks Na/K ATPase,
Slowing Na/Ca exchanger
Slowing removal of Ca
Digoxin results
Increased contractility Increase ejection Increase CO Increase renal perfusion Decrease Sympathetic and renal responses
How to bipyridines work
Phosphodiesterase-2 inhibitors keep cAMP from going to adp
Increase PKA
Phosphorylate L-type Ca
Contraction
Beta blocker suggested mechanism
Against adverse effects of catacholarmines
Up regulation of B receptors?
Decrease HR
Decrease catacholamine mediated remodeling
When using diuretics to treat heart failure start with ____ then move to _____ diuretics
STart with thiazides then move to loop diuretic
Non positive ionotropic treatments
B adrenergic receptor antagonist Diuretics ACE inhibitors Angiotensin antagonists Aldosterone receptor anatagonist Vasodilator
Medications for congestive heart failure can cause
Dry mouth
Gingivitis
Angina pectorals is characterized by
Chest pain from part of the heart not receiving enough oxygen
Classical angina
Variant angina
Unstable angina
Fixed/stable plaque
Spasm of coronary artery
Unstable plaque
Classifications of heart failure
Class I mild: nothing
Class II mild: ordinary activitiy results in fatigue
Class III moderate: less than ordinary activity results in fatigue
Class IV Severe: Unable to do physical activity w/o discomfort
Drugs to treat angina
Nitrates
Beta adrenergic rec. blocker
Ca channel blocker
Aspirin
