Medical Management of Cardiac Patients

Question 1

What is drug clearance?

3 mechanisms/organs which promote clearance

Answer 1

how quickly the drug leaves your body due to the amount of biological fluid within it

1. kidney
2. liver
3. pulmonary

Question 2

what is an inotropic drug?

how do they work?

Answer 2

drug which increases the force of ventricular contraction when myocardial systolic function is impaired
increasing calcium concentration

Question 3

what are the 2 desired effects of digitalis and cardiac glycosides?

Answer 3

improve contractability (of heart)
prolong refractory period of AV node (pts with supraventricular arrhythmias)

Question 4

what is the half life of digoxin?

which organ is it filtered through?

Answer 4

36-40 hours

liver

Question 5

what are 3 signs of digoxin toxicity?

Answer 5

1. nausea/vomiting
2. anorexia
3. arrythmias

Question 6

Effects of dopamine in low, medium, and high doses

Answer 6

Low <2mcg - block blood flow to kidneys
Medium 2-10mcg - increase CO
high 10mcg - vosoconstriction/elevates systemic resitance

Question 7

what is the function of phosodiesterase inhibitors?

Answer 7

enhances calcium entry into cell => greater contraction force

Question 8

what is the function of sympathomimetic amines?

Answer 8

increase release of calcium from SR

Question 9

what is the funciton of B-type natriuretic peptides? (BNP)

Answer 9

smooth muscle cell relaxation

Question 10

what is the function of ACE inhibitors? (2)

Answer 10

1. decrease arterial pressure

2. facilitate natriuresis (excretion of NA in urine)

Question 11

what is the function of Sodium Nitroprusside? (SNP)

what are 4 side effects of SNP?

Answer 11

potent dilator of arteries and veins used in hypertenisve emergencies

1. blurred vision
2. tinnitus
3. disorientation
4. Nausea

Question 12

what is the function of alpha adrenergic antagonists?

Answer 12

vasodilation

Question 13

what is the main physiological action of nitrates?
at low doses?
at high doses?

Answer 13

vasodilation of systemic veins
low doses - greater action at veins
high doses - reflex tachycardia

Question 14

what 3 things do beta blockers decrease?

what are 3 side effects of beta blockers?

Answer 14

HR, BP, & contractibility

1. fatigue
2. angina
3. elevation of triglycerides

Question 15

what is the function of lidocaine? (antiarrythmic)

what are 3 side effects?

Answer 15

suppress ventricular arrythmia

1. confusion
2. dizziness
3. seizure

Question 16

what is the function of amiodarone?

what are 3 side effects?

Answer 16

suppress ventricular and atrial arrythmias

1. anorexia
2. thyroid function
3. movement disorders

Question 17

what is adenosine useful in terminating?

Answer 17

supraventricular tachycardia

Question 18

what is the different uses for loop, thiazide, and potassium-sparing diruetics

Answer 18

loop - pulmonary edema/heart failure
thiazide - block reabsobtion of filtered sodium
potassium-sparing - antagonize sodium reabsorption

Question 19

what is the function of platelet inhibitors?

Answer 19

prevention of thorombotic stroke in patients with TIAs or previous CVAs

Question 20

what are 3 side effects of lipid lowering drugs?

Answer 20

1. muscle weakness
2. GI upset
3. Altered liver fcn