Rx_01.17 (Cardio) Flashcards
Categories of Ca-channel blockers + examples
- Non-dihydropyridine
- verapamil
- diltiazem
- Dihydropyridine
- amlodipine
- nifedipine
- nimodipine
Effects of non-dihyrdopyridine ca channel blockers
- e.g. verapamil, diltiazem
- potent effects on heart rate and contractility
- block L-type Ca channels ==> decreased m. contractility
- less effects @ vascular smooth m. compared to dihydropyridine
Effects of dihyrdopyridine ca channel blockers
- e.g. amlodipine, nifedipine, nimodipine
- less-potent @ heart
- more potent @ vascular smooth muscle
- ==> vasodilation
Causes of dilated cardiomyopathy
- ABCCCD (B C w/A C D C)
- alcohol abuse
- wet Beriberi
- Coxsackie B myocarditis
- chronic Cocaine
- Chagas
- Doxorubicin (Hodgkin’s lymphoma tx)
Adverse effects of fibrates
- myositis
- hepatotoxicity
- cholesterol gallstones
Fxn of thrombaxane + chemical source
- Arachidonic acid acted on by COX ==> endoperoxides ==> thromboxane A2 ==>
- increased platelet aggregation
- increased vascular tone
- increased bronchial tone
Fxn of B-blockers @ heart
- B-blockers inhibit GPCR ==>
- decreased cAMP/PKA ==?
- decreased Na and Ca current @ AV node ==>
- decreased slope of phase 4 and phase 0
- help to suppress abnormal pacemakers
Adverse effects of ACE inhibitors
- e.g. captopril
- hypotension
- hyperkalemia
- renal insufficieny
- angioedema
- metallic taste
- fetal renal damage
- cough
Cause of referred pain in MI
- viisceral sensory pain fibers synapse @ thoracic dorsal root danglia
- these synapses enter @ the same level as the brachila plexus ==> pain perceived in shoulder/neck
Characteristics of Mannitol
- osmotic diuretic
- ==> preferential water diuresis
- can cause pulmonary edema ==> contraindicated in patients w/CHF
MOA of Digoxin
- inhibits Na-K-ATPase pump ==>
- increase in intracell [Na] ==> inhibition of Na/Ca antiporter ==> increased intracell [Ca] ==>
- positive inotropic effect @ heart + increased vascular resistance + increased systemic BP
Phases of cardiac cycle?
- I = ventricular filling
- II = isovolumetric contraction
- III = centricular ejection
- IV = isovolumetric relaxation
Fibrous plaques = ?
- atherosclerosis
- intimal plaques w/necrotic lipid core
Medial calcific sclerosis of arteries = ?
- Monckeberg’s arteriosclerosis
- calcification of media of medium-sized muscular arterias
- no intimal thickening or obstruction of flow
Norepinephrine: MOA, SE
- action at a-receptors ==> vasoconstriction ==> elevated systemic resistance/BP
- stimulation of B1 receptors ==> increased heart contractility
- SE: reflex bradycardia (in response to increase venous return and contractility)
Embryonic orgins of smooth portions of ventricles
bulbus cordis
primitive atrium ==>
trabeculated regions of atria
trabeculated portions of ventricles derive from which embryonic structure?
primitive ventricle
Embryonic formation of smooth parts of atria
- sinus venosis ==> coronary sinus + smooth parts of RA
- portions of pulmonary veins ==> smooth LA
Embryonic formation of aorta/pulmonary artery
- truncus arteriosus ==> aorta + pulmonary artery
- neural crest cells ==> aorticopulmonary septum
Chronic exposure to industrial chemicals ==>
- nitroglycerin exposure ==> nitroglycerine withdarawal
- “monday disease” of headaches, dizziness, palpitations
- can lead to compensatory vasoconstriction @ coronary arteries ==> non-atherosclerotic ischemia ==> cardiac arrest
Cardiac drug contraindicated in cocaine users
- beta-blockers
- B-blocers + cocaine ==> unopposed alpha effects ==> excess vascular smooth m. contraction
VHL inheritence + gene location
- autosomal dominent
- VHL = deletion of tumor suppressor gene on chromosome 3p
