Test 1: Drugs Acting on the Heart

Question 1

________ is the strongest ß1- agonist

used as a cardiac stimulant

Answer 1

Isoproterenol

Question 2

Why is epinephrine, a ß1-agonist, the cardiac stimulant of choice

as compared to isoproterenol and NE?

Answer 2

Better than isoproterenol because: Iso can cause hypotension

Better than NE because: NE can cause hypertension

Epinephrine causes less of an increase in blood pressure because it also acts on ß2 as an antagonist

which avoids reflex bradycardia

Question 3

What is the drug of choice for a complete AV block?

How about for an incomplete AV block?

Answer 3

DOC for complete AV block= Epinephrine

DOC for incomplete AV block= Atropine

Question 4

Which route of administration of epinephrine

increases absorption by vasodilation?

Which route decreases absorption?

Answer 4

• Increases absorption* = IM
• Decreases absorption* = SC

Question 5

What ß1-agonist cardiac stimulant is used in

cardiogenic shock when there is a lack of

renal perfusion?

Answer 5

Dopamine

Question 6

This is a cardiac stimulant that can also be used as a

bronchodilator and in CHF emergency via

phosphodiesterase inhibition

Answer 6

Aminophylline

Question 7

Glucagon and Calcium Salts are

cardiac ________

Answer 7

stimulants

Question 8

In heart failure, you have a ________ in

cardiac contractility, output and blood pressure

and _________

sympathetic tone, RAAS, ADH, and myocardial

hypertrophy

Answer 8

In heart failure, you have a decrease in

cardiac contractility, output and blood pressure

and increased

sympathetic tone, RAAS, ADH, and myocardial

hypertrophy

Question 9

Restriction of salt and exercise are examples of

non-drug therapies used to treat

______________

Answer 9

Congestive Heart Failure (CHF)

Question 10

In the treatment of CHF,

positive ionotropic drugs

_______ contractility

Answer 10

increase

Question 11

What is the most commonly used positive

ionotropic drug used to treat CHF?

Answer 11

Digoxin

Question 12

How does Digoxin work as a positive ionotrope to treat CHF?

Inhibition of ________ increases sodium available for exchange with calcium.

The result is an increase in intracellular ______

which results in a positive ionotropic effect

Answer 12

Inhibition of Na/K ATPase increases

sodium ⇔ calcium

The result is an increase in intracellular Na+

Question 13

What are some adverse effects associated with

digitalis treatment of CHF?

Answer 13

GI irritation and vomiting

Diuretic effects