THERAPEUTICS(INTRO &CARDIAC FAILURE)

Question 1

ARTERIOSCLEROSIS & ATHEROSCLEROSIS

Answer 1

THICK AND STIFF ARTERIES
RESTRICT BLOOD FLOW
HEALTHY ARTERIES ARE FLEXIBLE AND ELASTIC

ARTERIOSCLEROSIS DUE TO THE ACCUMULATION OF FATS AND CHOLESTEROL CALLED PLAQUES

Question 2

HOW DO WE ADDRESS REVERSIBLE FACTORS

Answer 2

CORONARY ARTERY AND VALVE SURGERY
ALCOHOL ABSTAINANCE
TREAT HYPERTENSION

Question 3

HOW WE IMPROVE SYMPTOMS ASSOCIASTED WITH FLUID RETEINTION

Answer 3

REDUCE SALT INTAKE TO LESS THAN 2G PER DAY
REDUCE FLUID INTAKE TO 1-1.6L PER DAY
MONITOR WEIGHT GAIN

Question 4

DRUGS USED OVER THE PAST DECADES

Answer 4

DIURETICS AND DIGOXINS

Question 5

DIURETICS

Answer 5

IMPROVE SYMPTOMS OF FLUID ACCUMULATION
PROMOTE EXCRITION OF SALT(NA) AND WATER
REDUCE VENTRICULAR PRE LOAD BUT DOES NOT AFFECT STROKE VOLUME

Question 6

DIGOXIN

Answer 6

IONOTROPIC
INCREASE CONTRACTILITY
INCREASE DEMAND OF OXYGEN
INCREASE STROKE VOLUME,EJECTION FRACTION,ORGAN PERFUSION 
DECREASE OEDEMA AND AFTER LOAD

Question 7

STEPS

Answer 7

STEP 1: DIURETIC(HCT OR FUROSEMIDE + ACE INHIBITOR OR ARB
STEP 2: CARVERDILOL OR SPIRONOLACTONE
STEP 3; CARVERDILOL + SPIRONOLACTONE
STEP 4: DIGOXIN

Question 8

IN AN UNEXPLAINED HEART FAILURE

Answer 8

USE THIAMINE

Question 9

hydrochlorothiazide (HCT)

Answer 9

IMPROVE SYMPTOMS OF FLUID RETEINTION(SHORTNESS OF BREATH AND LEG SWELLING)
IMPROVE EXCRETION OF SODIUM AND WATER
NO EFFECT ON MORTALITY
USED IN MILD VOLUME OVERLOAD AND NORMAL RENAL FUNCTION

ADVERSE EFFECTS: DEHYDRATION,HYPOTENSION,HYPOKALAEMIA,ELECTROLYTE ABNORMALITIES
CAUTION: RENAL OR HEPATIC IMPAIREMENT
GOUT

Question 10

FUROSEMIDE

Answer 10

USED IN SIGNIFICANT VOLUME OVERLOAD OR RENAL OR HEPATIC IMPAIRMENT
IMPROVE SYMPTOMS OF FLUID RETENTION
NO EFFECT ON MORTALITY

Question 11

ACE INHIBITORS

Answer 11

NAME END WITH PRIL.E.G. CAPTOPRIL,ENALAPRIL,RAMIPRIL
INHIBIHT ACE,THEREFORE BLOCK ANGIOTENSIN 2 FORMATION
IMPROVE SYMPTOMS
PROLONG SURVIVAL
PREVENT CLINICAL DETORIATION
ADVERSE EFFECTS: HYPOTENSION,ELECTROLYTE IMBALANCE,DRY COUGH,ANGIOEDEMA, AND DECREASE KIDNEY FUNCTION

Question 12

WHY ACEI CAUSE DRY COUGH AND ANGIOEDEMA

Answer 12

THEY INHIBIT ACE WHICH CONVERT BRADYKININ TO INACTVE METABOLITES
THIS CAUSES INCREASE IN BRADYKININ
BRADYKININ CAUSE COUGH AND ANMGIOEDEMA

Question 13

STENOSIS

Answer 13

ABNNORMAL NARROWING OF ANY PASSAGE IN THE BODY

Question 14

ARBs

Answer 14

NAME END WITH SARTAN.E.G.VALSARTAN,LOSARTAN
BLOCK ANGIOTENSIN RECEPTORS
IMPROVE SURVIVAL

Question 15

ADRENALINE

Answer 15

LUNG-B2-BRONCHODILATION
HEART-B1-INCREASE CONTRACTILITY
ARTERIES-A-VASOCONSTRICTION
SKELETAL ARTERIES-B2-VASODILATION
KIDNEY-B1-RENIN

Question 16

BETA BLOCKERS

Answer 16

CARVEDILIN BLOCK B2,B1.A

Question 17

SPIRONOLACTONE

Answer 17

USED IN CARDIAC FAILURE GRADED 3 OR 4
GIVEN WITH ACE INHIBITOR
WEAK DIURETIC
REDUCE OEDEMA
FLUID FLOW 
IMPROVE SURVIVAL
HYPERKALAEMIA AND GYNAECOMASTIA
CAUTION: RENAL IMPAIRMENT

Question 18

DIGOXIN

Answer 18

IMPROVE SYMPTOMS
IONOTROPIC
PREVENT CLINICAL DETERIORATION
INCREASE CA2+
NO EFFECT OF MORTALITY

Question 19

DRUG THAT WORSEN CARDIAC FAILURE

Answer 19

NSAID

DRUG THAT WILL INCREASE NA+

Question 20

DRUGS IN ACUTE SEVERE HEART FAILURE WITH PULMONARY OEDEMA

Answer 20

OXYGEN
FUROSEMIDE 4
MORPHINE
IONOTROPIC DRUG:DOBUTAMINE,IF NO RESPONSE.THEN ADRENALINE IS GIVEN
ONCE A PATIENT IS STABLE AND MAINTAUINING BP ,ACE INHIBITOR IS GIVEN

Question 21

MORPHINE

Answer 21

ANXIOLYTIC PROPERTIES
VASODILATOR
CAN CAUSE VOMITING AND POSSIBILITY OF ASPIRATIONO
BENZODIAZEPINES IS MOSTLY USED