Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Heart Failure Drugs
Ch. 22 Pharm
| Question | Answer |
|---|---|
| What is automaticity? | Property of specialized excitable tissue that allows self-activiation through the spontaneous dev of an action potential, as in the pacemaker cells of the heart. |
| What is positive chronotropic? Negative chronotropic? | increase of heart rate decr of heart rate |
| What is + dromotropic? what is - dromotropic? | + = accelerate conduction - = deccelerate conduction |
| What is + inotropic? what is - inotropic? | + = incr. force of contraction - = decr. force of contraction |
| What is left ventricular end-diastolic volume? Also known as? | Total amt of blood in vent. immediately before it contracts Preload |
| what is ejection fraction? what is normal %? | proportion of blood that is ejected during ea vent contraction 65% |
| Systolic dysfunction is inadequate ventricular contraction or refilling? | contraction diastolic dysfunction is inadequate vent filling |
| Name two typical cardiac defects that lead to heart failure | Myocardial Infarction and Valve deficiency |
| Name three defects outside the heart that leads to heart failure | diabetes coronoary artery disease pulmonary hypertension |
| What are supraventricular dysrhythmias? | problems in the atria: atrial fibrillation, flutter |
| heart failure drugs that are most common positive inotropic drugs? | phosphodiesterase inhibitors cardiac glycosides B-type natriuretic peptids ACE inhibitors ARB's (angiotensin II receptor blockers) beta blockers |
| ACE inhibitors do what? | convert angiotensin I to II, a vasoconstrictor and induces aldosterone secretion. Prevents Na and H2O resportion by inhibiting aldosterone secretion. |
| What does aldosterone do? | stimulates Na and H2O resportion, can raise BP |
| What is renin? | vasoconstrictor released by kidneys |
| what is the renin-angiotensin-aldosterone system? | process to raise BP by reorption of Na and h20 |
| What is the most common ACE inhibitor? | lisinopril (Prinvil, Zestril) |
| What are three ARB's available? | valsartan, candesartan, losartan |
| What is an adverse effect of lisinopril? | dry cough, hyperkalemia |
| What is the advantage of ARB's over ACE ihnibitors? | no cough |
| What do ARB's ultimately do? | vasodilators which decr systemic vascular resistance or afterload |
| What are B-type natiurectic peptides and name one | used in severe life threatening heart failure. vasodilators, incr CO, suppress renin-angiotensin system, diuresis nesiritide (Natrecor) |
| What do beta blockers block? | SNS stimulation to the heart adn heart's conduction system. Prevent catecholamine actions on heart. |
| What is the most common beta blocker? | Metoprolol |
| catecholamines are what? | SNS neurotransmitters: epi, norepi, dopamine |
| Name 4 adverse effects for B-type natiurectic peptides | hypotension, dysrhythmia, headache, abd pain |
| phosphodiesterase inhibitors (PDI's)inhibit what? What is inodilators? Name two drugs | phosphodiesterase inodilators +inotropic,vasodilation inamirone, milirone |
| phosphodiesterase inhibitors are given when pxt does not respond to what? | digoxin, diurectics, &/or vasodilators short term mgmt for heart failure |
| What are adverse effects of inamrinone? milrinone? | thrombocytopenia (dec platelets) dysrhythmia, hypokalemia, hypotension |
| Cardiac glycosides are oldest cardiac drugs. Obtained from what plant? | foxglove |
| what is prototypical cardiac glycoside? What treatment is it used for? | Digoxin systolic heart failure, atrial fibrillation |
| Digoxin has a + intotropic or - without an increase in what? + or - dromotropic? What does it prolong? | + inotropic, w/o incr in O2 consum. - dromotropic refractory period (area b/n SA & AV nodes) |
| What is result of digoxin? | reduced cardiac heart rate and improved cardiac effeciency, reduced heart size, less edema, incr coronary circulation (more blood to heart), help pxt exert and breathe better |
| A normal ventricle squeezes how much blood out with how much blood left behind? Weak left vent? | 60%, 40% 33%, 67% |
| Heart Failure symptoms | SOB, feet swell, no energy, insomnia, abd swell, cough, diuresis, confusion |
| Dig adverse effects | very narrow therapeutic window, can get toxic quickly, drug levels must be .5-2ng/mL Low K incr toxicity electrolyte levels monitored dysrhythmias, headaches, colored vision, anorexia |
| What is the antidote for dig overdose? | Digoxin immune Fab (digibind) |
| In measure the apical pulse for Dig, what should you look for? | Measure apical for 1 min. If <60 or lower, or >100, then withhold dose and notify doctor |
| What food should not be adm. with Dig? | high fiber foods b/c fiber binds and alters absorption adn bioavailability |
| Therapeutic effects of pos. inotropic drugs | incr urinary output decr edema decr dyspnea/crackles decr fatigue resolve paroxysmal noct. dyspnea Impr. peripheral pulses,skin color, temp |
| What are the parameters for weight gain with heart failure drugs | 2+ lbs in day or 5+ in week, report |
| When adm. inamrinone or milrinone, how should you adm. it? | use infusion pump |
| An IV inamrinone should never be mixed with what? What color is the solution? | dextrose yellow |
Created by:
palmerag
Popular Pharmacology sets