Save
Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
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

Heart Failure Drugs

QuestionAnswer
Determinants of oxygen demand by heart (4): Diastolic filling pressure, affected by blood volume and venous tone. Resistance to ejection of stroke volume during systole, which depends on BP and arterial tone. Heart Rate. Contractility
Types and examples of groups of drugs that decreases oxygen demand by lowering determinants (3): Beta blockers: eg. proponolol, atenolol and labetalol. Calcium channel blockers: eg. verapamil, nifedipine Nitrates: eg. nitroglycerin.
Beta blockers: mode of action on heart Affected largely by B2 recept. activated B2 receptors release cAMP -> influx of Ca into cells -> ^ contractility. Also ^ HR by stimulating SA&AV node. B blockers antagonise these effects and also help w/ hypertension by reducing renin pdtn by kidney.
Beta blockers: mode of action on lungs and smooth muscle Affected predominantly by B1 receptors, therefore should not use non-selective on asthmatic patients, as it may precipitate asthma attacks due to bronchoconstriction.
Beta blockers: uses CHIG: Cardiac arrythmias (since catecholamines ^ HR), Hypertension (v renin pdtn and contractility), Ischaemic heart disease (decreasing oxygen demand from heart) and Glaucoma (reduces intraocular pressure by reducing aqueous humour production)
Beta blockers: toxicity and contraindications WEBS: Withdrawal symptoms (drug dose must be tapered off), Erectile dysfunction, Bradycardia (presents as coolness of extremities) and Sedation (since catecholamines increases anxiety)
Calcium channel blockers: summary (refer to anti-hypertensives for more detailed questions) Eg. Verapamil and Nifedipine. Blocks Ca channels, decreases Ca influx into cells -> relaxes smooth muscle. Vascular muscle particularly affected, esp arterioles, and so does not cause orthostatic hypotension. reduce contractility and SA AV node conduction
Nitrates: Mode of action & example Nitroglycerin. Taken up into smooth muscle cells and de-nitrated. Nitrite ion is then released and converted into NO, which relaxes all types of smooth muscle
Nitrates: Uses Relaxes all vascular smooth muscle, which ^ venous capacitance and v ventricular preload -> reduces oxygen demand of heart and CO. Increases coronary blood flow as epicardial coronary arteries affected. Decreased preload and afterload good for angina.
Nitrates: toxicity Major vasodilation -> hypotension -> baroreceptors activated -> tachycardia. Also increases tolerance
Signs & symptoms of heart failure Tachycardia, dyspnoea, orthopnoea, nocturnal paroxysmal dyspnea, pulmonary edema, peripheral edema, cardiomegaly, decreased exercise tolerance.
Drug used in heart failure: Cardiac glycosides/ Digitalis
Cardiac glycosides: mode of action Inhibits Na/K ATPase, increasing intracellular [Na] -> less Ca efflux (^ free Ca in sarcomere during systole) -> stronger systolic contractions. Affects both normal and failing heart.
Cardiac glycosides: effects on heart: digoxin -> ^ contractility -> ^CO -> ^carotid sinus receptor & renal blood flow -> decreased sympathetic activity & deactivation of RAAS -> decreased preload & afterload. There is a decrease in QT & ST interval, inversion of T.
Cardiac glycosides: uses Heart failure and atrial fibrillation, back up choice after ACEI and diuretics.
Cardiac glycosides: toxicity Cardiac problems eg. a&v fib, premature ventricular depolarisation. GIT (nausea, vomiting, anorexia), Headache, confusion, fatigue, blurred vision. Rarely, gynecomastia.
Cardiac glycosides: treatment of toxicity Reduce or stop treatment if side effects include vision & GIT. Correct K or Mg deficiency and anti-arrythmatic drugs to prevent cardiac arrest.
Cardiac glycosides: drug interactions K+ & digitalis inhibit each other's binding to Na/K ATPase, therefore hypokalemia will increase effect of digitalis. HyperCa might worsen action as ^ Intracellular Ca. Mg has opposite effect of Ca. Verapamil ^ [digoxin]. Interaction w corticosteroids.
Created by: Aurorahx
 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards