Cardiac Pharmacology

Front 1

Why are ACEI's the most efficacious of the vasodilators?

Back 1

Because they counter-act the major adverse hormonal and vasoconstrictor mechanisms, relieve symptoms, diminish ventricular dilation after MI and improve exercise capacity and ejection fraction

Front 2

What is positive inotropic action?

Back 2

The increase of the contractile actions of the heart, causing ventricles to empty more completely

Front 3

Name 5 positive inotropic drugs

Back 3

Digoxin, dobutamine, dopamine, epinephrine and isoproterenol

Front 4

What is negative inotropic action

Back 4

The weakening of the force of myocardial contraction

Front 5

Name 3 negative inotropic drugs

Back 5

Lidocaine, quinidine and propanolol

Front 6

What is positive chronotropic action

Back 6

Accelerates the heart rate by increasing the rate of impulse formation at the SA node

Front 7

Name a positive chronotropic drug

Back 7

Norepinephrine

Front 8

What is negative chronotropic action

Back 8

Slowing of the heart rate by decreasing the rate of impulse formation

Front 9

Name a negative chronotropic drug

Back 9

Propanolol (also negative inotropic drug)

Front 10

What is positive dromotropic action

Back 10

The increase in speed with which impulses from the SA node pass throught the conduction pathways

Front 11

Name a positive dromotropic drug

Back 11

Phenytoin

Front 12

What is negative dromotropic action

Back 12

The decrease in conduction velocity

Front 13

Name a negative dromotropic drug

Back 13

Verapamil (a calcium channel blocker)

Front 14

What type of vasodilator is recommended for patients with asymptomatic HF who have an LVEF of less than 40%

Back 14

ACEI's. (If there is a prior hx of fluid overload, use in conjuntion with diuretics)

Front 15

What are the advantages of using in ARB over an ACEI

Back 15

Increased selectivity and specificity as well as the ability to maintain blockade of circulating and tissue renin-angiotensin-aldosterone system at the angiotensin one receptor, without the adverse effects of the ACEI's

Front 16

Name 2 ARB's approved for use in HF

Back 16

Valsartan and Candesartan

Front 17

Which ARB is most widely stdied for use in HF

Back 17

Losartan

Front 18

What does Losartan do for a HF patient?

Back 18

Lowers BP, peripheral vascular resistance, pulmonary capillary wedge pressure and heart rate. It raises cardiac output. It also decreases dyspnea on exertion and exacerbation of HF.

Front 19

Why do ACEI's have an averse effect of coughing

Back 19

Cough is due to the accumulation of bradykinin

Front 20

What are the adverse effects of ARB's

Back 20

First dose hypotension (may also occur during upward titration of drug or when clinical status of patient worsens)

Front 21

What is the earliest sign of Digoxin toxicity

Back 21

Anorexia

Front 22

What are the two primary causes of Digoxin toxicity

Back 22

Improper dosing and hypokalemia secondary to the concurrent administration of diuretics

Front 23

What is the most common Digoxin-induced arrhythmia

Back 23

Premature ventricular contractions (PVC's) Also described as "skipped beats"

Front 24

Name the phosphodiasterase inhibitor used for short term management (2-3 days) of HF in patients not reponding to diuretics, digoxin or vasodilators

Back 24

Inamrinone

Front 25

Therapeutic levels of Digoxin will result in what changes on an ECG

Back 25

Narrowing of QRS, depression or inversion of the T wave and slowing of heart rate