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45 Cards in this Set

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  • Back
Name the 5 determinants of the level of myocardial oxygen consumption
There are five: end diastolic volume, blood pressure, heart rate, contractility, ejection time
Do nitrates affect preload or afterload?
preload
Do Beta-blockers affect preload or afterload?
afterload
What is the effect of nitrates on: diastolic volume, blood pressure, contractility, heart rate, ejection time?
decrease EDV, decrease BP, increase contractility (reflex response), increase HR (reflex response), decrease ejection time
What is the effect of Beta-blockers on: diastolic volume, blood pressure, contractility, heart rate, ejection time?
increase EDV, decrease BP, decrease contractility, decreased HR, increase ejection time
The effects of using nitrates and Beta-blockers together will: a) decrease myocardial oxygen demands by the same amount as using either alone, b) decrease myocardial oxygen demands by an amount greater than if each were used alone, or c) have no effect on myocardial oxygen demand
b) Decrease myocardial oxygen demands by an amount greater that if each were used alone
Nifedipine blocks -- channels
calcium
In its effects on myocardial oxygen consumption, is Nifedipine similar to Nitrates or B-blockers?
Nitrates (Nifedipine is similar to Nitrates)
In its effects on myocardial oxygen consumption, is Verapamil similar to Nitrates or B-blockers?
B-blockers
Dose nitroglycerin dilate arteries or veins more?
Veins>>arteries
Does nitroglycerin increase or decrease cGMP in smooth muscle?
Increase
In industrial exposure to nitroglycerine, weekend withdrawal is characterized by which three symptoms?
Tachycardia, dizziness , and headache ("Monday disease")
Toxic dosage of nitroglycerine causes which three symptoms?
Tachycardia, hypotension, headache
Digitalis has its action on which cell membrane transporter?
Na/K ATPase
Ryanodine has its action on which channel?
Calcium release channel in the sarcoplasmic receptor
Calcium enters cardiac cells through which channel?
Voltage-gated calcium channel
Cytoplasmic calcium concentrations in cardiac cells can be decreased by sequestering calcium in the sarcoplasmic reticulum. Calcium enters the SR through which transporter?
Calcium pump in the wall of the SR
Calcium channel blockers have their effect on which calcium transporters?
Voltage-gated calcium channel
What is digoxin's effect on the intracellular Na+ level?
Increase
What is digoxin's effect on the intracellular calcium level?
Increase
The 4 ECG changes ellicited by digoxin administration
There are 4: increase PR, decrease QT, scooping of ST segment, T-wave inversion
Name three symptoms of digoxin toxicity
Nausea, vomiting, diarrhea, blurry vision, arrhythmia
Which potentiates the effects of digoxin- hypo- or hyperkalemia?
hypokalemia
Which phase of the cardiac action potential do Class I antiarrhythmics decrease the slope of?
Phase 4 depolarization
What type of antiarrhythmic is Amiodarone?
Class 1A (Class 1A includes Quinidine, Amiodarone, Procainamide, Disopyramide, "Queen Amy Proclaims Diso's pyramid."
Do class 1A antiarrhythmics increase or decrease the effective refractory period, AP duration, and QT interval?
Increase ERP, increase AP duration, increase QT interval
What do class 1B antiarrhythmics do to the AP duration?
Decrease AP duration
What type of antiarrhythmic is mexiletine?
Class 1B (includes Lidocaine, mexiletine, tocainide)
What type of antiarrhythmic is encainide?
Class IC (includes flecainide, encainide, propafenone)
What effect do class 1C antiarrhythmics have on the AP duration?
No effect!
What does esmolol do to the cAMP in cardiac cells?
decreases cAMP (a beta-blocker)
What does atenolol do the calcium currents in cardiac cells?
decreases calcium current (beta-blocker)
Timolol decreases the slope of which phase of the cardiac AP cycle?
Phase 4 (a beta-blocker)
What does propanolol do the the PR interval?
Increases interval (beta-blocker)
Is esmolol a short- or long-acting beta blocker?
short-acting
Does amiodarone increase or decrease AP duration?
Increase (K+ channel blocker)
Does sotalol increase or decrease the effective refractory period?
Increase (K+ channel blocker)
Does bretylium increase or decrease the QT interval?
Increase (K+ channel blocker)
Name a symptom of sotalol toxicity.
Torsades de pointes (K+ channel blocker)
Name three of the symptoms of amiodarone toxicity.
Pulmonary fibrosis, corneal deposits, hepatoxicity, skin deposits resulting in photodermatitis, neurologic effects, constipation, bradychardia, heart block, CHF, hypothyroidism/hyperthyroidism. (Therefore, should check PFTs, LFTs, and TFTs)
Does verapamil increase or decrease the conduction velocity of the AV nodal cells?
Decrease (calcium channel blocker)
How does diltiazem affect the effective refractory period and the PR interval?
Increases ERP, increases PR (calcium channel blocker)
Name a potential use of Mg+ to treat arrhythmias.
To treat torsades de pointes and digoxin toxicity
Name a potential use of K+ to treat arrhythmias.
Depress ectopic pacemakers, especially in digoxin toxicity
Name a use of adenosine in treating arrhythmias.
Drug of choice to diagnose and abolish AV nodal arrhythmias.