Pharm Exam 1- 2014

Front 1

If pt has a wide QRS in NSR then do:

Back 1

Cardiac resynchronization

Front 2

Vasodilators work on decreasing ____ and increasing ______.

Back 2

Preload; tissue perfusion

Front 3

Drugs with positive inotropic effects used in CHF mainly work;

Back 3

On the heart

Front 4

Drugs without positive inotropic effects used in CHF mainly work:

Back 4

Outside of the heart

Front 5

Three drugs that are + inotropes:

Back 5

Dig, catecholamines, PDEI

Front 6

Four drugs that do not have + inotropic effects:

Back 6

ACEI/ARBs, BB, diuretics, direct vasodilators

Front 7

This drug class and prototype drug is potent and highly selective inhibitors of Na/K ATPase (Na pump). They increase the Ca-i which increases myocardial contraction and therefore CO.

Back 7

Digitalis glycosides; digoxin

Front 8

Glycosides increase _____ which decreases HR and O2 demand.

Back 8

Vagal activity

Front 9

Digoxin works by _____ the driving force for the Na/Ca exchanger so there is decreased ______ of Ca to the ECF.

Back 9

Decreasing; extrusion

Front 10

Therapeutic and toxic levels of digoxin:

Back 10

0.5-2ng/ml; > 2

Front 11

Therapeutic and toxic levels of digitoxin:

Back 11

10-25 ng/ml; > 35

Front 12

Glycosides have a _____ therapeutic window (50%).

Back 12

narrow

Front 13

Toxic effects of glycosides are oscillatory ______ and ____.

Back 13

After depolarization; VT

Front 14

CNS/vagal s/s of toxic OD of glycosides:

Back 14

N/V, blurred vision

Front 15

Catecholamines such as dopamine and dobutamine work by:

Back 15

activate B1R--> increased Ca influx--> enhanced contractility

Front 16

Inhibits PDE in cardiac and smooth muscle cells. Increases cAMP which increases Ca influx and contractility, and also inhibits myosin LCK in smooth muscle to cause vasodilation.

Back 16

Milrinone

Front 17

Milrinone is a weak _______. Mainly works as a ______.

Back 17

Positive inotrope; vasodilation

Front 18

Milrinone also:

Back 18

Bronchodilates

Front 19

Milrinone has a long term higher mortality than:

Back 19

cardiac glycosides

Front 20

Adverse effects: 12% life threatening ventricular arrhythmias, 3% H/A and hypotension.

Back 20

PDEI

Front 21

PDEI prevent ______ of cAMP which ____ the action of protein kinase which ______ the Ca channel.

Back 21

Hydrolysis; prolongs; phosphorylates

Front 22

DOC in HF, esp in combo with cardiac glycosides.

Back 22

ACEI

Front 23

Decreases AngII concentration which decreases TPR and ____. Also decreases Na retention which decreases _____. decreases sympathetic activity and long term _____ of the heart. Decreases both mortality and morbidity.

Back 23

Afterload, preload, remodeling

Front 24

This drug class is indicated for: a pt that has DOE but no symptoms of volume overload; any LV failure; immediately after MI.

Back 24

ACEI

Front 25

ACEI can cause severe hypotension especially in ______.

Back 25

Hypovolemia

Front 26

Hyperkalemia can be caused by both:

Back 26

ACEI and ARBs

Front 27

MOA is similar to ACEI except they bind Ang type 1 R to block the role of Ang II. Name the drug class and prototype drug.

Back 27

ARBs, losarton

Front 28

Efficient in reducing the symptoms of HF and slowing its progression. Used in combo and rarely alone to slow the HR and decrease BP and reduce the workload of the heart. Name the drug class and prototype drugs.

Back 28

B-adrenergic blockers; metoprolol (B1 selective) and labetalol/carvedilol (blocks alpha and beta receptors)

Front 29

Has the adverse effect of negative inotropic action which can worsen heart failure and cause decreased CO and hypotension.

Back 29

BB

Front 30

Do not use BB if there is significant ____ or _____ HF.

Back 30

Bradycardia; unstable