Pharmacology_2 01: Inotropics

Front 1

3 kinds of inotropic agents

Back 1

adrenoceptor agonists
digoxin
PDEIs

Front 2

adrenoceptor agonists act on cardiomyocyte via ___, which signals via ___

Back 2

beta1R
PKA

Front 3

2 targets of PKA in cardiomyocyte

Back 3

L-type Ca2+ channel
phospholamban

Front 4

phospholamban normally ___s SERCA, which pumps Ca2+ into ___. phosphorylation by ___ causes it to ___, which causes ___.

Back 4

inhibit
sarcoplasmic reticulum
PKA
dissociate from SERCA
enhanced Ca2+ reuptake

Front 5

phosphorylation of L-type Ca2+ channel by ___ causes ___.

Back 5

PKA
increased Ca2+ influx

Front 6

dobutamine is a ___ agonist used for ___ cardiac support. it's primary action is on ___R.

Back 6

beta
short-term
beta1

Front 7

dobutamine causes ___ via beta1 and ___ via beta2

Back 7

contractility
vasodilation

Front 8

___ limits effectiveness of beta agonists.

Back 8

receptor downregulation

Front 9

internalization happens when ___ phosphorylates the receptor, which allows ___ to bind it.

Back 9

PKA
arrestin

Front 10

beta blockers work by ___ing (2)

Back 10

reversing adrenoceptor internalization
blocking arrhythmogenic effects of catecholamines

Front 11

___ is a beta blocker

Back 11

metoprolol

Front 12

3 cardiac glycosides

Back 12

digoxin
ouabain
strophanthidin

Front 13

cardiac glycosides are made of ___ aka ___ plus ___.
the pharmagological activity is determined by ___, the pharmacokinetics by ___.

Back 13

steroid-lactone
aglycone
sugar
aglycone
sugar

Front 14

___ is produced endogenously

Back 14

ouabain

Front 15

increased CO from digoxin causes ___ (2)

Back 15

reduced CVP
reduced peripheral vascular hydrostatic P

Front 16

reduced peripheral vascular hydrostatic P causes ___

Back 16

reduced peripheral edema

Front 17

2 autonomic NS effects of digoxin

Back 17

reduced sympathetic tone
increased vagal tone

Front 18

increased vagal tone causes ___ (2)

Back 18

reduced SA rate
reduced AV conduction rate

Front 19

___ (2) from digoxin cause improved cardiac efficiency

Back 19

increased CO
bradycardia

Front 20

___ (2) from digoxin is a direct cardiac effect but ___ (3) is an indirect one.

Back 20

positive inotropism
increased automaticity
reduced sympathetic tone
increased vagal tone
reduced automaticity

Front 21

digoxin works by ___ing, which causes ___, which causes ___ (2).

Back 21

inhibiting myocyte Na+/K+ ATPase
2' inhibition of NCX
increased Ca2+ stores
increased Ca2+ release

Front 22

after prolonged administration of cardiac glycoside in vitro, AP duration ___s and you see ___. this can cause ___.

Back 22

shrinks
delayed afterdepolarization (DAD)
tachyarrhythmia

Front 23

in CHF patients digoxin causes ___, but in normals it may cause

Back 23

vasodilation
vasoconstriction

Front 24

4 digoxin side effects

Back 24

nausea
vomiting
diarrhea
altered color perception

Front 25

at high doses digoxin causes increased ___ (2)

Back 25

sympathetic activity
automaticity

Front 26

action potential duration decrease is prominent in ___. because of ___ (2) this is not so dangerous.

Back 26

atria
reduced AV node conduction
positive inotropism

Front 27

hypokalemia increases/decreases digoxin effect

Back 27

increases

Front 28

digoxin toxicity may be treated with ___

Back 28

anti-digoxin Fab

Front 29

digoxin t1/2 is ___. absorption is ___% and ___. it is excreted by ___

Back 29

36 h
75%
variable
kidney

Front 30

care must be taken when combining digoxin with other ___ drugs to prevent ___.

Back 30

AV conduction-reducing
complete heart block

Front 31

2 drugs which can cause digoxin toxicity by decreasing GI degradation

Back 31

quinidine
antibiotics

Front 32

T/F: digoxin prolongs life

Back 32

false

Front 33

cardiac PDE is ___. 2 cardiac PDEIs are ___.

Back 33

PDE3
amrinone
milrinone

Front 34

PDEIs cause ____.

Back 34

positive inotropism

Front 35

T/F: cardiac PDEIs prolong life

Back 35

false