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240 Cards in this Set
- Front
- Back
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A pregnant woman in her 3rd trimester has orthostatic hypotension: normal standing, 90/30 when supine. What does she have?
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Compression of the IVC
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35-year old man has high blood pressure in the arms and low blood pressure in his legs. What does he have?
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Coarctation of the aorta
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5-year old boy presents with a systolic murmur and a wide, fixed split S2. What does he have?
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Atrial septal defect (ASD)
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A young football player collapses during a game and dies immediately. Why?
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Hypertrophic cardiomyopathy
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Patient has a stroke following multiple bone fractures due to an auto accident. What caused the stroke?
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Fat emboli
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Elderly women presents with headache and jaw pain. Labs show elevated ESR. What does she have?
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Temporal arteritis
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80-year old man presents with a systolic crescendo-decrescendo murmur. What would cause this?
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Aortic stenosis
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Man starts a medication for hyperlipidemia. He then develops a rash, pruritis, and GI upset. What drug is it?
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Niacin
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Patient develops a cough and must discontinue their captopril. What is a good replacement drug, and why?
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Losartan (angiotensin II receptor antagonist) does not increase bradykinin like captopril
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PAtient presents with ringing ears, dizziness, headaches, and GI distress. What drug is she likely taking?
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Quinidine
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Patient with a history of hypertension presnets with sudden sharp, tearing pain radiating to the back. What will you see on chest X-ray?
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Mediastinal widening
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On auscultation, a pansystolic murmur at the apex with radiation to the axilla is noted. What is the most likely cause?
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Mitral insufficiency
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What 3 structures lie inside the carotid sheath?
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Internal jugular, Common carotid, and Vagus nerve
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What vessel supplies blood to the SA and AV nodes?
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Right coronary artery
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What vessel supplies blood to the apex, anterior face, and septum of the heart?
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Left anterior descending artery
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When do the coronary arteries fill?
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During diastole, unlike every other artery in the body
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Which vessel supplies blood to the right ventricle?
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Acute marginal artery
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If the left atrium gets enlarged, what are some possible non-cardiovascular effects?
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dysphagia and hoarseness; the left atrium can press against the trachea and esophagus
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Where do you ascultate the aortic valve?
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2nd intercostal space on the RIGHT
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Where do you auscultate the pulmonic valve?
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2nd intercostal space on the LEFT
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Where do you auscultate the tricuspid valve?
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4th intercostal space on the LEFT, parasternal
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Where do you auscultate the mitral valve?
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4th intercostal space on the left, mid-clavicular
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What is the equation for cardiac output?
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CO=stroke volume times heart rate
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What is the Fick principle?
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CO=(rate of O2 consumption) / (arterial O2 content - venous O2 content)
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What is the equation for mean arterial pressure?
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Mean arterial pressure = (cardiac output) x (total peripheral resistance)
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What is the other equation for mean arterial pressure?
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Mean arterial pressure = (2/3 x diastolic pressure) + (1/3 systolic pressure)
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How do you calculate the pulse pressure?
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systolic pressure - diastolic pressure
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What 4 things increase contractility?
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1) catecholamines
2) increase intracellular calcium 3) decreased extracellular sodium 4) digitalis |
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What happens to stroke volume and heart rate during exercise?
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CO increase first because of increased stroke volume. After prolonged exercise, CO increases because of heart rate.
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What three factors contribute to the stroke volume?
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Contractility, Afterload, and Preload
(CAP) |
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What 5 things decrease contractility?
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1) beta 1 blockade
2) heart failure 3) Acidosis 4) hypoxia/hypercapnea 5) calcium channel blockers |
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What 4 things increase the heart's need for oxygen?
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1) increased afterload
2) increased contractility 3) increased heart rate 4) increased heart size |
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What determines the preload?
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end diastolic volume
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What determines the afterload?
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mean arterial pressure
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What 3 things increase preload?
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1) exercise
2) increase blood volume 3) sympathetic excitement |
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What do venodilators (like nitroglycerin) do to preload?
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decrease preload
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What do vasodilators (like hydralazine) do to afterload?
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decrease afterload
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What is the equation for ejection fraction?
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stroke volume / end diastolic volume
-or- (end diastolic volume - end systolic volume) / end diastolic volume |
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What is the normal value for the ejection fraction?
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about 55%
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What happens to cardiac output as preload falls?
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cardiac output (or stroke volume) falls as preload falls. Force of contraction is proportional to the preload.
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What 3 things increase blood viscosity?
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1) polycythemia
2) hyperproteinemic states 3) Hereditary spherocytosis |
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Heart sound S1 is....what?
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The mitral and tricuspid valves snapping shut
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Heart sound S2 is.....what?
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the aortic and pulmonic valves snapping shut
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What causes S2 splitting?
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the aortic valve closing before the pulmonic valve. Inspiration increases this splitting
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What causes a holosystolic murmur, equal in volume between S1 and S2?
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Mitral (or tricuspid) regurgitation
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Crescendo-decrescendo murmur between S1 and S2, following an ejection click
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Aortic stenosis. the ejection click is the sound of the aortic valve opening
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What would a ventral-septal defect sound like on auscultation?
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harsh, holosystolic murmur between S1 and S2
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Late systolic murmur, loudest at S2, preceded by a mid-systolic click
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Mitral prolapse. The click is the mitral valve popping out of place
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High-pitched blowing murmur immediately following S2
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Aortic regurgitation
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snapping sound after S2, followed by a low rumbling
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Mitral stenosis
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What does a patent ductus arteriosus sound like on auscultation?
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Continuous murmur throughout both systole and diastole. Loudest at S2
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Name 3 differences between cardiomyocytes and normal skeletal muscle cells
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1) cardiac action potential has a plateau due to influxing Ca++
2) cardiac node cells spontaneously give of action potentials 3) cardiac myocytes are linked by gap junctions |
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What happens during phase 0 of the ventricular action potential?
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rapid depolarization, Na+ rushes into cell
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What happens during phase 1 of the ventricular action potential?
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initial re-polarization. Na+ influx stops, K+ channels open
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What happens during phase 2 of the ventricular action potential?
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the plateau. Ca++ influx balances K+ efflux. Ca++ triggers contraction.
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What happens during phase 3 of the ventricular action potential
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Rapid repolarization. Ca++ channels close, more K+ channels open
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What happens during phase 4 of the ventricular action potential?
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resting potential
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What happens during phase 0 of pacemaker action potential?
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slow opening of Ca++ channels. No sodium channels
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What happens during phase 2 of pacemaker action potential?
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There is no phase 2 (plateau) for pacemaker cells
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What happens during phase 3 of pacemaker action potential?
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Ca++ channels closed, K+ channels opened. K+ efflux from cell
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What happens during phase 4 of pacemaker action potential?
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slow diastolic depolarization. Slope of phase 4 determines heart rate. Na+ channels open
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In an EKG, what does the P wave represent?
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Atrial depolarization
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In an EKG, what does the P-R interval represent?
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conduction delay through the AV node
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In an EKG, what does the QRS complex represent?
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ventricular depolarization
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In an EKG, what does the Q-T interval represent?
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mechanical contraction of the ventricle
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In an EKG, what does the T wave represent?
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ventricular repolarization
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Where does atrial repolarization show up on an EKG?
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It doesn't. It is masked by the QRS complex of the ventricle
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In an EKG, what does the S-T segment represent?
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isoelectric period of depolarized ventricular muscle
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In an EKG, what does the U wave represent?
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abnormal bradycardia or hypokalemia. The U wave is a small fall-off the isoelectric line after the T wave.
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What do you call ventricular tachycardia, with shifting sinusoidal waveforms on EKG?
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Torsades de Pointes. Can lead to V-fib.
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What finding on EKG predisposes you for torsades de pointes?
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Anything that prolongs the Q-T interval
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What happens in Wolf-Parkinson-White syndrome?
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Conduction bypasses the AV node. Thus, the ventricles depolarize before they are supposed to. Delta wave on EKG
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1st degree AV block. How can you identify it and how do you treat it?
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P-R interval of >200 msec. Asymptomatic, so don't do anything
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2nd degree AV block, Mobitz type 1 (or Wenckebach). How to identify? How to treat?
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progressive lengthening of PR interval until a beat is dropped, then repeat. Usually asymptomatic
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2nd degree AV block, Mobitz type 2. How do you identify it? How do you treat it?
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Dropped beats with no preceeding lengthened PR interval. Can develop into 3rd degree AV block.
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3rd degree AV block, complete. Identify it, and how do you treat it?
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Atria and ventricles beat totally independent of each other. P waves are independent of QRS complex. Treat with a pacemaker
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Ventricular fibrillation. Identify it, and how do you treat it?
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completely erratic EKG with no discernable waves. Treat with CPR and defibrillation, or you'll DIE!!!!
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What effects do beta 1 agonists have on the cardiovascular system?
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increased heart rate, increased contractility, increased cardiac output
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What effects do alpha 1 agonists have on the cardiovascular system?
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increased venoconstriction, increased venous return, increased arterial constriction, increased total peripheral resistance, increased cardiac output
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How does angiotensin II affect the cardiovascular system?
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vasoconstriction leading to increased total peripheral resistance
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How does aldosterone effect the cardiovascular system?
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Increased blood volume, increased cardiac output
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Where are the two baroreceptors located?
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Carotid sinus - at the bifurcation of the inner and outer carotids
Aortic arch |
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What does the carotid sinus baroreceptor sense, and what nerve does it use?
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Responds to both high and low blood pressure. Uses glossopharyngeal nerve to get to the medulla
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What does the aortic arch baroreceptor sense, and what nerve does it use?
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Responds to high blood pressure only, and uses the vagus nerve to get to the medulla
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What happens when the baroreceptors are activated by low blood pressure?
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⇩ baroreceptor firing, ⇩parasympathetic action, ⇧ vasoconstriction, ⇧ HR, ⇧ contractility, ⇧ BP
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How does carotid massage lower your heart rate?
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it stretches the vessel, ⇧ baroreceptor firing, which leads to less sympathetic tone and a lower heart rate
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What do the carotid and aortic chemoreceptors respond to?
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decreased oxygen, increased CO2, and decreased pH of the blood
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What makes up the Cushing's triad?
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hypertension, bradycardia, respiratory depression
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What does Cushing's triad suggest?
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increased intracranial pressure
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What do central chemoreceptors respond to in the blood?
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changes in pH and CO2 content. Does not detect oxygen.
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How are the increased oxygen needs of the heart met?
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increased blood flow through the coronary arteries, NOT by increased O2 extraction
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Which organ sees the most blood flow per gram of tissue?
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The kidney
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Which organ gets the largest share of systemic blood, total?
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The liver
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What is the normal pressure in the right atrium?
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< 5 torr
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What is the normal pressure in the right ventricle?
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<25/<5, systolic/diastolic
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What is the normal pressure in the pulmonary artery?
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<25/<10 systolic/diastolic
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What is the normal pressure in the left atrium?
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<12
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What is the normal pressure in the left ventricle?
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<120/<10 systolic/diastolic
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What is the normal pressure in the aorta?
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same as systemic blood pressure: <130/<90
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What does hypoxia cause in most tissues in the body?
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vasodilation
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What does hypoxia cause in lung tissue?
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Vasoconstriction
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What are the 4 factors that determine fluid flow into and out of vessels?
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interstitial and capillary hydrostatic pressure, and interstitial and capillary osmotic pressure
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High hydrostatic capillary pressure makes fluid move _______ the vessel
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out of
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High hydrostatic interstitial pressure makes fluid move _________ the vessel
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into
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High osmotic capillary pressure makes fluid move _________ the vessel
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into
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High osmotic interstitial pressure makes fluid move _________ the vessel
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out of
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Net fluid flow into or out of capillaries is given by the equation:
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K times (Pc-Pi)-(πc-πi), where K=filtration constant, P=hydrostatic pressure, π=osmotic pressure
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Name 4 causes of edema
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1) increased capillary pressure
2) decreased plasma proteins 3) increased capillary permeability 4) increased interstitial osmotic pressure |
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Name the 5 congenital heart diseases that result in right-to-left shunt in babies
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1) tetrology of fallot
2) transposition of great vessels 3) patent truncus arteriosus 4) tricuspid atresia 5) total anomalous venous return |
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Name the 3 congenital heart diseases that result in left-to-right shunt in kids
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1) ventro-septal defect
2) atrio-septal defect 3) patent ductus arteriosus |
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Eisenmenger's syndrome; what is it?
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uncorrected VSD, ASD, or PDA that leads to pulmonary hypertension. See clubbing and cyanosis
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What are the 4 parts of tetrology of fallot?
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1) pulmonary stenosis
2) Right ventricular hyperplasia 3) overriding aorta 4) ventro-septal defect |
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What is the embryological defect that results in tetrology of fallot?
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anterior-superior displacement of the infundibular septum
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Kids with tetrology of fallot tend to squat a lot. How does this help their cyanosis?
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Compresses femoral arteries -> increased systemic resistance -> forces blood from the right heart into the lungs instead of into the left heart
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What is the embryological defect that results in transposition of the great vessels?
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failure of the aorticopulmonary septum to spiral during cardiogenesis
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How do patients with transposition of the great arteries survive?
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right to left shunts: VSD, ASD, foramen ovale, or ductus arteriosus
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How do you treat an infant with transposition of the great arteries?
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Give prostaglandins to maintain the ductusarteriosus until you can schedule a surgery
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What is wrong with a person who has coarctation of the aorta?
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stenosis of the aorta
proximal to ductus=infantile distal to ductus=adult |
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What would you see in a person with coarctation of the aorta?
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notched ribs, hypertension in arms, hypotension in legs
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How do you treat a pathologic ductus arteriosus?
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Indomethicin (a prostaglandin antagonist)
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What heart defects are associated with disorders on chromosome 22q11?
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truncus arteriosus, tetralogy of fallot
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What heart defects are associated with Down's syndrome?
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ASD, VSD, AV septal defect
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What heart defects are associated with congenital rubella?
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Septal defects, PDA, pulmonary artery stenosis
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What heart defects are associated with turner's syndrome?
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Coarctation of the aorta
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What heart defects are associated with Marfan's syndrome?
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Aortic insufficiency
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What heart defects will you likely have if your mother was diabetic while she was pregnant with you?
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Transposition of the great vessels
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What does hypertension put you at risk for?
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atherosclerosis, stroke, CHF, renal failure, retinopathy, aortic dissection
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What is the cutoff blood pressure for hypertension?
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greater than 140/90
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What are the 4 signs of hyperlipidemia?
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Atheromas, xanthomas, tendinous xanthomas, corneal arcus
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What percent of hypertension is primary? What is the remaining percent usually a result of?
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90% is primary. 10% is usually secondary to renal disease
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What is Monckeberg Arteriosclerosis?
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Calcification in the media of arteries. Often in the radial or ulnar arteries. usually benign
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What is arteriosclerosis?
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Hyaline thickening of small arterioles in primary hypertension. Hyperplastic in malignant hypertension
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What is atherosclerosis?
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fibrous plaques and atheromas forming in the intima of arteries
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What is aortic dissection?
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longitudinal tear forming a false lumen between layers of the aorta
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What are the symptoms/ complications of an aortic dissection?
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tearing chest pain radiating to the back, mediastinal widening on CXR, can result in aortic rupture and death
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Name the risk factors for atherosclerosis
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smoking, hypertension, diabetes, hyperlipidemia, family history
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Name some sequelae for atherosclerosis
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aneurysms, ischemia, infarct, peripheral vascular disease, thrombus, embolus
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How do atherosclerotic plaques form?
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endothelial cell dysfunction -> LDL/macrophage accumulation -> foam cells -> smooth muscle migration -> fibrous plaques
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How occluded do your coronaries have to be for you to experience angina?
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75%
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What's the difference between chronic ischemic heart disease and a myocardial infarct?
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CIHD is progressive over many years, MI is due to a thrombus and is sudden. Both damage myocytes and result in necrosis
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What is a red infarct?
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injury due to reperfusion, or in loose tissue with multiple blood supplies (liver, lungs, intestines)
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What is a pale infarct?
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necrotic tissue in solid organs with a single blood supply, like the heart, kidneys, or spleen
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What lab results suggest an MI?
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High cardiac troponin 1 (best)
High CK-MB High AST |
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What EKG findings suggest an MI?
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ST elevation (transmural), ST depression (subendocardial), pathologic Q waves
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How does an MI actually kill you?
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arrythmia, LV failure, pulmonary edema, ventricular wall rupture, aneurysms, fibrinous pericarditis
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What is Dressler's syndrome?
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autoimmune fibrinous pericarditis that appears several weeks after a heart attack
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Dilated cardiomyopathy can be caused by 6 things:
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1) alcohol abuse
2) beriberi 3) coxsackie B virus 4) cocaine use 5) Chagas disease 6) doxorubicin |
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What does a heart with dilated cardiomyopathy look like?
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Thin ventricle wall, increased ventricular volume. Looks like an inflated balloon. Systolic dysfunction
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Hypertrophic cardiomyopathy: who gets it? How do you treat it?
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Thick ventricle walls, small lumen. Cause of sudden death in young athletes. Treat with beta blockers of calcium channel blockers
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Restrictive/obliterative cardiomyopathy, 6 causes:
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1) sarcoidosis
2) amyloidosis 3) post-radiation fibrosis 4) endocardial fibroelastosis 5) Loffler's syndrome 6) hemachromatosis |
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Hypertrophic cardiomyopathy causes ____________ dysfunction in the heart.
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diastolic
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Restrictive/obliterative cardiomyopathy causes what sorts of problems in the heart?
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diastolic dysfunction; the heart can't squeeze as hard, and is also less elastic
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What are some signs of congestive heart failure?
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pulmonary edema, peripheral edema, dyspnea, backup of blood into the lungs and venous side
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Name the 6 types of emboli
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FAT BAT: fat, air, thrombus, bacteria, amniotic fluid, and tumor
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What are the components of Virchow's triad?
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Stasis, hypercoagulability, endothelial damage
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What does Virchow's triad predispose you to?
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deep vein thrombosis and pulmonary embolus
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Bacterial endocarditis usually affects which valve?
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mitral
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endocarditis due to IV drug use usually affects which valve?
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tricuspid
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What bug causes acute bacterial endocarditis?
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Staph aureus. large vegetations on mitral valve
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What bug causes subacute bacterial endocarditis?
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viridans steptococcus. smaller vegetations. due to dental procedures sometimes.
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What are the 8 signs of bacterial endocarditis?
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fever, roth's spots, osler's nodes, murmur, janeway lesion, anemia, nail-bed hemorrhage, emboli
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Libman-Sacks endocarditis
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Warty vegetations on both sides of the mitral valve. commonly seen in Lupus
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How do you get rheumatic heart disease?
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throat infections with group A strep. Type 2 hypersensitive reaction then attacks mitral valve
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Cardiac tamponade is caused by what?
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effusion or fluid compresses the heart within the pericardium
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What are some findings in a person with cardiac tamponade?
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hypotension, increased venous pressure, muffled heart sounds, increased heart rate, pulsus paradoxus
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What is pulsus paradoxus?
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decrease in amplitude of pulse during inspiration
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What are the 3 types of pericarditis?
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Serous
Fibrinous Hemorrhagic |
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What are common causes of pericarditis?
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Lupus, rheumatoid arthritis, viral infection, Dressler's syndrome, rheumatic fever
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What are some signs of pericarditis?
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pericardial pain, friction rub, pulsus paradoxus, muffled heart sounds, EKG has diffuse ST elevation
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How does syphilis affect the heart?
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dilates the aorta, calcification of the aorta, can result in aortic valve regurgitation and aneurysm
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What is the most common cardiac tumor?
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Myxoma in the left atrium for adults,
rhabdomyomas for children |
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Malformations in small vessels that make them look like dilated capillaries. What is this called?
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telangiectasia
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what does hereditary telangiectasia usually present with?
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nosebleeds and skin discoloration
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What condition leads to decreased blood flow to the skin in response to cold or stress due to arteriolar vasospasm?
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Raynaud's syndrome
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The triad of necrotizing vasculitis, necrotizing granulomas in the lung, and necrotizing glomerulohephritis suggests what diagnosis?
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Wegener's granulomatosis
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What symptoms does Wegener's granulomatosis present with?
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Perforation of nasal septum, chronic sinusitis, ototis media, cough, dyspnea, hemoptysis, hematuria
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What drugs are used to treat Wegener's granulomatosis?
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Cyclophosphamide and corticosteroids
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The ANCA gene plays a role in which 4 disease processes?
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Wegener's granulomatosis
microscopic polyangitis Primary cresentic glomerulonephritis Churg-Straus syndrome |
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Granulomatous vasculitis with eosinophilia that involves the lung, heart, skin, kidneys, and nerves is called.....what?
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Churg-Strauss syndrome
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Microscopic polyangitis is just like Wegener's granulomatosis except for what?
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Microscopic polyangitis lacks granulomas.
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ANCA-gene related vasculitis of the kidneys is called.....what?
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Primary cresentic glomerulonephritis
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Conginital vascular disorder that affects capillaries, presents with port-wine stain on the face and intra-cerebral vessel malformation. What is this called?
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Sturge-Weber disease
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A child has a skin rash, arthralgia, intestinal hemorrhage, abdominal pain, and melena. What do they have?
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Henoch-Schonlein purpura
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What size of vessels does Buerger's Disease affect?
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small and medium-sized ones
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A smoker presents with cold sensitivity, severe focal pain and cramping, and inflamed nodules in his veins. What does he have? How do you treat it?
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Buerger's Disease. Caused by smoking, so tell them to quit smoking!!
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necrotizing vasculitis of medium-vessels in children, with fever, congested conjunctiva, splotchy tongue/oral mucosa, swollen lymph nodes
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Kawasaki disease
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What disease is characterized by necrotizing immune complex inflammation of medium-sized arteries?
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Polyarteritis nodosa
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What are the symptoms of polyarteritis nodosa?
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Fever, weight loss, malaise, abdominal pain, melena, headache, myalgia, cutaneous eruptions
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What medicines do you use to treat polyarteritis nodosa?
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Corticosteroids and cyclophosphamide
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What are the symptoms of Takayasu's disease?
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fever, arthritis, night sweats, myalgia, skin nodules, eye disturbances, weak pulses in the arms
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Headache, jaw cramps, impaired vision, high ESR rate.....what do these symptoms suggest?
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Temporal arteritis. Also called Giant Cell Arteritis
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Side effects of hydrochlorothiazide?
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hypokalemia, hyperlipidemia, hyperuricemia, hypercalcemia, hyperglycemia, fatigue
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Side effects of loop diuretics? (eg, furosemide)
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Potassium wasting, metabolic alkalosis, hypotension, ototoxicity
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Side effects of Clonidine?
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Dry mouth, sedation, severe rebound hypertension
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Side effects of Methyldopa?
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Sedation, positive Coomb's test
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Side effects of Hexamethonium?
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Severe orthostatic hypotension, blurry vision, constipation, sexual dysfunction
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Side effects of Reserpine?
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Sedation, depression, nasal stuffiness, diarrhea
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Side effects of Guanethidine?
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Orthostatic and exercise hypotension, sexual dysfunction, diarrhea
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Side effects of Prazosin?
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1st-dose orthostatic hypotension, dizziness, headache
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Side effects of beta-Blockers?
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Impotence, asthma, bradycardia, CHF, AV block, sedation, sleep alteration
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Side effects of Hydralazine?
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Nausea, headache, lupus-like symptoms, reflex tachycardia, angina, salt retention
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Side effects of Minoxidil?
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excessive body hair, pericardial effusion, reflex tachycardia, angina, salt retention
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Side effects of Nifedepine and Verapamil?
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Dizziness, flushing, constipation, AV block, nausea
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Side effects of Nitroprusside?
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cyanide toxicity
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Side effects of Diazoxide?
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Hypoglycemia
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Side effects of ACE inhibitors? (eg, captopril, enalapril, fosinopril, lisinopril)
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Hyperkalemia, cough, angioedema, taste changes, hypotension, pregnancy problems, rash, increased renin
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side effects of Angtiotensin II receptor blockers (ARBs)? (eg, Losartan)
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Fetal renal toxicity, hyperkalemia
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What is the mechanism of Hydralazine?
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increase cGMP leads to smooth muscle relaxation in arterioles, reduces afterload
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What would you use to treat CHF or severe hypertension?
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Hydralazine
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What is the mechanism of action of Minoxidil?
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opens K+ channels, leads to hyperpolarization and relaxation of vascular smooth muscle
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What is the mechanism of action of Nifedepine, verapamil, and diltiazem?
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Block voltage-gated calcium channels, reduces cardiac and smooth muscle contractility
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Name the calcium-channel blockers in descending order of effectiveness for treating the heart
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verapamil > diltiazem > nifedipine
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Name the calcium-channel blockers in descending order of effectiveness for treating the blood vessels
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nifedipine > diltiazem > verapamil
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What is the mechanism of Nitroprusside?
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releases NO, causes increased cGMP and relaxation in smooth muscle in the veins. Decreases preload
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What do you use Fenoldopam for?
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it treats malignant hypertension by activating dopamine receptors in the kidney, relaxing the vessels there
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What do you use Diazoxide for?
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it treats malignant hypertension by opening K+ channels and hyperpolarizing vascular smooth muscle, making it relax
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What do nitrates do to help a person with angina?
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effects preload. decrease end diastolic volume, decrease blood pressure, reduce ejection time, decrease cardiac oxygen requirement.
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What do beta-blockers do to help a person with angine?
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effects afterload. increases end diastolic volume, decreases blood pressure, decreases contractility, decreases heart rate, increase ejection time, decrease cardiac oxygen requirement
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Which three beta-blockers should you NEVER give to a person with angine?
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labetolol, pindolol, and acebutolol
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What effects to statins have on LDL, HDL, and triglycerides?
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decrease LDL, little effect on HDL, little effect on tri's
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What effect does niacin have on LDL, HDL, and triglycerides?
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decrease LDL, increase HDL, little effect on tri's
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What effects do bile acid resins have on LDL, HDL, and triglycerides?
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decrease LDL, little effect on HDL, little effect on tri's
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What effects do cholesterol absorption blockers (ezetimibe) have on LDL, HDL, and triglycerides?
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decrease LDL, no effect on HDL, no effect on triglycerides
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What effects do fibrates have on LDL, HDL, and triglycerides?
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little effect on LDL, little effect on HDL, decreases tri's
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What drug increases the activity of lipoprotein lipase on the surface of somatic cells?
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fibrates
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What drug chemically prevents cholesterol reabsoprtion at the intestinal brush border?
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ezetimibe
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What drug mechanically prevents reabsorption of cholesterol in the intestines?
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bile acid binding resins
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What drug inhibits lipolysis in adipose tissue and reduces the liver's VLDL secretion?
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Niacin
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What drug inhibits the manufacture of the cholesterol precursor, mevalonate?
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Statins
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what is the mechanism of action of digoxin in the heart?
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blocks Na+/K+/ATP pump, which reduces the activity of the Na+/Ca++ pump, which leads to increased intracellular calcium and increased contractility
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What are some side effects of digoxin?
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elevated PR interval, depressed QT level, increased parasympathetic activity, arrythmia, renal failure, hypokalemia
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How do class I anti-arrythmic drugs work?
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local anesthetics that slow down conduction and increase the threshold for abnormal pacemaker cells by blocking sodium channels
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Which anti-arrhythmics increase action-potential duration, increase refractory period, and affect both atrial and ventricular arrythmias?
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Class IA: quinidine, amiodarone, procainamide, disopyramide
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Which anti-arrhythmics decrease action-potential duration, affect ventricular tissue, and are used digoxin-induced arrhythmias?
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Class IB: lidocaine, mexiletine, tocainide
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Which anti-arrhythmics have no effect on action potential, and used as a last resort for V-fib?
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Flecainide, encainide, propafenone
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In general, how do class II anti-arrythmic drugs work?
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they are beta-blockers that decrease cAMP and decrease Ca++ currents. Flatten out the slope of phase 4.
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In general, how do class III anti-arrhythic drugs work?
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Block K+ channels, increase action-potential duration, increase refractory period
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What are some side effects of class III anti-arrhythmics?
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pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroidism
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Which drugs acts as both a class I and a class III anti-arrhythmic?
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amiodarone
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When would you use magnesium to treat an arrhythmia?
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in torsades de pointes or i nthe case of digoxin toxicity
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