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36 Cards in this Set
- Front
- Back
- 3rd side (hint)
(+) Inotrope
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Increase force of contraction
How? |
An increase in intracellular calcium
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chronotropic effect
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rate of contraction
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dromotropic effect
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conduction velocity
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THIAZIDE
ADVERSE-REACTIONS include: H+ |
ADVERSE-REACTIONS
from ( __class__?) Rxs include: Hypokalemia and Intravascular Volume Depletion with resulting: : Hepatic Dysfunction-emia. Hyperglycemia Hyperuricemia Neutropenia Prerenal Azotemia Skin Rash-emia. Thrombocytopenia |
9ct
1+1(+7) = 9 H IVVD: : H D H G H U N P A S R T-C-P |
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Positive Inotropic Drugs:
3ct |
Positive Inotropic Drugs:
-Digitalis -Beta-Adrenoceptor Agonist ? -Phosphodiesterase Inhibitors ? |
Beta-Adrenoceptor Agonist (Dobutamine)
Phosphodiesterase Inhibitors. (Milrinone) |
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Digitalis
Beta adrenoceptor Agonists (?) Phosphodiesterase Inhibitors (?) Positively or Negative Inotropic drugs: |
Positive Inotropes
Beta adrenoceptor Agonists (Name ?) Phosphodiesterase Inhibitors. (Name ?) |
Beta adrenoceptor Agonists (Dobutamine)
Phosphodiesterase Inhibitors. (Milrinone) |
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Digoxin
Produces Modest +/- inotrope effect |
Modest + inotrope effect
(increase force of contraction) How |
caused by an increase in intracellular calcium
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Digoxin
Produces a +/- chronotropic effect of contraction |
Produces a (-) chronotropic effect of contraction
(decreased rate) |
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Digoxin
Produces a +/- dromotropic effect |
Produces a (-) dromotropic effect
(a decrease in the conduction velocity). |
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Digoxin Toxicity S/S
6ct |
-Arrhythmias: are Most-Serious-Manifestations.
-Siezures The earliest signs are : -Anorexia -Nausea -Vomiting -Blurred vision -Chromotropsia Yellow Green or Blue |
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Beta-blockers
prevent what cardiac issues from occurring? 8ct |
Prevent excessive-stimulation leading to:
: Cardiac Remodeling Dilatation Hypertrophy Increases O2 demand Increases infarct size RAAS Activation (renin-angiotensin-aldo-system) Tachycardia Ventricular wall thinning/rigidity |
C
D H I I R T V |
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These Rx sub catagories can cause
Reflex Tachycardia 2ct |
Nitrates
or Dihydropyridine - CCBs. They cause what? |
Reflex Tachycardia
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Major contraindications for BB
3ct |
-Bradyarrhythmias
-Bronchospastic Disease (Severe) -Decompensated Heart Failure. |
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Digoxin Causes a decrease or increase in parasympathetic tone
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Causes an Increase
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Digoxin
Causes an increase or decrease in conduction and AV node conduction velocity |
Decreases
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Digoxin Causes an increase or decrease in the
AV Node Refractory Period |
Increases the AV-Node Refractory Period.
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This drug is MOST HELPFUL in
Heart Failure(CHF) combined with Atrial Fibralation. |
Digoxin
This drug is MOST HELPFUL in ? |
Heart Failure(CHF)
combined with Atrial Fibralation. |
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the Dihydropyridine CCBs:
2ct |
the Dihydropyridine CCBs:
Amlodipine Nifedipine the NON-Dihydropyridine CCBs: ? 2ct |
the NON-Dihydropyridine CCBs:
Diltiazem Verapamil |
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Major -Contraindications for:
BB 3ct |
- Bradyarrhythmias
- (severe) Bronchospastic Disease - Decompensated Heart Failure. Name the BB? 2ct |
Carvedilol/Metoprolol XL
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B-Blockers w\ Verapramil cause what?
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they significantly reduce
Cardiac Output. What 2 Rxs do this? |
B-Blockers w\ Verapramil
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Oraganic Nitrates\Nitrites
Release what? & have what effect on: Vascular and Smooth Muscle Cells? |
release Nitric Oxide
in vascular and smooth muscle cells Relaxation |
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Oraganic Nitrates\Nitrites have what effect on:
Venous Smooth Muscle? |
Relax venous smooth muscle
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Oraganic Nitrates\Nitrites have what effect on:
Arteriolar Smooth Muscle? |
Relax Venous Smooth Muscle
but relatively small-to-little-effect on Arteriolar Smooth Muscle. ref+ |
Brenner 113 top Right
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Firstline Rx for Chronic Angina
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BB
Name the two? |
Carvedilol
Metoprolol XL |
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identify common adverse effects for
hydrochlorothiazide |
AEs =
hypokalemia, electrolyte imbalances, pH disturbance, increase blood glucose, hyperuricemia (causing gout). |
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identify common adverse effects for
furosemide |
AEs =
iuresis, dehydration, electrolyte imbalances. |
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identify common adverse effects for
spironolactone |
AEs =
gynecomastia impotence; hyperkalemia. |
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Describe the use of spironolactone as an aldosterone antagonist in patients with advanced HF
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Competes with aldosterone at the renal tubule and other tissues (heart).
Increase sodium excretion, decrease potassium excretion, has a moderate diuretic effect. Potassium-sparing diuretic. Prevents adverse effects of excessive aldosterone levels on the heart, and having high serum potassium. Good for mild to moderate HF. Bad for elderly due to hyperkalemia. |
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,
most commonly used treatment of angina describe mechanism of action Organic Nitrites & Nitrates |
increase total blood flow to heart, especially subendocardial tissue,
dilate collateral vessels, which decreases intraventricular pressure and decreases the resistance to perfusion. Reduce wall tension via their effects on ventricular volume and pressure. Act primary on venous tissue, and predominantly affect afterload. |
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,
most commonly used treatment of angina describe mechanism of action Calcium Channel Blockers (CCBs): |
same Nitrites/Nitrates, but act on arteriolar muscle to reduce afterload.
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,
most commonly used treatment of angina describe mechanism of action |
reduce intraventricular pressure. decrease heart rate & contractility
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(β-Blockers): are not used for
What? & Why? |
Not effective to tx
variant angina because they cannot counteract vasospasm and increase coronary blood flow. May actually reduce coronary blood flow by blocking the vasodilative effect of epinephrine. |
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Describe why calcium channel blockers are generally avoided in patients with HF
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They suppress cardiac contractility
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beta-blockers ...concomitant conditions that may limit their use.
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NOT used in management of
vasospastic angina or acute anginal attacks. |
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Ranolazine
Works by |
modifying myocardial metabolism
What is another mechanical benifit? |
reduces angina episodes without causing significant changes in
BP or Heart Rate |
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platelet-inhibiting agents that are recommended for all patients with angina, unless contraindicated
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Aspirin
Clopidogrel |
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