Pharm Exam 2 Sem 2

Front 1

First line medications for heart failure

Back 1

Diuretics

ACEI

ARBs

Front 2

Drug of choice for HF

Back 2

ACEI

Front 3

Diuretics reduce mortality?

Back 3

No

Front 4

Why do you not use beta blockers in acute HF

Back 4

Because of its contractility lowering effects

Front 5

Digoxin, which is a cardiac glycoside, is a positive inotropic Drug. What does that mean?

Back 5

Increased contractility, decreased HR

Front 6

Therapeutic Digoxin serum level?

Back 6

0.8-2.0 (>2.0 is toxic!)

Front 7

MOA of digoxin

Back 7

Promotes movement of calcium from extracellular to intracellular (increases the plateau)

Front 8

What is Digoxin used for?

Back 8

HF (lower dose, 1.0 or less)

AFIB/Flutter (higher dose)

Front 9

Digoxin is cleared by the

Back 9

Kidneys

Front 10

Digitalizing dose is also known as well

Back 10

Loading dose

Front 11

Digoxin Takes how many weeks to work and how many weeks to eliminate the drug?

Back 11

One week for both (unless digitalized)

Front 12

Contraindications for Digoxin

Back 12

Severe myocarditis, Vtach or Vfib, MI or heart block, electrolyte imbalances, renal impairment

Front 13

These electrolyte imbalances can cause Digoxin toxicity

Back 13

Hypokalemia, hypomagnesemia, hypercalcemia

Front 14

What condition can delay Digoxin metabolism?

Back 14

Hypothyroidism

Front 15

Hypoxia increases ________ sensitivity to Digoxin

Back 15

Myocardial

Front 16

Antidote for Digoxin and mode of action

Back 16

Digibind, pulls Digoxin out of tissue and into blood and inactivates it. Serum Digoxin levels will be high, but the drug will be inactivated

Front 17

Reduce Digoxin by ___% in renal failure

Back 17

50%

Front 18

Hold Digoxin if HR is LESS THAN

Back 18

60

Front 19

Normal heart can maintain adequate CO with ventricular rates of

Back 19

40-150 (diseased 60-120)

Front 20

MOA in rapid dysthymics (3)

Back 20

Reduce automaticity, slow conduction of electrical impulses through heart, prolong the refractory period of myocardial cells

Front 21

How does propranolol work in dysthymias

Back 21

Blocks SNS stim of beta receptors in the heart

Front 22

How does diltiazem work in dysthymias

Back 22

Reduces automaticity, slows conduction, prolongs refractory

Front 23

What does stimulation of beta 2 receptors do

Back 23

Bronchodilate, increase glucose

Front 24

What does stimulation of Alpha 1 receptors do

Back 24

Vasoconstriction

Front 25

What receptors does epinephrine stimulate?

Back 25

Beta 1, 2, & Alpha 1

Front 26

What receptors do Isuprel stimulate?

Back 26

Beta 1 & 2

Front 27

What receptors does phenylephrine stimulate?

Back 27

Alpha (vasoconstriction)

Front 28

Dopamine stimulates what receptors

Back 28

Alpha and beta

Front 29

Dobutamine mainly acts on _________ receptors, but what is special about it?

Back 29

Beta 1.

Increased contractility, minimal HR increase

Front 30

What does milrinone do?

Back 30

Increase CO, decrease PVR

Front 31

What medication is first line tx in septic shock?

Back 31

Norepinephrine (Levophed)

Front 32

Levophed stimulates what receptors?

Back 32

Alpha (vasoconstriction) and beta 1 (increased HR and contraction). Use in pts unresponsive to dopamine or dobutamine