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35 Cards in this Set
- Front
- Back
3 kinds of inotropic agents
|
adrenoceptor agonists
digoxin PDEIs |
|
adrenoceptor agonists act on cardiomyocyte via ___, which signals via ___
|
beta1R
PKA |
|
2 targets of PKA in cardiomyocyte
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L-type Ca2+ channel
phospholamban |
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phospholamban normally ___s SERCA, which pumps Ca2+ into ___. phosphorylation by ___ causes it to ___, which causes ___.
|
inhibit
sarcoplasmic reticulum PKA dissociate from SERCA enhanced Ca2+ reuptake |
|
phosphorylation of L-type Ca2+ channel by ___ causes ___.
|
PKA
increased Ca2+ influx |
|
dobutamine is a ___ agonist used for ___ cardiac support. it's primary action is on ___R.
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beta
short-term beta1 |
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dobutamine causes ___ via beta1 and ___ via beta2
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contractility
vasodilation |
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___ limits effectiveness of beta agonists.
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receptor downregulation
|
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internalization happens when ___ phosphorylates the receptor, which allows ___ to bind it.
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PKA
arrestin |
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beta blockers work by ___ing (2)
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reversing adrenoceptor internalization
blocking arrhythmogenic effects of catecholamines |
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___ is a beta blocker
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metoprolol
|
|
3 cardiac glycosides
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digoxin
ouabain strophanthidin |
|
cardiac glycosides are made of ___ aka ___ plus ___.
the pharmagological activity is determined by ___, the pharmacokinetics by ___. |
steroid-lactone
aglycone sugar aglycone sugar |
|
___ is produced endogenously
|
ouabain
|
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increased CO from digoxin causes ___ (2)
|
reduced CVP
reduced peripheral vascular hydrostatic P |
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reduced peripheral vascular hydrostatic P causes ___
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reduced peripheral edema
|
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2 autonomic NS effects of digoxin
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reduced sympathetic tone
increased vagal tone |
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increased vagal tone causes ___ (2)
|
reduced SA rate
reduced AV conduction rate |
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___ (2) from digoxin cause improved cardiac efficiency
|
increased CO
bradycardia |
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___ (2) from digoxin is a direct cardiac effect but ___ (3) is an indirect one.
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positive inotropism
increased automaticity reduced sympathetic tone increased vagal tone reduced automaticity |
|
digoxin works by ___ing, which causes ___, which causes ___ (2).
|
inhibiting myocyte Na+/K+ ATPase
2' inhibition of NCX increased Ca2+ stores increased Ca2+ release |
|
after prolonged administration of cardiac glycoside in vitro, AP duration ___s and you see ___. this can cause ___.
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shrinks
delayed afterdepolarization (DAD) tachyarrhythmia |
|
in CHF patients digoxin causes ___, but in normals it may cause
|
vasodilation
vasoconstriction |
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4 digoxin side effects
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nausea
vomiting diarrhea altered color perception |
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at high doses digoxin causes increased ___ (2)
|
sympathetic activity
automaticity |
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action potential duration decrease is prominent in ___. because of ___ (2) this is not so dangerous.
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atria
reduced AV node conduction positive inotropism |
|
hypokalemia increases/decreases digoxin effect
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increases
|
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digoxin toxicity may be treated with ___
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anti-digoxin Fab
|
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digoxin t1/2 is ___. absorption is ___% and ___. it is excreted by ___
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36 h
75% variable kidney |
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care must be taken when combining digoxin with other ___ drugs to prevent ___.
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AV conduction-reducing
complete heart block |
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2 drugs which can cause digoxin toxicity by decreasing GI degradation
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quinidine
antibiotics |
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T/F: digoxin prolongs life
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false
|
|
cardiac PDE is ___. 2 cardiac PDEIs are ___.
|
PDE3
amrinone milrinone |
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PDEIs cause ____.
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positive inotropism
|
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T/F: cardiac PDEIs prolong life
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false
|