Heart Failure Flash Cards

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Title: Heart Failure
Description: Pharmacology Heart Failure Exam Lippincotts
Number of Cards: 60
Save Count: 0
Author: renoir86
Created: 2012-01-24
Tags: heartfailure pharmacology
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    • Question
    • Answer
    • Side 3
    • What is Heart Failure
    • When heart is unable to pump blood
    • Heart failure is due to what ?
    • failure to fill or eject enough blood
    • Right heart failure sign ?
    • peripheral edema
    • Left heart failure sign ?
    • pulmonary edema
    • Underlying causes Heart F ?
    • Artherosclerosis - Myocardial infarction
      Hypertensive disease -Valvular heart
      Dilated Cardiomyopathy -Congenital
      Left systolic dysf -Coronary artery
    • HF compensatory changes ?
    • activation of Sympatetic
      Rening angiotensin activation
      Myocardial hypertrophy
    • Goals treat HF ?
    • alleviate symptoms
      slow disease progression
      improve survival
    • 6 classes effective in HF ?
    • Inhibitors of Renin Inotropic agents
      B-adreno blockers Diuretics
      Direct vasodilators Aldosterone antago
    • which drug blocks sodium in phase 0
    • Quinidine (antiarrythmic)
    • What happens in plateau phase ?
    • calcium enters potassium leaves
    • Repolarisation phase ?
    • calcium blocked K+ leaves cell
    • Net result of AP
    • gain in sodium and loss of K+
      corrected by Na/K ATPase
    • Systolic HF ?
    • Heart cannot pump out
    • Diastolic HF ?
    • Heart cant relax and fill properly
    • Stim of aldosterone increases what ?
    • salt and water retention
      preload and afterloasd increased also
    • high levels of aldosterone and angiotension causes what to heart ?
    • injury to heart
      remodelling and fibrosis
    • Ace Inhibitors indicated in ?
    • Left ventricular failure
      after and MYI
    • ACE Inhibitors requires ?
    • hepatic activation
      because they are only prodrugs
    • give an exampel of ACE Inhib
    • Enalapril
      they all end with pril
    • Decreased angiotensin 2 leads to ?
    • decreas output of sympateic
      increase vasodilation vascular smooth
      decrease sodium and water
      increase levels of bradykinin
    • ACE inhibitors inhibits degradation of ?
    • Bradykinin so it levels increases
    • ACE inhib can be used together with ?
    • Diuretics B-blockers
      Dogoxin aldosterone antagonists
    • Adverse effects of ACE inhibitors
    • postural hypotension, renal insufficien
      hyperkalemia, engioedma,
      persistent dry cough
    • Ace inhibitors are toxic to ?
    • the Fetus
    • Ace inhib decreases and increases what?
    • decrease preload and afterload
      increase in cardiac output
    • When are ARB`s used ?
    • when ACE inhibitors are not tolerated
    • ARB works on which receptor ?
    • angiotensin type 1 receptor
    • example of an ARB
    • Losartan
    • Losartan is different how ?
    • undergoes extensive first pass metabolism in liver
    • ARB how different from ACE inhib ?
    • Do not effect bradykinin levels
    • ARB in the blood ?
    • highly plasma protein bound
    • ARB in pregnancy ?
    • Never used
    • example of 2 b-blockers in HF
    • Carvedilol
      Metoprolol
    • b-blocker improve what in HF ?
    • systolic function
    • b-blockers prevents what in HF ?
    • changes that occur because of sympatetic activity.
      deleterious effect of epinephrine on heart
    • b-blockers reverse what and decreases ?
    • cardiac remodelling and decreases heart rate
    • Carvedilol is a ?
    • non-selective b-adreno antagonist
      also blocks alpha adrenoreceptor
    • Metoprolol is a ?
    • B-1 selective antagonist
      long acting
    • B-blockers are not reccommended in which heart failure
    • Acute Heart Failure
    • How should doses with Carvedilol and Metoprolol be administered ?
    • start of low and escalate gradually
      patient tolerance is different
    • Diuretics relief what in HF ?
    • pulmonary congestion
      peripheral edema
    • Diuretics decrease what 2 things ?
    • preload and cardiac work
      meaning less oxygen demand
    • Mosrt common diuretics in HF ?
    • Loop diuretics
    • Direct vasodilators leads to ?
    • decrease in preload
    • commonly used in congestive HF ?
    • Nitrates
    • If additional treatment of vasodilators are needed give ?
    • Combination of
      Hydralazine + Isosorbide dinitrate
    • arrythmia symptoms ?
    • bradychardia
      tachycardia
    • regular arrythmia ?
    • sinus tachy or bradychardia
    • irregular arrythmia ?
    • atrial fibrillation
    • Causes of arrythmia ?
    • abnormal automacity
      defect impulse conduction
    • whats used in atrial fibrillation ?
    • b-blockers
    • what reduces stroke associated with AF?
    • longterm low dose anticoagulants
    • Av-node conduction is slowed with ?
    • Propranolol Verapamil Digoxin
    • Ventricular tachycardia can become ?
    • Ventricullar fibrillation , very severe
    • Drugs affecting automacity affects what ?
    • N+ or Ca2+ Channels
      decrease of phase 4 slope
      or make threshold stimi harder
    • what can cause an irregular beat or a extra beat of the heart
    • Reentry phenoma
    • what can acutely terminate ventricular tachycardia ?
    • Lidocaine
    • supraventricular tachycardia is treated with what ?
    • adenosine or verapamil
    • What do inhibition of potassium channels lead to ?
    • widened AP curve, prlonged QT,
      lead to ventricular tachyarrythmia
    • fluconazole and itraconazole
    • inhibits drug metabolism