In each blank, try to type in the
word that is missing. If you've
typed in the correct word, the
blank will turn green.
If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: Objectives of Long Term Management of Chronic Failure:Answer: Improve cardiac performance at rest and during exercise
Relieve symptoms
Improve efficiency
Improve quality of life (particularly symptom-free and effort tolerance)
Improve patient survival Question: caused by HF:Answer: Reduced force of contraction
Decreased total peripheral resistance
Inadequate organ perfusion
Edema
Decreased exercise tolerance
IHD
Sudden death
Ventricular remodeling and decreased function Question: What are the non-pharmacologic treatments of Failure?Answer: Salt
Treat the cause
Moderate exercise
Heart Transplantation Question: What drug are commonly used in HF?Answer: Diuretics
Aldosterone receptor antagonists
Angiotensin-converting enzyme inhibitors
Angiotensin receptor blockers
Beta blockers
Cardiac glycosides
Vasodilators
Beta agonists
Bipyridines
Natriuretic Question: What is the of using diuretics in HF?Answer: They mostly treat the congestive symptoms
Decrease BP and increase K+ loss
Can be used in combination with Question: How are diuretics in HF?Answer: Question: What are the of diuretic resistance in HF?
Answer: Noncompliance with regimen
Excess dietary Na+ intake
Decreased renal perfusion and GFR
Selective in glomerular perfusion pressure following initiation of ACEI therapy
NSAIDs
Primary renal pathology
Reduced or impaired diuretic absorption Question: What are the pharmacological of ACEIs?Answer: Reduce A II levels
Increase bradykinin
Decreased NE release and upregulation of B1 receptors
Reduction of afterload and preload
Reduce myocyte & fibroblast GFs
Decrease aldosterone causing decreased fluid , K+ loss, and arrhythmias Question: What is the value of ACEIs?Answer: DOC in HF
No tolerance
Retard progression of HF
Decrease drugs which decrease mortality, but only when the highest tolerated doses are used Question: What are the preparations of ACEIs?Answer: Captopril
Enalapril
Lisinopril
Quinapril
Fosinopril end with the suffix -pril
Careless
Evidence
Leads
Questionable
Foreigners Question: What does of ACEIs cause?Answer: Hypotension - First dose phenomenon
Renal - Proteinurea
K+ retention
Cough Question: of ARBs:Answer: (Approvel)
Telmisartan(Micardis) Question: When are ARBs used?Answer: When patients can not tolerate ACEIs because of Question: of Beta Blockers:Answer: Negative inotropic
Not useful in refractory of HR, decreased cardiac work and consequently decreased myocardial O2 consumption and enhanced efficiency lessen the frequency of ischemic events and arrhythmias Question: How can Beta improve myocardial contractility?Answer: resensitization of the down-regulated receptor Question: How are Beta blockers ?Answer: Started with low doses and gradually Question: Examples of Beta :Answer: Metoprolol
Carvedilol
Bicindolol
Bisiprolol
Many Cute Babies Question: When are beta contraindicated?Answer: In severe, refractory, or cases Question: How do positive agents increase force of contraction?Answer: By increasing cardiac Ca++ concentration Question: Examples of Cyclic AMP Independent :Answer: Question: Examples of Cyclic AMP Dependant Agents: Answer: B-adrenergic Inhibitors Question: Action of Digitalis:Answer: Inhibits Na/K Question: of Pimobendan:Answer: Sensitizes myocytes to Ca++,also inhibits Question: Examples of Digitalis :Answer: purpura
Digitalis lanata
Strophanthus Question: Further action of Digitalis :Answer: Positive Inotropic Effect
Vascular Muscle Contraction
Vagal Stimulation
Effects on Electrical of Cardiac Tissues Question: Effects of Toxicity:Answer: G.I.T: Anorexia, nausea, cramping, diarrhea
Visual: Xanthopsia, color blindness
Neurologic: Malaise, confusion, depression, vertigo
Cardiac: bradycardia, Palpitations, , arrhythmias, AV node block, VT
Interactions Question: Pharmacological and effects are greater inAnswer: Hypokalemic Question: Major contributing to digoxin toxicityAnswer: K+-depleting Question: How is digitalis toxicity ?Answer: Reduce or stop the drug
Cardiac pacemeker for heart block
Digitalis antibodies
Arrhythmias may be converted to sinus rhythm by K+
Antiarrhythmic drugs, such as lidocaine, phenytoin, procainamide, or propranolol, used when K+ conc is high Question: Therapeutic benefits of Digitalis :Answer: Only useful in CCHF with arrhythmia
Might decrease morbidity Question: Examples of B-adrenergic agonists (which are cAMP agents):Answer: NE
Ep
Dopamine
Dobutamine Question: Examples of phosphodiesterase inhibitors (which are cAMP agents):Answer: Amrinone
Inamrinone
Milrinone
Vesanirone
Sildenafil Ideas Meet Slimy Verbs Question: What is the function of B-adrenergic agonists?Answer: All increase myocardial oxygen consumption, may be used (IV) for short term or in heart failure Question: When is NE used?Answer: In shock, but caused severe vasospasm and gangrene Question: When is Ep used?Answer: In cardiac arrest, by injection Question: When is used?Answer: used in cardiogenic shock Question: Low doses of cause:Answer: Stimulation of DA1 receptors to renal vasodilation and improved renal function Question: Intermediate of dopamine cause:Answer: Positive inotropic actions by working on B1 Question: High of dopamine cause:Answer: Stimulation of α receptors leading to and elevation of blood pressure Question: Side of dopamine:Answer: changes Question: What is ?Answer: Selective β1 Question: When is used?Answer: (IV) in CCHF Question: General function of phosphodiesterase :Answer: Accumulation of cAMP and cGMP leading to positive inotropic and peripheral vasodilation Question: Phosphodieserase are generally used for:Answer: Parenteral therapy of heart failure Question: of phosphodiesterase inhibitors:Answer: Inamrinone (PDE-3)
Milrinone (PDE-3)
Vesanirone (PDE-3)
Sildenafil (PDE-5) Men View Stars Question: Toxicity, as a result of phosphodiesterase inhibitors to:Answer: Question: What is the of vasodilators?Answer: Affect preload and/or afterload directly affecting contractility
Consequently can decrease myocardial ischemia, enhance coronary blood flow and decrease MVO2 Question: When are used?Answer: In acute heart failure and for short periods in Question: Action of Hydralazine-Isosorbide combinationAnswer: mortality
Reducing remodeling of the heart Question: Vasodilators can be with:Answer: ACEI, and digitalis Question: Venous :Answer:
Isosorbide dinitrate Question: action vasodilators:Answer: Nitroprusside
Captopril
Enalopril
Hydralizine + Question: Atrial :Answer: Hydralazine Question: Examples of nitrate vasodilators:Answer: Nitroglycerin
Isosorbide Question: Examples of Nitric oxide donors used for Answer: Nitroprusside Question: Examples of ACEIs used for Answer: Captopril
Enalapril
Lisinopril
Question: Examples of ARBs used for Answer: Losartan
candesartan Question: Phosphodiesterase inhibitors used for :Answer: Question: -acting K+ channel agonist used for vasodilators:Answer:
Minoxidil Question: Adrenergic antagonists used for :Answer: Question: Nonselective a-adrenergic antagonists used for :Answer: Question: B1-adrenergic used for vasodilators :Answer: Question: Ca2+ blockers used for vasodilatorsAnswer: Question: of (BNP)-Niseritide:
Answer: Binds to receptors in the vasculature, kidney, and other organs, producing potent vasodilation with onset and offset of action by increasing levels of cGMP Question: BNP is by:Answer: ventricular myocytes in to stretch Question: Niseritide is used for the of:Answer: Acute decompensated Question: Action of :Answer: systemic and pulmonary vascular resistances, causing an indirect increase in cardiac output and diuresis Question: Why is BNP- useful in HF?Answer: Reduction in and afterload Question: Main side in Niseritide?Answer: Question: Errors in Management of HF Answer: Improper dosage of diuretics
Failure to consider long term therapeutic goals
Underprescribing ACEIs
Use of potentially harmful drugs
Failure to use hydralazine-isosorbide |
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