Pharm > Ch 13 Chf > Flashcards

Ch 13 Chf Flashcards

(87 cards)

Study These Flashcards
1
Q

What does heart failure generally indicate?

A

The heart is failing to meet the needs of the tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does congestive heart failure imply?

A

There is a build-up of fluid due to ineffective heart pumping.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the five-year mortality rate for heart failure patients?

A

About 50%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What condition is most commonly associated with heart failure?

A

Coronary artery disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to heart cells during a myocardial infarction?

A

They start to die off and are replaced with scar tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is systolic failure characterized by?

A

Reduced cardiac function and thinner heart walls.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can lead to systolic failure in COVID-19 patients?

A

Cytokine storm attacking heart cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is diastolic failure usually associated with?

A

Chronic high blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens to the heart muscle in diastolic failure?

A

The muscle becomes thickened, reducing effective filling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the effect of high blood pressure on the heart’s function?

A

It increases afterload, making it harder for the heart to pump.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the primary cause of angina?

A

O2 debt

Decreased oxygenation due to plaque build-up in coronary arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the role of troponins in diagnosing heart attacks?

A

They are blood markers indicating heart cell damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is afterload?

A

The pressure the heart must pump against to eject blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is preload?

A

The amount of blood returning to the heart that stretches the ventricles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the Frank-Starling Law?

A

The heart’s contraction strength increases with greater stretch of cardiac myocytes.

Optimal stretch = optimal force

Under stretched = less, overstretched = less force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does pulmonary congestion affect preload?

A

It increases preload by raising pressure in the pulmonary circuit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What treatments can decrease preload?

A
  • Salt restriction
  • Diuretics
  • Nitroglycerin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is high output failure?

A

Heart can’t keep up with increased body demands, despite normal heart function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What conditions might lead to high output failure?

A
  • Hyperthyroidism
  • Severe anemia
  • Arterial-venous shunts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

True or False: Diastolic failure results in a normal ejection fraction.

A

True

Systolic failure = decreased EF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens to blood flow if the right ventricle fails?

A

It leads to peripheral congestion due to backflow = decreased cardiac output

Leads to peripheral Edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the consequence of left ventricle failure?

A

It causes pulmonary congestion due to increased pressure in the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the relationship between cardiac output and central nervous system intervention?

A

Decreased cardiac output triggers CNS response to compensate via sympathetic responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fill in the blank: The _______ is the amount of blood remaining in the ventricles after systole.

A

end systolic volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the effect of diastolic failure on total blood pumped out?
Decreased total amount being pumped out, despite normal ejection fraction.
26
What is the typical pressure range for the right atrium?
0 to 8 mmHg.
27
How does the heart compensate for high afterload?
By increasing contractility and heart rate. Works harder
28
What is preload?
The volume of blood in the ventricles at the end of diastole ## Footnote Preload affects stroke volume and cardiac output.
29
How does afterload correlate with blood pressure?
Higher blood pressure increases afterload ## Footnote Afterload is the resistance against which the heart pumps.
30
What happens when cardiac output decreases?
The central nervous system activates norepinephrine release ## Footnote This is usually triggered by a decrease in blood pressure.
31
What is the relationship between afterload and ejection fraction?
Increased afterload decreases ejection fraction ## Footnote The heart pumps less effectively with higher afterload.
32
What contributes to a decrease in cardiac output?
Decreased preload (anemia, hypovolemia, vasodilation) Increased afterload ( vasoconstriction / resistance ) and decreased ejection fraction ## Footnote This can lead to heart failure over time.
33
What is a vicious spiral of heart failure?
A progressive worsening of cardiac performance over time ## Footnote It involves decreased cardiac output and increased afterload.
34
What are the four determinants of cardiac output?
* Preload * Afterload * Contractility * Heart rate ## Footnote These factors directly affect cardiac output.
35
What is the first compensatory mechanism in response to decreased cardiac output?
Increase in heart rate ## Footnote This is mediated by the sympathetic nervous system.
36
Fill in the blank: Increased _______ leads to increased stroke volume.
[preload]
37
Fill in the blank: Increased afterload results in decreased _______.
[cardiac output]
38
What is the role of renin-angiotensin-aldosterone in heart failure?
It increases preload and afterload ## Footnote This response is part of the body's attempt to maintain cardiac output.
39
What is digoxin's mechanism of action?
Inhibits sodium-potassium ATPase pump ## Footnote This increases intracellular calcium and enhances cardiac contraction by reversing na/ca exchanger. More Ca stays instead of being taken out
40
How does increased end systolic volume relate to ejection fraction?
Lower ejection fraction correlates with higher end systolic volume ## Footnote More blood remains in the heart after contraction.
41
What is the primary goal of heart failure treatments?
Correcting failure of cardiac contractility - normal range cardiac output ## Footnote Positive ionotropic drugs are often used.
42
Fill in the blank: ACE inhibitors are used to decrease _______.
[afterload] Block Angtiotension II - prevents vasoconstriction and RAAS system
43
What is the effect of increased trigger calcium on cardiac contraction?
More trigger calcium leads to stronger contractions ## Footnote It activates more ryanodine receptors.
44
What is the resting membrane potential of cardiac myocytes?
About negative 70 to negative 90 millivolts ## Footnote This is essential for the normal function of cardiac cells.
45
True or False: Increasing preload always leads to heart failure.
False ## Footnote While increased preload can be beneficial initially, it may contribute to remodeling over time.
46
What happens to sodium and calcium levels during digoxin treatment?
Sodium accumulates and calcium influx increases ## Footnote This enhances cardiac contractility.
47
What is the significance of gap junctions in cardiac myocytes?
They allow rapid depolarization across cardiac muscle ## Footnote This enables coordinated contraction of the heart.
48
What does the sodium-calcium exchanger do?
Exchanges sodium for calcium across the membrane 3 na in / 1 ca out ## Footnote It operates based on concentration gradients.
49
What is heart failure?
The heart not meeting the demands of the body
50
What are the two types of heart failure mentioned?
* Systolic failure * Diastolic failure
51
What is the role of positive inotropic drugs in heart failure?
They improve the contractility of the heart
52
What is Digitalis and what does it include?
A family of medications including digoxin Comes from the foxglove plant 4 ring structure - like steroid - lipid soluble - crosses BBB easily Can lead to dropped qt interval - schwoop stache
53
What is the prototype drug of the Digitalis family?
Digoxin
54
What is the typical oral absorption percentage of digoxin?
65-80%
55
What is the half-life of digoxin?
30 to 40 hours
56
How does digoxin affect the sodium-potassium ATPase?
It blocks some of the sodium-potassium ATPases
57
What effect does digoxin have on calcium levels in myocytes?
Increases calcium levels leading to more forcible contractions
58
What are the primary pacemakers affected in the heart?
* SA node * AV node
59
What is the digitalis effect on EKG?
Characterized by a decrease in the return to the normal wave
60
What can prolonged PR intervals indicate?
Possible arrhythmias or heart block
61
Fill in the blank: Digoxin can induce ______.
arrhythmias
62
What effect does hyperkalemia have on digoxin?
Decreases the overall effect of digoxin
63
What is the role of phosphodiesterase inhibitors in heart failure?
They increase cyclic AMP and promote cardiac contraction Increase camp in heart = more protein kinase A = more ca influx - positive inotropic , and some chronotrophy
64
What is the only phosphodiesterase inhibitor mentioned?
Milrinone
65
What is the half-life of milrinone?
2 to 3 hours
66
What is the role of beta agonists in heart failure?
They are positive inotropes and positive chronotropes
67
What are ACE inhibitors used for in heart failure?
To target the renin-angiotensin-aldosterone system
68
Fill in the blank: Beta blockers are not suitable for ______ heart failure.
acute
69
What is the mechanism of calcium sensitizers?
They bind troponin and stabilize the calcium-bound conformation
70
What is the status of the calcium sensitizer syndax in the U.S.?
Still in phase three clinical trials
71
What should be avoided in patients with heart failure?
* NSAIDs * TCDs * Metformin
72
What is a potential effect of metformin in heart failure patients?
Increases lactic acidosis
73
What is the primary medication discussed for managing type two diabetes?
Glucopods ## Footnote The effectiveness and mechanism of glucopods in diabetes management is still not fully understood.
74
What condition can glucopods increase in patients with heart failure?
Lactic acidosis ## Footnote This presents challenges as heart failure patients often have multiple comorbidities.
75
What are the four stages of heart failure according to the American Heart Association?
Stage A, Stage B, Stage C, Stage D ## Footnote Each stage reflects the progression of heart failure and associated symptoms- decrease salt in all stages Stage A- high risk - treat comorbidities Stage B - early signs , treat like stage A Stage C- structural changes - positive inotropes Stage D- heart transplant , avd, hospice .
76
What characterizes Stage A of heart failure?
High risk for heart failure without symptoms ## Footnote Patients may have conditions associated with heart failure but do not show congestion or other symptoms.
77
What treatments are typically targeted in Stage A heart failure?
Education and healthier lifestyle ## Footnote The focus is on reducing risk factors before symptoms arise.
78
What comorbidities might be present in Stage B heart failure?
Hypertension, diabetes, dyslipidemia ## Footnote Management includes targeting these conditions with medications.
79
What medications are often used in Stage B heart failure?
ACE inhibitors and angiotensin receptor blockers ## Footnote These help manage hypertension and other risk factors.
80
What occurs in Stage C of heart failure?
Structural disease with previous or current symptoms ## Footnote The patient may start to show signs of heart disease.
81
What treatment options might be considered in Stage C heart failure?
Positive ionotropes, digoxin, salt restriction ## Footnote The goal is to manage symptoms and improve heart function.
82
What is indicated in Stage D of heart failure?
Severe heart failure with refractory symptoms ## Footnote Options may include advanced interventions or hospice care.
83
What are some advanced treatment options for Stage D heart failure?
Heart transplantation, ventricular assist devices ## Footnote These are considered when other treatments fail.
84
True or False: The Batista procedure is still practiced for heart failure.
False ## Footnote The Batista procedure had a high mortality rate and is no longer used. Shave off thick muscle
85
What is cardiomyoplasty?
Skeletal muscle augmentation to aid heart function ## Footnote This involves attaching skeletal muscle to the heart to provide additional support.
86
What is cellular cardiomyoplasty?
Injecting cultured cardiac myocytes into the heart ## Footnote This aims to enhance heart muscle function without invasive procedures.
87
What is a common treatment for acute heart failure?
Diuretics, dopamine, vasodilators ## Footnote These medications help manage fluid overload and improve heart function.
Pharm
flashcards
Decks in class (37)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions