Final Section 4 (CV)

Question 1

What is stable angina & what is usually the causes? What can relieve it?

Answer 1

Angina of effort (exercise), classic angina
Plaque
Rest can help sometimes

Question 2

What is unstable angina & what is usually the causes?

Answer 2

Acue coronary syndrome, happens at rest
Casue = Plaque
Emergency!!!!

Question 3

What is variant angina & what is usually the causes?

Answer 3

Prizmetal, hyperreactive vessels
Happens at rest
Rare

Question 4

What are the actions of NO, nitrites, & nitrates on vascular smooth muscle?

Answer 4

Activate GC > Increases cGMP = relaxation

Question 5

What are the actions of beta blockers on vascular smooth muscle?

Answer 5

decrease the demand of the heart

Question 6

What are the actions of CCB on vascular smooth muscle?

Answer 6

less calcium available overall - causes relaxation

Question 7

What are the actions of Sildenafil on vascular smooth muscle?

Answer 7

Blocks PDE
Increases cGMP
= relaxes vascular scmooth muscle

Question 8

What is good about nitrates/nitrites?

Answer 8

decreases preload, heart size & CO

Question 9

What is bad about nitrates/nitrites?

Answer 9

can cause orthostatic hypotension, syncope, HA, & reflex tachycardia

Question 10

Where are the L-type calcium channels?

Answer 10

vascular smooth muscle & the heart

Question 11

What effect do CCB’s have on the heart? Are these short or long acting?

Answer 11

Smooth muscle relaxation mostly on the vasculature
Long lasting
Decreases HR contractility, HR, & AV node velocity

Question 12

What are the Dihydropyridines more selective for?

Answer 12

peripheral vasculature

Question 13

What are Verapamil & Diltiazem more selective for?

Answer 13

cardiac

Question 14

What kind of angina are beta blockers good for?

Answer 14

Unstable angina
ACS

Question 15

What is the main benefit of a beta blocker?

Answer 15

decreases the oxygen demand of the heart

Question 16

All antihypertensive meds act on one of these four sites, name them:

Answer 16

Diuretics (deplete sodium)
Sympathoplegics/blockers (decrease PVR reduce CO)
Direct Vasodilators (relax vascular smooth muscle)
Anti-angiotensins (block angiotensin 2 production or activity)

Question 17

How do you calculate BP?

Answer 17

BP = CO x PVR

Question 18

What things go into cardiac output? (3 things)

Answer 18

Stroke volume
HR
Venous capacitance (preload)

Question 19

What are the two CNS acting alpha blockers? Where do they mainly bind?

Answer 19

Clondine
Methyldopa

alpha 2 primarily on the brainstem

Question 20

What are Clondine & Methyldopa used for?

Answer 20

antihypertensive decreases sympathetic stimulation on the brainstem

Question 21

What is propanol? What receptors does it mainly work at?

Answer 21

Beta blocker, Lowers BP, decreases CO, blocks renin
B1 & B2

Question 22

Name three alpha 1 blockers

Answer 22

Prazosin
Terazosin
Doxazosin

ends in -zosin

Question 23

What do the alpha 1 blockers mainly do?

Answer 23

block alpha 1 receptors in arterioles & venules
dilates both resistance & capacitance vessels
BP reduced in upright position

Question 24

How does minoxidil work?

Answer 24

Opens K channels in smooth muscles
Dilates arteries & arterioles

Question 25

How does hydralazine work? Name some SE

Answer 25

Dilates arterioles (NO production) SE= Headache, nausea, sweating, flushing

Question 26

What is Sodium Nitroprusside used for? How does it work?

Answer 26

Htn emergencies & heart failure Dilate the arterial & venous vessels to release NP

Question 27

What is fenoldopam used for?

Answer 27

Peripheral arteriolar dilator Htn emergencies & post op htn

Question 28

What receptors does Fenoldopam work at ?

Answer 28

D1 in the kidney

Question 29

What does the drug Aliskiren do?

Answer 29

Direct renin inhibitor Prevents conversion of angiotensinogen → angiotensin I

Question 30

What does the ACE inhibitor Captopril do?

Answer 30

blocks the angiotensin converting enzyme (blocks a1 to a2)

Question 31

Where do the ARBs work? Name 2 examples.

Answer 31

Angiotensin 2 receptor blockers Blocks Angiotensin II receptors that cause vasoconstriction & aldosterone secretion EX: Losartan & Valsartan

Question 32

What is systolic HF?

Answer 32

Reduced cardiac function, acute failure Decreased CO & EF

Question 33

what is diastolic HF? What drugs does it NOT respond well to?

Answer 33

Reduced cardiac filling, cardiac hypertrophy decreased CO, NORMAL EF positive inotropes

Question 34

What is CHF

Answer 34

increased LV pressure at end diastole results increased Pulm pressure >> pulmonary edema

Question 35

What four things is cardiac performance based on?

Answer 35

Preload Afterload Contractiltiy HR

Question 36

How does digoxin work?

Answer 36

blocks Na/K ATPase keeps the membrane resting Positive inotrope

Question 37

Name a PDE inhibitor & what does it inactivate?

Answer 37

Milrinone inactivates cAMP & cGMP

Question 38

What are the main actions of Milrinone

Answer 38

Vasodilation Positive inotropic

Question 39

What happens at phase 0 of a ventricular AP?

Answer 39

Na goes in

Question 40

What happens at phase 1 of a ventricular AP?

Answer 40

K & Cl go out

Question 41

What happens at phase 2 of a ventricular AP?

Answer 41

Ca IN K out

Question 42

What happens at phase 3 of a ventricular AP?

Answer 42

K moves out (repolarization)

Question 43

What happens at phase 4 of a ventricular AP?

Answer 43

K inward rectifier

Question 44

What do class 1 antiarryhtmics do? Give an example

Answer 44

Sodium channel blockade Quinidine Lidocaine Flecainide

Question 45

What do class 2 antiarryhthmics do? Give examples

Answer 45

adrenergic blocker (sympatholytic) Propanolol

Question 46

What do class 3 antiarryhthmics do? Give examples

Answer 46

prolong AP Amiodarone (does a lot of other random shit than just sodium channels)

Question 47

What do class 4 antiarryhthmics do? Give examples

Answer 47

Blocks cardiac calcium channels Verapamil

Question 48

There are three types of Type 1 Sodium channel blockers, what are they? What is the differences & give examples of each

Answer 48

A - Quinidine - lengthens APD - intermediate B - Lidocaine - shortens APD - FAST C - Flecainide - no APD effect - SLOW

Question 49

How do you treat symptomatic bradycardia?

Answer 49

1st atropine 2nd epi & dopamine

Question 50

How do you treat symptomatic heart block?

Answer 50

atropine pacing

Question 51

How do you treat symptomatic SVT?

Answer 51

adenosine

Question 52

How do you treat symptomatic sinus tachy?

Answer 52

adenosine, CCBs cardiovert

Question 53

How do you treat symptomatic vtach?

Answer 53

amio lido

Question 54

How do you treat symptomatic afib?

Answer 54

CCBs

Question 55

How do you treat symptomatic Vfib?

Answer 55

CPR defib epi vaso

Question 56

What is an example of a carbonic anhydrase inhibitor, what does it do?

Answer 56

Azetylzolamide Blocks CA enzyme in the PCT wastes Na K & bicarb

Question 57

What is an example of a loop diuretic, what does it do?

Answer 57

Lasix wastes Na & K

Question 58

What is an example of a thiazide, what does it do?

Answer 58

Hydrochlorothiazide wastes Na & K

Question 59

What is an example of a K Sparing diuretic?

Answer 59

Spiranolactone Conivaptan

Question 60

What is an example of an osmotic diuretic?

Answer 60

Mannitol