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40 Cards in this Set
- Front
- Back
Therapuetic tree for treatment of heart failure:
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Heart hypertrophy effect on ejection fraction:
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As the heart hypertrophies, the chambers get smaller leading to a decreased ejection fraction.
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Eplerenone
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Use of ACE inhibitors in heart failure:
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Use of aldosterone antagonists in HF:
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Use of diurectics in heart failure:
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Use of vasodilators/venodilators in heart failure:
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Use of beta blockers in heart failure:
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Reduces compensatory salt retention
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Reduces compensatory salt retention
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Lupus like syndrome
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ACC guidelines for beta blocker use in heart failure:
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Afterload decrease
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Positive inotropic agent use in heart failure:
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MOA of Digoxin:
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Therapeutic indications for use of digoxin:
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Digoxin toxicity and electrolyte levels:
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Digoxin binds to Na/K pump and blocks the outflow of Na+ while blocking inflow of K+
When you have low serum potassium, you have less competition with digoxin for binding spots on the Na/K pumps, which can lead to digoxin toxicity. |
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Digoxin effect on action potential:
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- Lowered action potential makes SA node more irritable; makes arrhythmias more likely
- Increased intracellular calcium causes earlier phase 4 upstroke; increased automaticity! |
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Effects of digoxin on an EKG:
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- A decrease in QT interval means a decreased ventricular refractory period.
- An increased PR interval means slower AV nodal conduction. - Inverted T wave has something to do with K+ changes - DAD = ectopic or abnormal ventricular beats |
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Bigeminy on an EKG resulting from digoxin toxicity:
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Note the abnormal T wave and the abnormal ventricular beats that are coming from a ventricular electrical source and not the AV node.
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Shortens ventricular refractory period
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Adverse effects of digoxin:
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Contraindications to digoxin therapy?
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Ventricular fibrillation
Ventricular arrhythmias/tachycardia Wolff-Parkinson-White syndrome AV block or Bradycardia Hypokalemia (correct 1st ) |
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MOA of Dobutamine:
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Dopamine:
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Adverse effects of beta-1 agonists:
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Digoxin
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Phosphodiesterase Inhibitors MOA:
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Treatments for Stage A or B heart failure:
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Treatments for stage C or D heart failure:
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MOA of Nesiritide:
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Therapeutic tree for treating pulmonary hypertension:
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Overview of therapeutics for pulmonary hypertension:
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*Calcium channel blockers will not help if the vessels are incapable of reacting to vasodilators.
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Use of Calcium channel blockers in PH:
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PAH Patients are infused with NO or adenosine-if they react by vasodilating (about 20% patient), then they are administered CCB’s. Evidence suggests CCBs significantly reduce PAH in vasoreactive patients BUT not in other PAH patients.
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PDE5 inhibitors in treatment of PH:
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Endothelin receptor antagonists in treatment of PH:
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Use of prostacyclins in pulmonary hypertension:
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Treatment algorithm for pulmonary hypertension:
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Antiarrhythmic indications:
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