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| 2876075041 | Heart failure | Occurs when cardiac output is inadequate to provide the oxygen needed by the body | 0 | |
| 2876078905 | 50% | 5 year mortality of heart failure | 1 | |
| 2876081592 | CAD | Most common cause of heart failure in the USA | 2 | |
| 2876083057 | Systolic failure | 50% of younger patients have ______, with reduced contractility and reduced ejection fraction | 3 | |
| 2876085678 | Diastolic failure | 50% of younger patients have _________ with stiffening and loss of adequate relaxation playing a major role in reducing filling and cardiac output | 4 | |
| 2876090239 | Ejection fraction | ___________ may be normal even though stroke volume is significantly reduced | 5 | |
| 2876094426 | Diastolic | The proportion of patients with ______ failure increases with age | 6 | |
| 2876125360 | Excitation-contraction coupling | The primary defect in early systolic heart failure resides in the _________ machinery of the heart | 7 | |
| 2876141822 | Non-cardiac targets | Therapy directed at __________ is more valuable in the long-term treatment of heart failure than traditional positive inotropic agents such as cardiac glycosides (digitalis) | 8 | |
| 2876154786 | ACE inhibitors, AT receptor blockers, beta blockers, aldosterone receptor antagonists, and combined hydralazine therapy | Agents in current use that prolong the life of patients in chronic heart failure; useful in both systolic and diastolic failure | 9 | |
| 2876159065 | Positive inotropic drugs | Drugs that are helpful in acute systolic failure | 10 | |
| 2876166411 | Cardiac glycosides | Reduce symptoms in chronic systolic heart failure | 11 | |
| 2876172650 | Chronic heart failure | Diuretics, aldosterone receptor antagonists, ACE inhibitors, AT receptor blockers, beta blockers, cardiac glycosides, vasodilators | 12 | |
| 2876176860 | Acute heart failure | Diuretics, vasodilators, beta agonists, bipyridines, natriuretic peptide | 13 | |
| 2876181737 | Calcium | Cardiac contraction results from the interaction of ______ during systole with the actin-troponin-tropomyosin system | 14 | |
| 2876201872 | Levosimendan | Drug that increases calcium sensitivity and reduces symptoms in models of heart failure | 15 | |
| 2876204585 | Omecantiv mecarbil | Alters the rate of transmission of myosin from a low-actin binding state to a strongly actin-bound force-generating state | 16 | |
| 2876215686 | RyR | A small rise in free cytoplasmic calcium, brought about by calcium influx during AP, triggers the opening of ________ in the membrane of cardiac SR and the rapid release of a large amount calcium into the cytoplasm | 17 | |
| 2876235737 | SERCA pump | Pump maintains free cytoplasmic calcium at very low levels during diastole by pumping calcium into the SR | 18 | |
| 2876239150 | Pospholamban | SERCA is normally inhibited by __________ | 19 | |
| 2876242130 | Beta agonists | Phosphorylation of phospholamban by PKA (Beta agonists) removes this inhibition | 20 | |
| 2876250266 | SNS | The amount of calcium sequestered in the SR is determined (partly) by the ______ activity | 21 | |
| 2876303147 | Sympathomimetics | Cause an increase in calcium influx through an action on channels | 22 | |
| 2876323384 | Calcium channel blockers | Reduce this influx and depress contractility of cardiac tissue | 23 | |
| 2876327108 | NCX antiporter | Uses the sodium gradient to move calcium against its concentration gradient from the cytoplasm to the extracellular space | 24 | |
| 2876332500 | Na/K ATPase channels | Removes intracellular sodium Major determinant of sodium concentration in the cell | 25 | |
| 2876338584 | Digoxin | N/K ATPase is the primary target of ______ and other cardiac glycosides | 26 | |
| 2876355812 | Systolic dysfunction | __________ with reduced cardiac output and significantly reduced ejection fraction (<45%) is typical of acute failure, especially that resulting from MI | 27 | |
| 2876358666 | Diastolic dysfunction | Often occurs as a result of hypertrophy and stiffening of the myocardium Cardiac output may be reduced while ejection fraction may be normal | 28 | |
| 2876367402 | Positive inotropic drugs | Heart failure due to diastolic dysfunction does not response optimally to __________. | 29 | |
| 2876372326 | High-output failure | Rare form of heart failure where the demands of the body are so great that even increased cardiac output is insufficient Responds poorly to drugs | 30 | |
| 2876379202 | Hyperthyroidism, beriberi, anemia, and AV shunts | Causes of high-output failure | 31 | |
| 2876391980 | Tachycardia, dyspnea, cardiomegaly, edema | Primary signs and symptoms or heart failure | 32 | |
| 2876394153 | Diminished cardiac output | Decreased exercise tolerance with rapid muscular fatigue is the major direct consequence of ___________. | 33 | |
| 2876400046 | Extrinsic compensation | Neurohumoral or _________ involves the SNS and renin-angiotensin-aldosterone hormonal response. | 34 | |
| 2876406509 | Baroreceptor | This reflex resets with a lower sensitivity to arterial pressure in extrinsic compensation. | 35 | |
| 2876418270 | Decreased Carotid Sinus Firing | -Increased sympathetic discharge -Increases force, rate, and preload | 36 | |
| 2876422746 | Decreased blood flow | -Increased renin release -Increased AT II -Increased preload, after load, and remodeling | 37 | |
| 2876431749 | Increased sympathetic outflow | Causes tachycardia, increased cardiac contractility, and increased vascular tone | 38 | |
| 2876442324 | ATII and endothelia | Vascular tone is further increased by __________ | 39 | |
| 2876443868 | Endothelin | Potent vasoconstrictor released by vascular endothelial cells | 40 | |
| 2876445025 | Afterload | Vasoconstriction increases _______, which further reduces ejection fraction and cardiac output | 41 | |
| 2876458685 | Beta one | Down-regulatory changes to the _____ adrenoceptor-G protein-effector system result in diminished stimulatory effects | 42 | |
| 2876462709 | Beta two | Receptors are not down-regulated and may develop increased coupling to the IP3-DAG cascade | 43 | |
| 2876467613 | Beta three | Has been suggested the cardiac _____ receptors may mediate negative inotropic effects | 44 | |
| 2876472823 | Beta activation | Excessive _________ can lead to leakage of calcium from the SR via RyR channels and contributes to stiffening of the ventricles and arrhythmias. | 45 | |
| 2876476485 | Caspases | Prolonged beta activation increases ________, the enzyme responsible for apoptosis | 46 | |
| 2876479471 | ATII | Increased _____ leads to increased aldosterone secretion with associated salt and water retention. The after load is increased | 47 | |
| 2876487818 | Arrhythmogenesis | Changes in ion channels, particular potassium channels leads to __________. | 48 | |
| 2876493207 | RyR channels | Phosphorylation of ______ in the sarcoplasmic reticulum enhances Ca2+ release | 49 | |
| 2876497441 | Protein phosphatease 1 (PP1) | Enzyme that is primarily responsible for RyR dephosphorylation is unregulated in heart failure | 50 | |
| 2876524020 | Myocardial hypertrophy | Most important intrinsic mechanism | 51 | |
| 2876529723 | Hypertrophy | _______ can lead to ischemic changes, impairment of diastolic filling and alterations in ventricular geometry | 52 | |
| 2876531589 | Remodeling | Term applied to dilation (other than that due to passive stretch) and other slow slow structural changes in the myocardium | 53 | |
| 2876536475 | Apoptosis | Myocytes in the failing heart die at an accelerated rate through ________ | 54 | |
| 2876540282 | Left ventricular function curve | Measure of left ventricular performance such as stroke volume or stroke work is plotted as a function of left ventricular filling pressure or end-diastolic fiber length | 55 | |
| 2876546214 | Preloads | _____>20-25 mm Hg result in pulmonary congestion | 56 | |
| 2876551424 | Blood volume and venous tone | Preload is usually increased in heart failure because of increased ________ and ________ | 57 | |
| 2876556715 | filling pressures | The goal of a low salt diet is to decrease _________. | 58 | |
| 2876561396 | Preload | Ventilator drugs such as nitroglycerin reduce preload by redistributing blood away from the chest into the peripheral veins | 59 | |
| 2876564881 | Afterload | Resistance against which the heart must pump blood Represented by aortic impedance and systemic vascular resistance | 60 | |
| 2876568645 | Systemic vascular resistance | As cardiac output falls in chronic heart failure, a reflex increase in _________ occurs. It is mediated by increased sympathetic outflow and circulating catecholamines | 61 | |
| 2876578008 | heart rate | Major determinant of cardiac output | 62 | |
| 2876582173 | Beta adrenoreceptors | As stroke volume diminishes, and increase in heart rate through sympathetic activation of _______ is the first compensatory mechanism that maintains cardiac output | 63 | |
| 2876592760 | Digoxin | Prototype of cardiac glycosides or cardenolides | 64 | |
| 2876594095 | pH dependent | Because glycosides lack an easily ionizable group, their solubility is not _________. | 65 | |
| 2876597489 | Oleander, lily of the valley, milkweed | Plants with digoxin like activity | 66 | |
| 2876601909 | 65-80% | Digoxin is _____ absorbed after oral administration | 67 | |
| 2876602850 | Digoxin | Only cardiac glycoside in use in the United States | 68 | |
| 2876606154 | Widely distributed | Once present int he blood, all cardiac glycosides are _________ to tissues, including the CNS | 69 | |
| 2876609643 | kidneys | Digoxin is not extensively metabolized by the _______. | 70 | |
| 2876611249 | Creatinine clearance | The renal clearance of digoxin is proportional to the __________. | 71 | |
| 2876613109 | 36 hours | The half-life of digoxin in patients with normal renal function is ______. | 72 | |
| 2876616519 | Na/K ATPase | All therapeutically useful cardiac glycosides inhibit the ________. | 73 | |
| 2876625117 | Free calcium | Cardiac glycosides increase _______ of the cardiac sarcomere by increasing the ________ concentration in the vicinity of the contractile proteins during systole | 74 | |
| 2876629279 | Intracellular sodium | Cardiac glycosides increase intracellular calcium via a two step process. First, the ______ increases due to Na/K ATPase inhibition. Second, there is a reduction in calcium expulsion from the cell by the NCX (sodium-calcium exchanger) | 75 | |
| 2876635337 | SERCA | The increased intracellular calcium associated with cardiac glycosides is sequestered by the _______ pump. | 76 | |
| 2876644469 | Tension and relaxation | The development of ________ and ________ are increased with little change in time to peak tension when cardiac glycosides are administered | 77 | |
| 2876651190 | Glycosides | The electrical effects of ________ are as follows: prolonged AP, increased K+ conductance, reduction in resting membrane potential (most positive) | 78 | |
| 2877958393 | Delayed after-depolarizations (DADs) | As glycoside toxicity progresses, oscillatory depolarizing after-potentials appear following normally evoked action potential Associated with overloading intracellular calcium stores | 79 | |
| 2877968901 | Premature depolarizations | Occur when after-potentials reach threshold Couple to preceding AP May create bigeminy | 80 | |
| 2877979919 | Digoxin toxicity | Tachycardia may deteriorate into fibrillation in the case of ________ toxicity. | 81 | |
| 2877984839 | Parasympathomimetic effects | In the lower range for digoxin dosage, _______ (atropine-blockablp)predominate. | 82 | |
| 2877988766 | Digitalis | Early actions of digitalis include sensitization of baroreceptors, central vagal stimulation, and facilitation of muscarinic transmission at the cardiac muscle cell | 83 | |
| 2877993142 | Atria | Cholinergic innervation is much richer in the _____ | 84 | |
| 2877995346 | Atria and AV node | Digitalis initially affects the ______ and ______ substantially more than the Purkinje fibers or ventricular function | 85 | |
| 2878002469 | sympathetic | At toxic levels, ______ outflow is increased by digitalis | 86 | |
| 2878006570 | AV junctional rhythm, premature ventricular depolarization, bigeminal rhythm, second-degree AV blockade | Most common cardiac manifestations of digitalis toxicity | 87 | |
| 2878008792 | GI tract | Most common site of digitalis toxicity outside the heart Anorexia, nausea, vomiting, and diarrhea | 88 | |
| 2878013170 | SA node | Heart tissue that has decreased rate at both therapeutic and toxic doses of digitalis | 89 | |
| 2878014521 | Atrial muscle | Digitalis affects the ______ by decreasing the refractory period at both therapeutic and toxic doses. At toxic doses, arrhythmia also occurs. | 90 | |
| 2878018157 | AV node | Digitalis decreases conduction velocity and increases the refractory period at the _______ at therapeutic doses. At toxic doses, there is a decrease in refractory period and the possibility of arrhythmia | 91 | |
| 2878023829 | Purkinje system, ventricular muscle | Digitalis Therapeutic doses: slight decrease in refractory period Toxic doses: extrasystoles, tachycardia, fibrillation | 92 | |
| 2878026741 | ECG | Digitalis Therapeutic- increased PR interval, decreased QT interval Toxic- tachycardia, fibrillation, and arrest | 93 | |
| 2878037837 | Hyperkalemia | Reduces the enzyme-inhibiting actions of glycosides | 94 | |
| 2878038891 | Hypokalemia | Facilitates the actions of glycosides | 95 | |
| 2878044364 | Calcium | Facilitates the toxic actions of cardiac glycosides by accelerating the overloading of intracellular _______ stores that appear to be responsible for digitalis-induced abnormal automaticity | 96 | |
| 2878051183 | Hypercalcemia | Increases the risk of digitalis-induced arrhythmia | 97 | |
| 2878053933 | Hypermagnesmia | Decreases the risk of digitalis induced arrhythmia | 98 | |
| 2878059022 | Istaroxime | Investigational steroid derivative that increases contractility by inhibiting Na/K ATPase and facilitates sequestration of Ca2+ by the SR | 99 | |
| 2878066592 | Arrhythmogenic | Because Istaroxime facilitates calcium sequestration, the drug is less _________ that digoxin | 100 | |
| 2878074422 | phosphodiesterases | Drugs that inhibit ___________ (cAMP and cGPM inactivators) have long been used in therapy of heart failure | 101 | |
| 2878078196 | vasodilation | Though phosphodiesterases have positive inotropic effects, most of their benefits appear to derive from _________ | 102 | |
| 2878082572 | Inamrinone and milrinone | Most successful bipyridines Inhibit phosphodiesterases | 103 | |
| 2878084762 | Levosimendan | Drug that sensitizes the troponin system to calcium; appears to inhibit phosphodiesterase and cause so vasodilation in addition to its inotropic effects | 104 | |
| 2878098107 | Inamrinone and milrinone | Bipyridine compounds that inhibit PDE-3 Active orally and parenterally; available only parenterally | 105 | |
| 2878100884 | 3-6 hours | Inamrinone and milrinone have a half-life of ______ and are 10-40% excreted in the urine | 106 | |
| 2878119947 | inward calcium flux | Bipyridines increase myocardial contractility by increasing the ________ during the AP Bipyridines may also alter the intracellular movements of calcium by influencing the SR Have important vasodilating effects | 107 | |
| 2878128763 | contractility and vasodilation | Inhibition of posphodiesterase results in an increase in cAMP and an increase in _________ and _________ | 108 | |
| 2878130781 | Inamrinone | The toxicity of ______ includes nausea and vomiting, arrhythmias, thrombocytopenia, and liver enzyme changes | 109 | |
| 2878134227 | Milrinone | Of the bipyridines, ________ appears less likely to cause bone marrow and liver toxicity than inamrinone. It does cause arrhythmias | 110 | |
| 2878138717 | Acute heart failure | Inamrinone and milrinone are used only intravenously for _______ or severe exacerbation of chronic heart failure | 111 | |
| 2878141648 | Dobutamine | The selective beta-1 agonist that has been most widely used in patients with heart failure is ________ | 112 | |
| 2878143311 | parenterally | Dobutamine is administered _________ | 113 | |
| 2878145402 | Cardiac output, ventricular filling pressure | Dobutamine produces as increase in ______ and a decrease in _________. | 114 | |
| 2878148932 | angina, arrhythmia, tachyphylaxis | The potential for producing ______ or _______ in patients with CAD is significant as is the ________ that accompanies the sue of any beta-stimulant | 115 | |
| 2878157466 | Diuretics, ACE inhibitors, ATIIr antagonists, aldosterone antagonists, and beta blockers | First line therapies for chronic heart failure | 116 | |
| 2878162127 | Furosamide | Diuretics, especially ______ are drugs of choice in heat failure Have no direct effect on cardiac contractility | 117 | |
| 2878164969 | Ventricular preload | The mechanism of diuretics in heart failure it to reduce venous pressure and __________. This results in reduction of salt and water retention and edema and its symptoms | 118 | |
| 2878169899 | Spironolactone and eplerenone | Aldosterone antagonis diuretics Have the additional benefit of decreasing forbidding and mortality in patients with severe heart failure who are also receiving ACE inhibitors and other standard therapy | 119 | |
| 2878174994 | baroreceptor dysfunction | It is thought that aldosterone may cause myocardial and vascular fibrosis and ___________ in addition to its renal effects | 120 | |
| 2878208711 | Afterload | ACE inhibitors reduce ________. They also reduce salt and water retention by reducing aldosterone secretion, which reduces preload | 121 | |
| 2878218959 | Norepinephrine release | The reduction in tissue angiotensin levels reduces sympathetic activity through diminution of angiotensin's presynaptic effects on ______________ | 122 | |
| 2878275941 | ACE inhibitors | AT receptor blockers should be considered in patients intolerant of ACE inhibitors because of incessant cough | 123 | |
| 2878280555 | Aliskiren | Renin inhibitor approved for hypertension | 124 | |
| 2878283900 | preload, afterload | Vasodilators are effective in acute heart failure because they provide a reduction in _______ though ventilation or a reduction in ________- through arteriolar dilation | 125 | |
| 2878288116 | Hydralazine and isosorbide dinitrate | Use of ________ and ________ can reduce damaging remodeling of the heart | 126 | |
| 2878289586 | Nesiritide | A synthetic form of endogenous peptide BNP approved for use in acute (not chronic) cardiac failure | 127 | |
| 2878292598 | cGMP | Nesiritide increases _____ in smotth muscle cells and reduces venous and arteriolar tone in experimental preparations Also causes diuresis | 128 | |
| 2878298769 | 20 minutes | The half-life of nesiritide is short at ______. It is initially administered as an IV bolus followed by continuous infusion | 129 | |
| 2878301400 | hypotension | The most common adverse effect of nesiritide is excessive _______. Significant renal damage and death have occasionally occurred | 130 | |
| 2878305286 | Endogenous BNP | Plasma concentrations of _________ increase in most patients with heart failure and are correlated with severity | 131 | |
| 2878308899 | Carperitide and Ularitide | Synthetic analogs of ANP and urodilantin | 132 | |
| 2878310934 | Bosentan and tezosentan | Orally active competitive inhibitors of endothelia | 133 | |
| 2878312383 | pulmonary hypertension | Bosentan has been approved for use in ________. It has significant teratogenic and hepatotoxic effects | 134 | |
| 2878317790 | Bisoprolol, carvedilol, metoprolol, nebivolol | Beta blockers associated with a reduction in mortality in patients with severe stable heart failure *Effect not seen with bucindolol | 135 | |
| 2878323026 | Beta blcokers | Anttentuate adverse effects of high concentrations of catecholamines, up-regulation of beta receptors, decreased heart rate, and reduced remodeling through inhibition of the mitogenic activity of catecholamines | 136 | |
| 2878326922 | Stage A | Stage of heart failures where patients are at high risk because of other disease but have no sign or symptoms of heart failure | 137 | |
| 2878329432 | Stage B | Patients have evidence of structural heart disease but no symptoms of failure | 138 | |
| 2878330765 | Stage C | Patients have structural heart disease and symptoms of failure Symptoms are responsive to ordinary therapy | 139 | |
| 2878331812 | Stage D | Patients have heart failure refractory to ordinary therapy and specify interventions Resynchronization therapy or transplant are required | 140 | |
| 2878333182 | Stage C | Once ______ is reached, the severity of heart failure is usually described according to a scale devised by the NY heart association | 141 | |
| 2878335707 | Class I | _____ heart failure is associated with no limitations on ordinary activities. Symptoms only occur with greater than normal exercise | 142 | |
| 2878338077 | Class II | ________ is characterized by slight limitation of activities Results in fatigue and palpitations with ordinary physical activity | 143 | |
| 2878340679 | Class III | ______ results in no symptoms at rest Fatigue, SOB, and tachycardia occur with less that ordinary physical activity | 144 | |
| 2878342359 | Class IV | Associated with symptoms, even when the patient is at rest | 145 | |
| 2878344070 | A, prefailure | No symptoms but risk factors present Treat obesity, hypertension, diabetes, hyperlipidemia etc. | 146 | |
| 2878344896 | B, I | Symptoms with severe exercise ACEI/ARB, beta blcoker, diuretic | 147 | |
| 2878346272 | C, II/III | Symptoms with marked (class II) or mild (class III) exercise Add aldosterone antagonist, digoxin; CRT, hydralazine/nitrate to ACEI/ ARB, beta-blocker and diuretic | 148 | |
| 2878349554 | D, IV | Severe symptoms at rest Transplant, LVAD | 149 | |
| 2878352127 | Thiazide | Diuretic used in very mild failure | 150 | |
| 2878352833 | Furosamide | Loop agent used for symptomatic heart failure | 151 | |
| 2878353978 | Potassium | Sodium loss causes secondary loss of ______, which is particularly hazardous for patients taking digitalis | 152 | |
| 2878355666 | Hypokalemia | Can be treated with potassium supplementation or through the addition of an ACE inhibitor or potassium-sparing diuretic such as spironolactone | 153 | |
| 2878358316 | ACE inhibitor | In patients with left ventricular dysfunction and no edema, a ______ should be the first drug used | 154 | |
| 2878361173 | Digoxin | ACE inhibitors cannot replace _______ in patients that already receive the glycoside Patients that withdraw from _____ deteriorate while ACE therapy | 155 | |
| 2880304070 | Ventricular dilation | By reducing preload and after load in asymptomatic patients, ACE inhibitors slow the progress of ________. | 156 | |
| 2880306806 | ACE inhibitors | Medication that is useful in all subsets of patients Asymptomatic to severe and chronic failure | 157 | |
| 2880313134 | AT-1 receptor blockers | Produce beneficial hemodynamic effects similar to those of ACE inhibitors These medications are best reserved for patients who cannot tolerate ACE inhibitors | 158 | |
| 2880321532 | Venous dilators (nitrates) | In patients with high filling pressures in whom the principal symptom is dyspnea, _______ such as _______ will be most helpful in reducing filling pressures and the symptoms of pulmonary congestion | 159 | |
| 2880327839 | Hydralazine | In a patient with low left ventricular output, an arteriolar dilator such as _______ may be helpful in increasing cardiac output | 160 | |
| 2880340824 | BiDil | Fixed combination of ACE hydrazine and isosorbide dinitrate Approved for use only in African Americans | 161 | |
| 2880351767 | Bisoprolol, carvedilol, metoprolol, nebivolol | Reduce mortality | 162 | |
| 2880355119 | Heart failure and A-fib | Digoxin is indicated in patients with _____ and ______ if ACE inhibitors and diuretics have failed to control symptoms | 163 | |
| 2880359838 | 50% | About _____ of patients with a normal sinus rhythm will have relief of heart failure with digitalis treatment | 164 | |
| 2880371369 | Therapeutic end point | With digitalis, toxic effects occur before the _______ is reached | 165 | |
| 2880376832 | Decreased | Mortality is decreased in patients with serum digoxin concentrations <0.9 mg/mL but increased when digoxin levels > 1.5 ng/mL | 166 | |
| 2880741538 | Wolff-Parkinson White syndrome | Digoxin is explicitly contraindicated in patients with ___________ and atrial fibrillation | 167 | |
| 2880755917 | WPW syndrome | caused by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles. Electrical signals traveling down this abnormal pathway (known as the bundle of Kent) may stimulate the ventricles to contract prematurely, resulting in a unique type of supraventricular tachycardia referred to as an atrioventricular reciprocating tachycardia | 168 | |
| 2880764169 | Renal dialysis | If administering digitalis, it is particularly important to monitor potassium levels in patients on _______. | 169 | |
| 2880769065 | elevated | In severe digitalis intoxication, serum potassium will already be _______ at the time of diagnosis | 170 | |
| 2880776263 | Digoxin immune fab | If severe digoxin intoxication occurs, it is important to insert a pacemaker and administer ________. | 171 | |
| 2880782202 | arrhythmias | Digitalis-induced _______ are frequently made worse by cardioversion | 172 | |
| 2880791351 | Nebivolol | Effective in both systolic and diastolic failure | 173 | |
| 2880803250 | Furosemide | Most commonly used diuretic | 174 | |
| 2880805284 | Dopamine or dobutamine | Positive inotropic drugs with prompt onset and short durations of action Most useful in patients with severe hypertension | 175 | |
| 2880809909 | Nitroprusside, nitroglycerine, and nesiritide | Vasodilators used in patients with acute decompensation | 176 | |
| 2880811456 | Conivaptan | Parenteral treatment of euvolemic hyponatremia | 177 | |
| 2880817084 | Vasopressin antagonists | Do not seem to reduce mortality | 178 | |
| 2880820681 | Furosamide | Loop diuretic: Decreases NaCl and KCl reabsorption in thick ascending limb of the loop of Henle in the nephron Increased excretion of salt and water • reduces cardiac preload and afterload • reduces pulmonary and peripheral edema | 179 | |
| 2880828562 | Acute and chronic heart failure, severe hypertension, and edematous conditions | Furosemide can be used for _________. | 180 | |
| 2880834030 | Hypovolemia, hypokalemia, orthostatic hypotension, ototoxicity, and sufa allergy | Furosemide toxicities | 181 | |
| 2880846100 | oral and IV | Furosemide is available in _______ forms. The duration is 2-4 hours | 182 | |
| 2880835793 | Hydrochlorothiazide | Decreases NaCl reabsorption in the DCT Effects same as furosemide; less effective | 183 | |
| 2880841387 | Mild chronic failure and mild-moderate hypertension | Hydrochlorothiazide is used in _______. It has not been shown to reduce mortality | 184 | |
| 2880848785 | Oral | Hydrochlorothiazide is available in ______ form only. It's duration is 10-12 hours | 185 | |
| 2880853172 | Hyponatremia, hypokalemia, hyperglycemia, hyperuricemia, hyperlipidemia, sulfa allergy | Adverse effects of hydrochlorothiazide | 186 | |
| 2880858099 | Bumetonide and torsemide | Loop diuretics similar to furosemide | 187 | |
| 2880859624 | Spironolactone | Blocks cytoplasmic aldosterone receptors in collecting tubules of nephron • possible membrane effect ncreased salt and water excretion • reduces remodeling • reduces mortality | 188 | |
| 2880907693 | Chronic heart failure, HTN and aldosteronism | Spironolactone is used for __________. It has been shown to reduce mortality | 189 | |
| 2880912289 | Hyperkalemia and antiandrogen actions | The toxicity of spirinolactone includes _______ and _______. Duration is 24-72 hours with low onset and offset | 190 | |
| 2880918854 | Cirrhosis and adrenal tumor | Aldosteronism is frequently associated with 2 diseases | 191 | |
| 2880923829 | ATI to ATII | ACE inhibitors such as captopril inhibit the conversion of ____ to ____ | 192 | |
| 2880930217 | Arteriolar and venous dilation, reduced aldosterone secretion, and reduced cardiac remodeling | The effects of ACE inhibitors include _________, ________ | 193 | |
| 2880935753 | Chronic heart failure, HTN, diabetic renal disease | ACE inhibitors are used for _______. They have been shown to reduce mortality | 194 | |
| 2880978249 | Cough, hyperkalemia, angioneurotic edema | ACE inhibitor toxicity Additive with other AT antagonists | 195 | |
| 2880981777 | Orally | ACE inhibitors are administered. The half life is short, but they are given every 12-24 hours in large doses | 196 | |
| 2880988876 | ARBs | Antagonize all effects of AT-1 receptors Actions similar to ACE inhibitors | 197 | |
| 2880990992 | ACE inhibitors | ARBs are used in patients that cannot tolerate ________. They do reduce mortality | 198 | |
| 2880998455 | Oral | ARBs are available in ____ form. The duration is 6-8 hours. | 199 | |
| 2881002027 | Hyperkalemia, angioneurotic edema | Side effects of ARBs include _________. These are additive with other angiotensin antagonists | 200 | |
| 2881006872 | Beta blockers | Medications such as carvedilol that competitively block beta 1 receptors | 201 | |
| 2881011361 | Decreased HR, BP, heart failure | Actions of beta blockers include ____________ | 202 | |
| 2881014061 | chronic heart failure | Beta blockers are used to ________ and reduce mortality in moderate and severe heart failure. | 203 | |
| 2881016404 | Oral | _____ administration is used for beta blockers. Their duration of action is 10-12 hours. | 204 | |
| 2881020678 | Bronchospasm, bradycardia, AV block, acute cardiac decompensation | Dis effects of beta blockers include __________. | 205 | |
| 2881021793 | Digoxin | Na+/K+-ATPase inhibition results in reduced Ca2+ expul- sion and increased Ca2+ stored in sarcoplasmic reticulum | 206 | |
| 2881026794 | contractility and parasympathomimetic effect | Digoxin increases cardiac ______ and ________, which is seen with a slowed sinus HR and slowed AV conduction | 207 | |
| 2881064228 | Chronic symptomatic heart failure | Digoxin is used for __________ and rapid ventricular rate in atrial fibrillation It has not been definitively shown to reduce mortality | 208 | |
| 2881066340 | Oral or parenteral | Digoxin is administered ______ or _______. It lasts 36-40 hours | 209 | |
| 2881095202 | Nausea, vomiting, diarrhea, and cardiac arrhythmia | The toxicity of digoxin is apparent with the following symptoms: | 210 | |
| 2881100105 | Venodilator | Isosorbide dinitrate is a _______. It causes NO release and activates guanylyl cyclase | 211 | |
| 2881102676 | preload and ventricular stretch | Venodilators decrease ______ and _____. | 212 | |
| 2881105217 | Acute and chronic hear failure and angina | Venodilators are used for ________. | 213 | |
| 2881110881 | Postural hypotension, tachycardia, and headache | Side effects of venodilators are __________. Administration is oral | 214 | |
| 2881112093 | PDE5i | Venodilators are additive with other vasodilators and have a synergistic effect with _______. | 215 | |
| 2881120484 | Arteriolar dilators | _______ such as hydrazine increase NO synthesis in endothelium | 216 | |
| 2881122066 | reduces BP and afterload | Hydralazine and other arteriolar dilators reduce ____ and ______, resulting in higher CO | 217 | |
| 2881124764 | Nitrates | Hydralazine + _______ have reduced mortality | 218 | |
| 2881131138 | Tachycardia, fluid retention, lupus-like syndrome | Toxicities of hydrazine include _______ | 219 | |
| 2881140747 | Nitroprusside | Combined arteriolar and venodilator Release NO spontaneously and activates GC | 220 | |
| 2881150755 | Nitropursside | Used for acute cardiac decompensation and hypertensive emergencies such as malignant hypertension | 221 | |
| 2881152354 | IV | Nitroprusside is available via ____ administration. The duration is 1-2 minutes | 222 | |
| 2881156516 | Hypotension, thiocyanate, and cyanide toxicity | Side effects of nitroprusside include __________. It is additive with other vasodilators | 223 | |
| 2881161028 | Dobutamine | ________ is a beta-1 selective agonist that increases cAMP synthesis. | 224 | |
| 2881163300 | Cardiac contractility and output | Dobutamine increases _______ and _______ | 225 | |
| 2881168417 | Acute decompensated heart failure and intermittent therapy in chronic failure | Dobutamine is used for _______ and ________ to reduce symptoms | 226 | |
| 2881169521 | IV | Dobutamine is administered by _____. The duration of action is only a few minutes | 227 | |
| 2881171042 | Arrythmia | The most common dobutamine toxicity is ________. It has additive interactions with other sympathomimetics | 228 | |
| 2881177993 | Dopamine | Dopamine receptor agonist; higher doses activate beta and alpha adrenoceptors Acts by increasing renal blood flow (low dose) | 229 | |
| 2881185451 | Cardiac force and BP | Higher doses of dopamine increase _______ and _______ | 230 | |
| 2881188654 | Acute decompensated heart failure | Dopamine is used for ________ and shock. | 231 | |
| 2881203684 | IV | Dopamins is administered via ____. The duration is only a few minutes | 232 | |
| 2881223436 | Sympathomimetics | The action of dopamine is additive with _______. | 233 | |
| 2881226010 | Bipyridines | ______, such as inamrinone and milrinone are PDE3 inhibitors that decrease cAMP breakdown | 234 | |
| 2881229787 | vasodilators | Bipyridines are ______. they lower peripheral vascular resistance and increase cardiac contractility | 235 | |
| 2881232968 | Acute decompensated heart failure | Bipyridines are used in ________. They are not used in chronic failure due to an increase in mortality | 236 | |
| 2881242974 | arrhythmogenic | Bipyridines are additive with other _________ agents. | 237 | |
| 2881322933 | Nesiritide | Activates BNP receptors and increases cGMP | 238 | |
| 2881324427 | vasodilation and diuresis | Nesiritide causes ______ and ______ | 239 | |
| 2881325815 | Acude decompensated failure | Nesiritide is used for ________. It has not been shown to reduce mortality | 240 | |
| 2881327234 | IV | Nesiritide is administered via ____. The duration is 18 minutes | 241 | |
| 2881328986 | Renal damage, hypotension | Nesiritide toxicity is associated with ______ and ______. It may increase mortality as well. | 242 |
