A Pharm- summer 1- cardiac
Card Set Information
A Pharm- summer 1- cardiac
aa emory pharm
____________, treating _____ prob.
Vasopressors: Increase ________, and ________ and treat ____ problem
treat PIPE problem
Relaxation of cardiac myocytes occurs when _____ ____ channels close.
INOtropy: ________ of intracellular Ca2+ and ________. (IQT)
CHRONOtropy: _____ of Ca2+ delivery.
Rate of __________. (CRC^2)
LUSItropy: _________ of
intracellular Ca2+. _______ of __________. (LRR)
Rate of Relaxation
An increase in cAMP in heart cell will increase ______ release. What are two drugs that use this pathway?
β- Agonists mechanism of action? Main method?
stimulate adenylate cyclase, ^ cAMP.
B1 increases what?
B2 increases what?
Smooth muscle vasodilation (pulm)
A1 causes what effect?
Epi has _____ fx on B1, B2, a1. side fx include:
What two drugs have higher a than B fx?
Norepi side fx:
intense SVR increase can cause CO drop
Dobutamine side fx:
Isoproteronol is a _____ __ _______. side fx include what three things?
Pure B agonist.
Significant TACHY, ARRHYTMIA, drop SVR.
Phosphodiesterase Inhibitors mechanism of action:
prevent cAMP breakdown.
PDE’s breakdown cyclic nucleotides (____, ____) and are ________ __________ that ACTIVATE PROTEIN KINASES and OPEN ___ ________.
PDE3 A receptors found where?
CARDIOVASCULAR SYSTEM and PLATELETS
PDE3 B receptors found where? activated by?
PDE3 INHIBITORS: What two areas are effected by these drugs?
^ cAMP = ^ Ca2+, increase contractility
^ cyclic nucleotides, smooth muscle relaxation, Decrease PA pressure and SVR
what are 3 PDE-I drugs?
How is Enoximone excreted?
Why is NOREPI 1st line of support? What can be added is systolic function is poor?
some + inotropy, maintain perfusion pressure
Epi, dobutamine, PDE-I
T or F, second messenger in a receptors of vasculature is cAMP? Do they cause Ca2+ release?
What are the non-catecholamine sympathomimetics? (3) PME
Phenylephrine- pure direct a agonist
Methoxamine- direct direct a agonist
What are the 2 pure direct a agonists?
how does Ephedrine work?
causes Norepi release from neurons
T or F, Ephedrine has some B2 activation? Is it direct? What prolongs ephedrine? How much is excreted unchanged from the kidney? Does it affect uterine vasc resistance?
Vasopressin: a ___-______________ vasopressor. No __ receptors involved, vasoconstriction due to ___ receptors. Second messenger system is utilized, and Ca2+ release causes vasoconstriction- T or F?
Where are the following receptors located?
AVP main role is not ___ _____ _____. levels increase by 2-3X with _____. Levels decrease following ___
vasc tone reg
Vasopressin side effects and what causes them:
Intense vasoconstriction = Myocardial ischemia, decreased CO, mesenteric ischemia
less effect on pulmonary vasculature
why can Vasopresson be beneficial with pulmonary HTN?
Less of an effect on pulmonary vasculature
Conventional Inotropes are ______ __________.
“Calcium Sensitizers” work at the interaction
of_______/____ or response to ____ binding.
Why the fact that calcium sensitizers don't increase calcium possibly a benefit?
Do not increase O2 consumption
Calcium Sensitizers are _________ with other agents.
What are the Calcium Sensitizer drugs? (3)
What is Methylene Blue mechanism? what are side fx of high doses?
Block GC activation by NO, leading to LESS vasodilation.
High doses = hyperbilirubinemia/ hemolytic anemia
What causes a higher change in VO2? Milrinone or Levosimendan?