Cardiovascular system Drugs - HEART FAILURE (Chapter 1 / 7)

-

 HEART FAILURE

HF=complex, progressive disorder in which the heart is unable to pump sufficient blood to meet the needs of the body.

Symptoms; Dyspnea, Fatigue, Fluid retention.

Also called” Congestive Heart failure (C.H.F)

Action Potential=

Phase 0:Fast Upstroke:

Na+ channels open (fast channel) resulting in afast inward current ……Sodium current is blocked by Quinidine

Phase l: Repolarization:

inactivation of Na+ channel…K+ channels rapidly open & close…outward current

Phase ll: Plateau:

Voltage sensitive Ca++ channels open…Slow inward current(depolarizing)…. Slow outward current (Polarizing) leak of K+

Phase lll: Repolarization

Ca++ channels close…K+ channels open…outward current lead to repolarization… net gain of Na+ & Loss of K+….corrected by Na+/K+-ATPase

Phase lV: Forward Current

Increase depolarization from gradual increase in sodium….bring the cell to Threshold of next action potential.

Cardiovascular drugs heart failure and mcqs interview important points for revision

Angiotensin-Converting Enzyme Inhibitor

Angiotensinogen (α2-globulin in blood)…Renin (in kidney) acton Angiotensinogen & convert into Angiotensin l(inactive)…ACE convert Angiotensin into Angiotensin ll…

MOA=ACEI inhbit ACE and block conversion of Angiotensin l into Angiotensin ll….leads to increase Vasodilation…Decreased output of sympathetic nervous system..

Decrease ALDOSTERONE secretion…decrease retention of Na+ & H2O..

ACEI ϴ degradation of BRADYKININ….Increase level of Bradykinin….vasodilation occur


Actions= decrease PRELOAD & increase AFTERLOAD…increase cardiac output..

T.E= DOC in Left Ventricular Failure & Lowest Ejection Fraction

P.K= food decreases their Absorption…Except for CAPTOPRIL, all are prodrugs…..

Fosinopril only eliminate through Feces, O.D administer

S.E= Hyperkalemia, Dry cough (due to increase level of Bradykinin) , Angioedema,Hypotension, Renal insufficiency

Angiotensin Receptor Blocker

Non-peptide…orally active..Losartan is Prototype..Candesartan have large Vd..

MOA= competitive Antagonist of Angiotensin receptor type 1…complete blockade of Angiotensin action

S.E=same to ACEI...do not produce Cough...Contraindicated in Pregnancy

 β-Blocker

-Ve ionotropic effect, increase systolic functioning …reverse cardiac remodeling...prevent the changes produced by Sympathetic nervous sys..decrease heart rate & inhibition of Renin..

Carvedilol and Metoprolol= mostly used

Diuretics

Relieve Pulmonary congestion and Peripheral edema… reducing Volume Overload & Venous return…decrease O2 demand…Loop Diuretics mostly used

Direct Vasodilator

Dilation of Venous blood vessels…decrease cardiac preload & increase Venous Capacitance

Dilation of Arterials vessels reduce arteriolar resistance & afterload

Nitrates common vasodilator decrease Preload…Hydralazine reduce Afterload

Ca++ channel blocker should be avoided

Inotropic Drugs

+Ve inotropic agentsenhance Cardiac muscle contractility…increase cardiac output…

Digoxin= obtained from Digitalis Glycoside (Foxglove)…..low therapeutic index

MOA= inhibit Na+/K+ exchange by Na+/K+ ATPase….conc. of intracellular Na+ increases..Conc. gradient across the memb decreases… inceased Na+ conc. 

Decreases driving force Na+/Ca++ exchanger…decrease extrusion of Ca++ into extracellular space 

more Ca++ inside the cell for contractility 

Increases Force of contraction increase cardiac output..decrease end-diastolic Volume.. 

increase efficiency of contraction(Ejection-fraction)…improved circulation

T.E= Pt. with Left Ventricular Systolic Dysfunction & HF with atrial Fibrillation….do not indicated in Pt. with Diastolic or Right sided HF…

Dobutamine another Inotropic agent , available as Direct Intra Cardiac inj. 

P.K=t1/2 of Digoxin 36hr, large Vd, accumulate in Muscle…Dosage based on Lean Body Weight…

S.E= decrease COLOR PERCEPTION...Halos on Dark objects...HYPOKALEMIA. 

PhosphoDiesterase Inhibitor= Milrinone & Amrinone inhibit Phosphodiesterase.. 

increase cAMP…increase Ca++… increase cardiac contractility..

Aldosterone Antagonists 

Spiranolactone= direct Antagonist of Aldosterone..prevent salt retention, Myocardial  hypertrophy and Hypokalemia…

Eplerenone= competitive Antagonist of Aldosterone at Mineralocorticoid receptor…

Cardiovascular drugs mcqs screening point and test interview



Comments

Post a Comment

Popular posts from this blog

AGHA KHAN HOSPITAL PAST PAPER FOR PHARMACIST - IMPORTANT POINTS | SOLVED PAST PAPER

-
Image
RIGHT ASNWERS OF TRAINEE PHARMACIST TEST AKUH 2020   1. Solution 2.Diazepam 3.Unbound.  4.Which hypertensive cannot be given in gout? 5. B - blockers ( propranolol, acebutolol, atenolol) 6. Female mosquito. 7. Imipramine. BECAUSE IT IS TCA 8.Filgrastim used in Neutropenia. 9. Anticholinergic poisoning is treated with? (PHYSOSTIGMINE) 10. Morphine antidote? ( NALOXONE) 11. Benzodiazepine antidote? (FLUMAZENIL) 12. Organophosphate antidote? ( PRALIDOXIMINE & ATROPINE) 13. Anoxaperin antidote? ( PROTAMINE) 14. Para sympathetic system is also called Craniosacral sympathetic system is also called thoracolumbar 15. Vagal nerve is Cholinergic. 16.Detail information. 17.Which is not parenteral route of administration? Oral and chewable. 18 BBB is crossed by drug when Inflamed meningitis.  19. Creatinine clearance is determined through GFR. 20. Clearance and plasma drug concentration  21. Diuretics contraindicated in gout? Right answer : THIAZIDE 22. QRS com...
Read more

AKUH PAST PAPER | INTERVIEW AND SCREENING TEST QUESTIONS FOR TRAINEE PHARMACIST WITH REFERENCE AND ANSWER KEY

-
Image
 OTHER PAST PAPERS OF AKUH Pharmacology   1) ______ is used to prevent H1N1 A)Amentadine B)Oselteamivir C)Acyclovire D)Ganciclovir  2) Competitive alters____ and non-competitive inhibitors alters______. A) Efficacy: Potency  B)Potency: Efficacy  C)Efficacy: efficacy  D) Potency: potency 3) ________ fungal infection is very difficult to irradiate. A) Nail B) Scalp C) Skin D) Mucous membrane            4) A 300 mg dose of a drug is given whose t1/2 is 6 months. What is the amount remaining after 2 years (F=1) (hint: exponential elimination) 5) ______ cream 1% is used in burn. A)cortisole B)clotrimazole C) Silver sulfadiazine D)        c is annnnns 6) _____ is used to treate scabies 7) A person allergic to easter type anesthetic, what would you give? A) Tetracain B) Bupivacain C) Procain D) All 8) Rauwolfia alkaloid is/are: A) Raserpine B) ephedrine C) bromocriptine D) All  9) Which prostaglandin is used i...
Read more

COLLIGATIVE PROPERTIES - PHARMACEUTICAL PRINCIPLES AND DRUG DOSAGE FORMS

-
Image
  Colligative properties of solutions are properties that depend upon the concentration of solute molecules or ions, but not upon the identity of the solute. Colligative properties include vapor pressure lowering, boiling point elevation, freezing point depression, and osmotic pressure. Lowering the Vapor Pressure: Let's first remind ourselves about what vapor pressure is and what affects it chemically and physically. In a closed container, a liquid will evaporate until an equal amount of molecules are returning to the liquid state as there are escaping into the gas phase. The pressure of the vapor phase above the liquid at this point is called the equilibrium vapor pressure. This vapor pressure is dependent on a number of factors, including the temperature of the system (kinetic energy is required to help the molecules escape into the gas phase), the pressure of the system (high pressure can keep the gas contained in the liquid e.g. a bottle of coke), and also the intermolecular f...
Read more