Question 1

Cardiac glycosides such as digitalis are used to treat heart failure because these drugs exert:&#10;A)a positive inotropic effect.&#10;B)a negative inotropic effect.&#10;C)a positive dromotropic effect.&#10;D)a negative dromotropic effect.&#10;E)a positive chronotropic effect.

Accepted Answer

Cardiac glycosides such as digitalis exert a positive inotropic effect, which means they increase the force of contraction of the heart muscle. This can be beneficial in treating heart failure, as it can improve cardiac output and reduce symptoms such as shortness of breath and fatigue.

Question 2

Digitalis exerts its primary mechanical effect by _____ the sodium-potassium pump on the myocardial cell membrane,which leads directly to _____ in intracellular sodium concentration.&#10;A)stimulating;an increase&#10;B)inhibiting;an increase&#10;C)stimulating;a decrease&#10;D)inhibiting;a decrease&#10;E)none of the above;digitalis does not affect the sodium-potassium pump

Accepted Answer

Digitalis inhibits the sodium-potassium pump on the myocardial cell membrane, leading to an increase in intracellular sodium concentration.

Question 3

Digitalis may exert some of its beneficial effects by decreasing heart rate via a(n)_______ in _______ stimulation of the heart.&#10;A)increase;parasympathetic&#10;B)decrease;sympathetic&#10;C)increase;sympathetic&#10;D)decrease;parasympathetic&#10;E)A and B

Accepted Answer

A and B

Question 4

Angiotensin converting enzyme (ACE)inhibitors are often essential in treating heart failure because ACE inhibitors:&#10;A)stimulate renin production from the kidneys.&#10;B)increase heart rate.&#10;C)prevent the detrimental effects of epinephrine on the failing heart.&#10;D)may increase life expectancy in people with heart failure.&#10;E)all of the above

Accepted Answer

ACE inhibitors may increase life expectancy in people with heart failure by preventing the progression of heart failure, reducing hospitalizations for heart failure, and improving symptoms. They do not stimulate renin production or increase heart rate, but they do prevent the detrimental effects of angiotensin II on the failing heart, which includes reducing vasoconstriction and aldosterone secretion.

Question 5

In people with heart failure,the best drugs for reducing fluid accumulation and congestion in the lungs and peripheral tissues are:&#10;A)alpha blockers.&#10;B)beta blockers.&#10;C)angiotensin II receptor blockers.&#10;D)calcium channel blockers.&#10;E)diuretics.

Accepted Answer

In people with heart failure, diuretics are the best drugs for reducing fluid accumulation and congestion in the lungs and peripheral tissues. These medications work by increasing urine output, which helps to eliminate excess fluid from the body. This can reduce swelling in the legs, ankles, and feet and make it easier for the heart to pump blood. Diuretics are often used in combination with other medications, such as ACE inhibitors or beta blockers, to effectively manage heart failure symptoms.

Question 6

The primary cardiac problem in digitalis toxicity is:&#10;A)decreased coronary blood flow.&#10;B)increased coronary oxygen demand.&#10;C)decreased cardiac intracellular sodium concentration.&#10;D)arrhythmia.&#10;E)isolated systolic hypotension.

Accepted Answer

The primary cardiac problem in digitalis toxicity is the development of arrhythmia. This can include various rhythms such as atrial fibrillation, premature ventricular contractions, and more dangerous rhythms such as ventricular tachycardia and fibrillation. Other cardiac effects may include decreased cardiac output and decreased conduction velocity. However, arrhythmia is the most significant cardiac problem.

Question 7

Digitalis and other cardiac glycosides increase the mechanical pumping ability of the heart by bringing about an increase in _________ concentration.&#10;A)extracellular potassium&#10;B)intracellular potassium&#10;C)extracellular calcium&#10;D)intracellular calcium&#10;E)extracellular sodium

Accepted Answer

Cardiac glycosides such as digitalis work by inhibiting the sodium-potassium ATPase pump, which leads to an accumulation of intracellular sodium. This increase in intracellular sodium ultimately leads to an increase in intracellular calcium, which in turn enhances the mechanical pumping ability of the heart. Therefore, the best choice is D, intracellular calcium.

Question 8

In people with heart failure,the best drugs for reducing excessive sympathetic stimulation of the failing heart are:&#10;A)alpha blockers.&#10;B)beta blockers.&#10;C)angiotensin II receptor blockers.&#10;D)calcium channel blockers.&#10;E)diuretics.

Accepted Answer

Beta blockers are the best drugs for reducing excessive sympathetic stimulation of the failing heart. They reduce the heart rate and contractility, thereby reducing oxygen demand and improving cardiac function. Alpha blockers, angiotensin II receptor blockers, calcium channel blockers, and diuretics may have some beneficial effects in heart failure, but they are not as effective as beta blockers in reducing sympathetic stimulation.

Question 9

Phosphodiesterase inhibitors such as inamrinone (generic)and milrinone (Primacor)may help increase myocardial contraction in heart failure by ______ the breakdown of cyclic adenosine monophosphate (cAMP),which leads to a(n)______ in calcium in cardiac cells.

A)inhibiting;increase
B)stimulating;increase
C)inhibiting;decrease
D)stimulating;decrease
E)none of the above;these drugs do not affect cAMP concentrations in cardiac cells

Accepted Answer

Phosphodiesterase inhibitors work by inhibiting the breakdown of cAMP, leading to increased cAMP levels, which enhances calcium influx into cardiac cells, thereby increasing myocardial contraction.

Question 10

All of the following types of drugs will decrease cardiac workload in people with heart failure EXCEPT:&#10;A)angiotensin converting enzyme (ACE)inhibitors.&#10;B)beta blockers.&#10;C)alpha-1 stimulants.&#10;D)vasodilators.&#10;E)diuretics.

Accepted Answer

Alpha-1 stimulants are not used to treat heart failure as they increase cardiac workload. The other options listed all decrease cardiac workload in people with heart failure.

Deck 24: Treatment of Congestive Heart Failure