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Flashcards in Cardio XI Deck (21)
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1
Q

What is the cause of the proarrhythmic effect of digoxin?

A

Lower K concentration within myocytes

2
Q

What lab values must be kept an eye on with dig?

A

K

3
Q

What is the half life of digoxin?

A

36-48 hours

4
Q

How long does it take to achieve steady state [digoxin]?

A

7 days

5
Q

What organ is responsible for digoxin clearance?

A

Kidneys

6
Q

What disease can affect the digoxin dosing?

A

CKD

7
Q

What is the bacteria that inactivated digoxin?

A

Eubacterium lentum

8
Q

What is the margin of safety for digoxin?

A

only 5- 10 times minimal effective dose

9
Q

What are the two major adverse effect with digoxin?

A

Hypokalemia and arrhythmias

10
Q

What are the first three symptoms that come about with digoxin overdose?

A

Anorexia
N/v
neuro disturbances

11
Q

What is the major use of digoxin?

A

CHF with AF with RVR

12
Q

Does digoxin improve QOL? All cause mortality? Hospitalization rates?

A

Improves everything, but does NOT improve all cause mortality

13
Q

What are the two drugs to administer to pts with digoxin overdose?

A

cholestyramine

digoxin immune Fab (des IgG) digibind

14
Q

What is the MOA of cholestyramine in digoxin intoxication?

A

Impairs absorption

15
Q

What is the MOA of inamrinone?

A

Phosphodiesterase 3 inhibitors

16
Q

What is the MOA of milrinone?

A

Phosphodiesterase 3 inhibitors

17
Q

What is the MOA of phosphodiesterase inhibitors?

A

Inhibits the degradation of type II phosphodiesterase, which degrades cAMP, maintaining a high Ca level in the cell in response to beta activation

18
Q

What is the MOA of viagra?

A

Blocks phosphodiesterase 5 (that degrades cAMP)

19
Q

What is the overall effect of phosphodiesterase inhibitors?

A

Same as beta blockers

20
Q

When are phosphodiesterase inhibitors indicated?

A

Short term support in advanced CHF

21
Q

What are the three goals that all drugs used in HF aim to achieve?

A
  • Decrease mortality
  • Increase exercise tolerance
  • Increase QOL