Main Points Of Congestive Heart Failure
1 ) Most better drug for congestive heart failure
2) 1ACE Inhibitors. Captopril And Enalapril .
2ACe Also Destroy The Bradykinin
3) when Aldosterone is High it produce fibrosis of the Heart .
4) When Ang 2 Increase It Act As A Growth factors .
5) When Radius of Heart Increase It becomes Globular.
6) Normal Shape Of The Heart is Elliptical
7) ACE Inhibitors Are Given To Those who Have Ejection fraction Is Less Than 35©
8) Captopril Are Active Drugs
9) Other Are Inactive Drugs . Convert In Liver To Active Form
10) All ACE Are Go out of the Body By Kidney except Fasinopril
11) Balance clearance Drug Is Fasinopril It Go Out Through Liver . Kidney
12) Angiotensin acts On , Veins , Artery , Hypothalamus, thirst Center , Zona Glamerulosa , Sympathetic nervous ending
13) Beta blockers Are Not only Reduce Heart Rate But Aslo Reduce The Abnormal function of the Heart . ( cardiac remodeling)
14) Metaprolol Is Long Acting Beta Blockers
16) Carvidalol is Both Alpha And Non selective Beta Blocker
17) NoTe : In many Acute serious CHF beta blockers should not he Given to a Patient Because They Are -ve Inotropic.
18) Thiazide is mild diuretics
19) Loop diuretics Strong Diuretics
20) Action of SA node AV node , Atria and Ventricles depends on calcium .
21) For Any Cell Which undergo contractions 1st it will undergo Electrical stimulations
22) The Calcium which come from the outside of cell are called triggered calcium .
23) These calcium when touch the sarcoplasmic membrane , Alot of calcium released from sarcoplasmic called Calcium spark .
24) During diastolic relaxation the Calcium back absorb by sarcoplasmic reticulum . And the triggered calcium go out from the cell .
25) (Troponin ) tropomyosin the troponin prevent actin and myosin to don't attach with one another, But when calcium spark occur ,it pull the troponin and actine myocine attach and couse contractions of the cell
26) uses of ACE Inhibitors are
1-CHF
2-HTN
3-patient with recent MI
4-Diabetic Nephropathy
5- Diabetic Retinopathy
27) All of ACE -I taken Orally preferably on Empty stomach Because Food retard Its Absorption.
28) Benefits Of ACE -I in Diabetic Nephropathy patients
Decrease Systolic BP
Decrease Glomerular Hypertension
Decrease Ang 2
29) Frank Starling Law
the More you put the more you eject , Mean when ventricle are fill more , they contract more
more you stretch the ventricles , more it contract within physiological limit.
30) Digoxin commonly used
Having shorter Half life --(36 Hrs or 1.5 day )
Shorter action After 20 minutes
Plasma Proteins Binding 30%
clearance By Glomeruli
31 ) Digitoxin half life 5 Days longer action
start action after 60 minutes
plasma Proteins Binding=90%
Clearance by Hepatobillary system
32) +ve ionotropic Drugs Are in 3 Groups
33) What are Positive Ionotropes ?
34) Inotropy : Change in the contraction of Myocardium - positive and Negative
35) Chronotropy: any thing which change the HR Are Positive and Negative
36) Dromotropy : Change in the conductivity of Av Node positive and Negative
37) Bathmotropy : some tissue in myocardium Have Automatism
38) Cleinotropy : increase of Velocity Of Contractions .
39) Lamlos Law
P=T/R T= tension R= Radius
40) pre load : Load in the ventricles before contractions preload= EDV
41) After Load : resistance against which ventricle have to perform post load = resistance
42) Adverse Effects Of ACE -I
CAPTOPRIL Mnemonic
C- Cough ( Dry Cough) Because Bradykinin Not destroyed because ACE are inhibited, The Bradykinin in lungs Couse Cough.
A- Angioedema
P- protein urea
T- taste Change
O- Hypotension
P - pregnancy ( Contraindicated)
R- Rashes
I- increase potassium and Renin
L- Low Ang II and Aldosterone
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ReplyDeletemetoprolol succinate is long acting
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