Anesthesia Pharmacology Practice Questions: Congestive Heart Failure

Concerning arteriovenus vasodilation and congestive heart failure with reduced ejection fraction, choose the correct statement(s):
1. Increased survival in heart failure with reduced ejection fraction has been demonstrated with combined hydralazine and nitrate treatment.
2. Hydralazine decreases systemic vascular resistance well inducing arterial vasodilation. The underlying mechanism relates to changes in intracellular calcium kinetics.
3. Improved survival as a result of treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists appears greater than the combination of nitrates and hydralazine regimens.
4. A & B
5. A & C
6. A,B & C
For heart failure patients with reduced ejection fractions unable to tolerate treatment based on the renin-angiotensin-aldosterone system, the combination of nitrate + hydralazine may offer a reasonable alternative.
1. True
2. False
Ivabradine reduces heart rate without negative inotropic effects. This drug , and inhibitor of the SA nodal If current, may prove useful in managing heart failure with reduced ejection fraction, pending further clinical research.
1. True
2. False
Digoxin, a cardiac glycoside, exhibits which one(s) of the following properties?
1. Digoxin inhibits sarcolemmal sodium, potassium-ATPase, resulting in reduced cytosolic sodium
2. Digoxin reduces cardiac automaticity and increases diastolic resting membrane potential in both atrial and atrioventricular nodes.
3. Digoxin extends the effect refractory. And reduces AV nodal tissue conduction velocity. These effects on nodal tissue may result in sinus bradycardia,, sinus arrest, or AV block.
4. A & B
5. B & C
6. A, B & C
Effects associated with high cardiac glycoside concentrations include:
1. Induction of atrial and ventricular arrhythmia
2. Increasing rates of diastolic depolarization (increased automaticity)
3. Predisposition to malignant ventricular arrhythmias
4. All of the above
Contemporary clinical trials have validated the use of cardiac glycosides as first-line agents in congestive heart failure treatment.
1. True
2. False
Which one(s) of the following drugs may be helpful for short-term circulatory support in advanced congestive heart failure?
1. Dopamine
2. Dobutamine
3. Both
4. Neither
Dopamine, and endogenous catecholamine, is of limited usefulness in treating most patients with cardiogenic circulatory collapse/failure.
1. True
2. False
Dobutamine neously ß-adrenergic receptor agonist of choice for managing CHF patients with systolic dysfunction. Dobutamine activates both ß1 and ß2receptor subtypes.The major dobutamine hemodynamic effect is manifest in elevated stroke volume secondary to positive inotropic activity.
1. True
2. False
Dobutamine side effect(s):
1. Bradycardia
2. Ventricular arrhythmia
3. Both
4. Neither