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CARDIOVASCULAR – HEART FAILURE1. Digoxina. Causes a decrease in intracellular sodiumb. Causes hypokalaemia in overdosec. Has a half life of 40 hours in a normal patientd. Decreases cardiac outpute. Has no role in the treatment of heart failure2. Digoxina. Does not cross the blood brain barrierb. Hypokalaemia decreases efficacy of digoxinc. Hypomagnesaemia decreases efficacy of digoxind. Antibiotics have effects on digoxine. ?3. Digoxina. Is not very lipid soluble and has a low volume of distributionb. Is extensively metabolized prior to its excretionc. Is highly protein boundd. Has a half-life of 100 hours, thus allowing for once daily dosinge. None of the above are correct4. The electrical effects of digoxin in therapeutic concentrations include:a. The ability to revert atrial fibrillation to normal sinus rhythm in >60% of patients <12 hoursb. No indirect effect (ie. Vagal) upon the Purkinje fibres in the ventriclesc. Increased refractory period at the atrioventricular noded. Increased rate of firing of the sinoatrial nodee. ST segment elevation in the inferolateral segments of the ECG5. Which of the following drugs has no significant interaction with digoxin?a. Quinidineb. Amlodipinec. Verapamild. Warfarine. Thiazide diuretics6. Digoxin exerts its effects upon myocardial muscle at a cellular level bya. Increasing intracellular calciumb. Inducing Na+/K+/ATPase at the cell membranec. Acting as a second messenger for G proteinsd. Acting directly upon actin and myosin filaments to promote contractilitye. Sub-contracting non-union labour and threatening legal action via the high court if the cell doesn’t give into its demands!7. Digoxin Fab antibodiesa. Are used routinely in the management of digoxin toxicityb. Decreases the serum digoxin level in the circulationc. Are commonly associated with tachyarrythmias after administrationd. Take approximately 12 hours to have an effecte. Are metabolized in the liver8. digitalisa. is a positive inotropeb. ?c. ?d. ?e. ?9. The primary mechanism of action of digoxin involves:a. An increase in action potential amplitudeb. An increase in ATP synthesisc. Modification of the actin moleculed. An increase in intracellular Ca2+ levelse. Block of the Na+/Ca2+ exchange10. Regarding pharmacokinetics of digoxina. It is poorly absorbed with oral administrationb. Its renal clearance is increased with renal disesasec. 40% of individuals have enteric bacteria inactivating itd. two thirds of digoxin is excreted by the kidneyse. the enterohepatic circulation contributes to the short half-life11. All of the following may increase the effect of digoxin EXCEPT:a. Amiodaroneb. Frusemidec. Carbamazepined. verapamile. quinidine ................
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