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Pharmacology Unit 5

Pharmacology Unit 5

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Published by n2biology
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Categories:Types, School Work
Published by: n2biology on Dec 02, 2011
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05/03/2012

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CardiovascularDiseaseis the #1 cause ofdeath in the U.S.,Tx: Sx & mechanicaldevices, Majority ofCV disorders stilltreated w/ medicationsBasic HeartAnatomy -Chambersatria & ventricles,must fxn incoordinated fashionon both sides ofheartBasic HeartAnatomy - ValvesProblems causeinconsistency offlow & potentialheart failure or clotsthatmay result inembolism, heartattack, or stroke.May tx w/ anticoagulantsHeart Physiology -Cardiac electricalconduction system(1) SA node (2) AVnode (3) Bundle ofHis (4) PurkinjesystemWhy is the heartstrength, rate, &rhythm important?The tissue requiresa consistent level ofO2 & nutrientsFast AP in cardiaccellsatrial & ventricularcells, purkinje fibers,also in Bundle ofHisSlow AP in cardiaccellsatrial & ventricularcells, purkinje fibers,SA node & AV nodeAP in cardiac cells -Phase 0RAPIDDEPOLARIZATIONcaused by rapidmovement of Na+ion into the cell thruselectivelypermeable channelsAP in cardiac cells -Phase 1QUICKREPOLARIZATIONTO THE PLATEAUof the AP caused bythe closing of theNa+ ion gate & theactivation of anoutward K+ ioncurrent
 
AP in cardiac cells -Phase 2The PLATEAUPHASE caused bythe activation of theCa++ ion channel(or slow channel)allowing Ca++ ion in& triggering thereleaese of internalCa++ ion.AP in cardiac cells -Phase 3The Ca++ IONCHANNELSCLOSE (deactivate)while the outwardchannels for K+ ionis increasing,COMPLETINGREPOLARIZATION.AP in cardiac cells -Phase 4A SLOW,GRADUALDEPOLARIZATIONdue to a"background" of K+ion movement out &Na+ & Ca++ ions in.AP in cardiac cells -In sinus nodal cells,the current causedby Na+ ion movinginward activates in ashorter time periodthan other cells,allowing sinuscontrol of heartrhythm. This earlyactivation occurs for3 main reasons.(1) During phase 4the nodes showbackground"pacemaker"current. (2) Thenodal cells are ofthe "slow" varietywhich does notdepolarize asrapidly as fast cells& has essentially nophase 2 plateau;repolarizationoccurs soonerreadying the cellsfor the next impulse.(3) Restingmembrane potentialfor the SA node is -60mV instead of the-80 to -90mV inother cardiac cellsso it repolarizessooner.Automaticitycapacity forspontaneous,repetitive self-excitation
 
Automaticity - whereis it found?Chiefly in: SA & AVnode, Bundle of His,& Purkinje systemAutomaticity - howdoes it work?Due, in part, to aslow influx of Na+ &Ca++ ions.Ultimately triggeredby a time-dependent"pacemaker" currentthat opens the Na+ion channels.Automaticity - ratemay be modified byNERVES &HORMONESAutomaticity - Typeof receptorsBoth SA & AVnodes have ß
 adrenergic &muscariniccholinergicAutomaticity - Typeof stimulants(1) Adrenergic
stimulation: ↑ the
background influx of
Na+ & Ca++, ↑ the
rate of the"pacemaker"current. (2) Vagal
stimulation: ↑ K+
efflux whichhyperpolarizes thecellsFunctionalRefractory PeriodTime when heartmay not bestimulated again.AV node limited toabout 200bpm.Explains use ofelectroshock for:Ectopic foci, Circusmovements,FibrillationEctopic fociout of placepacemakers,"escape" beats arelifesaversCircus movementssame impulsetravels around &around (damagedheart does notdepolarizeefficiently, abnormalmovement causedby reentry)

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