Cardiac Medications

Question 1

What calcium channel blocker is a commonly used cardiac medication? What is its mechanism of action? What is its indication for use?

Answer 1

Amlodipine

inhibits calcium entry into smooth muscles + vasodilation

treats systemic hypertension

Question 2

What should be monitored for when using Amlodipine to treat hypertension?

Answer 2

hypotension and bradycardia

Question 3

What ACE inhibitor is a commonly used cardiac medication? What is its mechanism of action? What are 4 indications for use?

Answer 3

Enalapril

blocks angiotensin II formation, causing vasodilation of glomerular efferent arterioles, decreased intraglomerular pressure, and decreased GFR

1. CHF
2. systemic hypertension
3. chronic renal failure
4. PLN

Question 4

What should be monitored for when using Enalapril?

Answer 4

• hypotension
• bloodwork –> renal failure, electrolytes

Question 5

What loop diuretic is commonly used as a cardiac medication? What is its mechanism of action? What are 2 indications for use?

Answer 5

Furosemide

acts in thick ascending loop fo Henle to inhibit reabsorption of Na and Cl

1. CHF to reduce pulmonary edema
2. oliguria, anuria

Question 6

What should be monitored with using Furosemide?

Answer 6

• electrolytes
• azotemia development
• hydration status

advise owners that pet will urinate more and should have access to water at all times

Question 7

What anti-arrhythmic is commonly used as a cardiac medication? What is its mechanism of action? What are 2 indications for use?

Answer 7

Lidocaine

binds to and inhibits voltage-gated sodium channels

1. ventricular tachyarrhythmias
2. local analgesia

Question 8

When should Lidocaine be used cautiously?

Answer 8

• hepatic disease
• hypokalemia = decreased efficacy

Question 9

What is the mechanism of action of Pimobendan (Vetmedin)? What is its indication for use?

Answer 9

calcium sensitizer and selective inhibition of phosphodiesterase (PDE3) = inotropy, vasodilation

adjunctive therapy for treating CHF secondary to DCM or mitral valve disease

Question 10

When is the use of Pimobendan for CHF contraindicated?

Answer 10

• HCM
• use cautiously with arrhythmias

Question 11

What aldosterone competitive antagonist is a commonly used cardiac medication? What is its mechanism of action? What is its indication for use?

Answer 11

Spironolactone

competitively inhibits aldosterone at the distal renal tubules

diuretic used for CHF and nephrotic syndrome

Question 12

What kind of diuretic is Spironolactone?

Answer 12

WEAK competitive aldosterone inhibitor at the distal tubule –> use in combination with more potent diuretics

Question 13

What should be monitored for when using Spironolactone?

Answer 13

potassium levels –> potassium-sparing diuretic, monitor for hyperkalemia