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Pharmacology > cardio drugs > Flashcards

cardio drugs Flashcards

1
Q

name the two types of heart failure

A

dilatative/congestive and hypertrophic cardiomyopathy

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2
Q

groups of antiarrythmic drugs

A
  • Na channel blockers
  • beta receptor blockers
  • potassium channel blockers
  • calcium channel blockers
  • others - digoxin, atropine
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3
Q

I class antiarrythmic drugs

A

Na channel blockers

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4
Q

I A class antiarrhythmic drugs

A
  • quinidine

- procainamide

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5
Q

IB class antiarrhythmic drugs

A

lidocaine, mexiletine,

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6
Q

II class antiarrhythmic drugs

A

beta blockers - 1st and 2nd generation

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7
Q

1st generation beta blockers

A

propanolol

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8
Q

1st gen beta blockers act on which receptors

A

beta1 and 2

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9
Q

2nd gen beta blockers

A

metoprolol, atenolol, esmolol

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10
Q

2nd gen beta blockers act on which receptors

A

beta1

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11
Q

3rd generation beta blockers

A

carvedilol

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12
Q

3rd gen beta blockers act on which receptors

A

beta1 and peripheral+ alpha1

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13
Q

III class antiarrhythmic drugs what are they

A

K channel blockers

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14
Q

III class antiarrhythmic drugs

A

sotalol, amiodarone

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15
Q

IV class antiarrhythmic drugs what are they

A

Ca channel blockers

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16
Q

two types of Ca channel blocker drugs

A
  • dihydropyridine type - vessels

- non dihydropyridine type - heart

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17
Q

dihydropyridine type Ca channel blockers

A

amlodipine, nifedipine

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18
Q

non dihydropyridine type Ca channel blockers

A

verapamil, diltiazem

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19
Q

cause for acute congestive heart failure

A

sudden deterioration of heart pump function

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20
Q

cause for chronic congestive heart failure

A

gradual and slow deterioration in heart pump and function and performance

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21
Q

name three main factors affecting heart performance

A

contractility, preload and afterload

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22
Q

treatment options of chronic heart failure

A
  • incr frequency
  • incr contractility
  • decr preload and afterload
  • inodilators
  • vasoactive substances
  • diuretics
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23
Q

how do we incr frequency in case of chronic heart failure

A

only in life threatening cases! - epinephrine -> pos inotropic and chronotropic -> increases myocardial oxygen demand

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24
Q

what substance could be used to increase contractility

A

digitalis glycosides

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25
Q

decr preoload and afterload what substances could we use

A

ACE inhibitors

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26
Q

inodilators what substances could be used

A

PDE inhibitors - Pimobendan, not only incr contractility but dilation too

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27
Q

what vasoactive substances could we use

A

nitroglycerine

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28
Q

why can diuretics be useful

A

they can decr preload

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29
Q

cardiotonics for use in acute heart failure

A

epinephrine, dobutamine, dopamine

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30
Q

cardiotonics for use in chronic heart failure

A

digitalis glycosides, pimobendan

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31
Q

cardiotonics what do they do to cardiac action

A

pos inotropic -> cardiac output incr

improves RBF -> water and NA excretion

32
Q

how do cardiotonics incr vagal tone

A

neg chronotropic, neg dromotropic

33
Q

digoxin administration

A

orally

34
Q

digoxin is a what

A

digitalis glycoside, cardiotonic

35
Q

digoxin protein binding

A

high when combo with NSAIDs - other drug level v high

36
Q

where does digoxin accumulate in the body

A

myocytes

37
Q

how long should we wait after digoxin admin before measuring plasma level

A

3-5 days

38
Q

how is digoxin excreted

A

kidneys

39
Q

TI digoxin

A

small - hypokalaemia - before applying pls check K levels

40
Q

what does hypokalaemia do to digoxin toxicosis

A

it promotes it

41
Q

what will hypercalcaemia do to digoxin toxicosis

A

promote it

42
Q

digoxin cardiac side effects

A

arrhythmias, bradycardia, hypokalamia

43
Q

digoxin extracardial side effects

A

GI signs, severe vomiting

44
Q

digoxin usage

A

prolong survival time in heart failure, supraventricular tachyarrhythmias

45
Q

digoxin contraindication

A

outflow obstruction eg HCM, stenosis

46
Q

which methylxanthine is also used as an PDE inhibitor

A

theophylline

47
Q

what does pimobendan do to preload and afterload

A

increases them

48
Q

pimobendan mechanisms of action

A

PDE inhibtion -cAMP accumulated in myocytes->Ca conc incr-> pos inotropic
Ca sensitiser
arterial and venous vasodilation

49
Q

when is pimobendan contraindicated

A

outflow obstruction eg HCM, stenosis

50
Q

pimobendan administration route

A

per os

51
Q

should pimobendan be given before or after feeding

A

1hr before, F higher on empty stomach

52
Q

ACE inhibitiors

A

captopril, enalapril, ramipril, benazepril, lisinopril

53
Q

ACE inhibitors mechanism of action

A

blocks renin-angiotnesin system

54
Q

why can you get a dry cough as a side effect of ACE inhibitors

A

bc ACE inhibits bradykinin, so when we block it theres more bradykinin

55
Q

ACE inhibitors pharmacological effects

A
  • arterial vasodilation -> peripheral resistance + afterload decr
  • venodilation -> CVP + preload decr
  • does not alter contractility -> heart performance incr + blood pressure decr
56
Q

indications for ACE inhibitors

A
  • heart failure
  • hypertension
  • proteinuria
57
Q

in which species is heart failure most common

A

dogs, horses

58
Q

in which species is hypertension most common

A

cats but also sometimes dogs

59
Q

how do ACE inhibitors help with proteinuria

A

they vasodilate the efferent vessel-> allows more protein to flow through kidney rather than be filtered into urine

60
Q

another side effect that can happen with use of ACE inhibitors to help with proteinuria

A

azotemia - due to incr amount of proteins(N compounds) in blood

61
Q

ACE inhibitors absorption

A

good when given orally except captopril

62
Q

metabolism of enalapril

A

enalaprilat

63
Q

metabolite of benazepril

A

benazeprilat

64
Q

metabolite of ramipril

A

ramiprilat

65
Q

onset of action ACE inhibitors

A

4-6hrs

66
Q

duration of action ramipril, enalapril

A

12-14hrs

67
Q

duration of action benasepril and lisinopril

A

12-24 hours

68
Q

whats special about the metabolism of lisinopril

A

it has no activation in the liver

69
Q

excretion of ACE inhibitors

A

kidney except benazepril - via kidney or via bile

70
Q

side effects of ACE inhibitors

A
  • azotemia
  • hypotension - tiredness, faintness
  • anorexia, vomiting, diarrhoea
71
Q

benazepril dose

A

0.25-0.5mg/kg SID

72
Q

which ACE inhibitor is best to use in case of kidney insufficiency

A

benazepril - can be metabolised via bile too

73
Q

advantages of using angiotensin II receptor antagonists

A

more effective, no bradykinin activation

74
Q

angiotensin II receptor antagonists

A

losartan, valsartan, telmisartan

75
Q

why dont we use beta blockers in case of heart failure in animals

A

they affect renin

76
Q

ACE inhibitors are often combined with which drugs

A

spironolactone and furosemide

77
Q

how does the action of spironolactone help in heart failure

A

it prevents heart remodelling - its an aldosterone receptor agonist

Pharmacology (23 decks)

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