Cardiovascular Flashcards
Drugs that affect the FORCE of myocardial contraction.
Inotropic drugs
Drugs that affect the rate of formation of impulse in SA node.
Chronotropic drugs
Drugs that affect the speed of conduction of impulse through myocardium.
Dromotropic drugs
Drugs that are used to suppress abnormal rhythms of the heart.
Antiarrhythmic drugs
Drugs that dilates arteries and/or veins to improve cardiac output.
Vasodilators
Agents that have both vasodilators and positive inotropic properties
Inodilators
Inotropic Drugs groups
- Cardiac Glycosides
- Sympathomimetics
- Bypyridine derivative (Inodilators)
Drugs under Cardiac Glycosides
- Digoxin
- Digitoxin
Drugs under sympathomimetics inotropic drugs
- Epinephrine
- Isoproterenol
- Dopamine
- Dobutamine
Common inodilator
Pimobendan
Drugs under ACE inhibitors
- Enalapril
- Captopril
- Benazepril
Give 4 other Vasodilators
- Prazosin
- Hydralazine
- Nitrovasodilators
- Calcium blockers
Class 1 Anti-arrhythmic drugs
(Sodium Channel Blockers)
- Subclass 1a
-Quinidine
-Procainamide
-Disopyroramide - Subclass 1b
-Lidocaine
-Phenytoin
-Tocainude
-Maxiletin
-Aprindin - Subclass 1c
-Encainamide
-Lorcainude
-Flecainide
-Profenone
Class 2 Anti-arrhythmic Drugs
Beta Adrenergic Blockers
- Propanolol
- Pindololand
- Timolol
- Metoprolol
- Alprenolol
- Sotalol
- Esmolol
Class 3 Anti-arrhythmic Drugs
(Potassium Channel Blockers)
- Bretylium
- Amiodarone
- Sotalol
- Dofetilide
- Ibutilide
Class 4 Anti-arrhythmic Drugs
Calcium Channel Blockers
- Verapamil
- Diltiazem
- Bepridil
- Nifedipine
- Amlodipine
Phase 4
Resting Membrane Potential
Phase 0
Rapid Depolarization
Note: Inward of Na+
Phase 1
Initial repolarization
Note: Outward K+
Phase 2
Plateau phase
Note:
- Delayed repolarization
- Inward of Ca+ (L-type Channels)
*Not found in pacemaker action potential
Phase 3
Repolarization phase
Note:
-Open K+ channels
-Inactive Ca+ Channels
Slow Response Action Potential
Pacemaker Action Potential
(SA and AV node)
Cardiac Glycosides are drugs derive from what species?
Purple Fox Gloves plant species
Digitalis purpurea
MOA of Cardiac Glycosides as Cardiovascular drug
Reversibly bind to the alpha subunits of the Na+ K+ ATPase pump
T/F
Ouabain can be given orally.
False
It is given only by injection
Drugs for Congestive Heart Failure
Cardiac Glycosides
T/F
Cardiac Glycosides has low margin of safety.
True
Conditions that may lead CHF.
- Cardiomyopathy
- Hypertension
- Valvular Disease
Drug of choice for Supraventricular arrhythmia with concurrent heart failure
Cardiac Glycosides
Most toxic effect of Cardiac Glycosides
Ventricular fibrillation
T/F
K+ can reverse the Digitalis Toxicity
True
T/F
Digitoxin is recommended for cats.
False
Digoxin
MOA of sympathomimetics
Increase cardiac contractility by stimulating B-1 receptors in the heart.
Action of sympathomimetics
- Increase Cardiac output
- Increase Blood Pressure
- Increase Blood Glucose Level
Preparation for Epinephrine solution
1 ml of epinephrine for 9 ml sterile water
0.5 ml of epinephrine for 4.5 sterile water
T/F
Epinephrine has beta activity only.
False
It has Alpha and Beta Activity
Drug use for emergency management of heart failure.
Dobutamine
T/F
Dobutamine is direct B-1 adrenergic agent.
True
Emergency management for Dilated Cardiomyopathy
Dobutamine
MOA of Pimobendan as positive inotropic.
Inhibits phosphodiesterase III activity to reduce the breakdown of cAMP
MOA of Pimobendan as Vasodilator
Inhibits phosphodiesterases III and V in the vascular smooth muscle.
Protein Kinase C is inactivated and Intracellular calcium is decreased causing the dilation.
T/F
Venous dilation reduces afterload.
False
Preload because it venous.
T/F
Arterial vasodilation reduces afterload.
True
Drug indicated for Myxomatous Mitral Valvular Disease (MMVD)
Pimobendan
Effective drug for treating myocardial failure in dog.
Milrinone (Inodilator)
Aside from Pimobendan what other drugs are inodilators
Inamrinone
Milrinone
Types of Vasodilator Drugs
- Balance/ Mix vasodilators
- Arteriolar Vasodilators
MOA of ACE inhibitors
Blocks the enzyme ACE that convert angiotensin I to angiotensin II in the RAAS
Drugs under balance vasodilators - ACE inhibitors
Usually ends with -pril
- Enalapril
- Imidapril
- Benazepril
Effects of Angiotensin II
- Vasoconstriction
- Aldosterone Release (Na+ reabsorption+ K+ wasting)
- ADH secretion (water retention)
=Volume overload and Hypertension
=More Workload
Drug for Chronic management of heart failure
ACE inhibitors
Benazepril and Spironolactone combination
Heart Failure in dogs
Adverse effect of ACE inhibitors
Systemic hypotension
MOA of Nitrovasodilators
Activate the enzyme guanylate cyclase
Drugs that belongs to Nitrovasodilators
- Nitroprusside
- Nitroglycerin
- Isosorbide dinitriate
Arteriolar Vasodilators
- Hydralazine
- Calcium Channel Blockers
MOA of Calcium Channel Blockers
Inhibits L-type calcium channels to suppress Ca++ influx through plasma membrane
Group of Calcium Channel Blockers
- Dihydropyridine
-Amlodipine
-Nifedipine - Nondihydropyridine
-Diltiazem
-Verapamil
Define Flutter
Very rapid but regular contractions
Define Fibrillation
Disorganized, irregular, unsynchronized contractile activity
Defines as the automatic or spontaneous depolarization of pacemaker cells
Automaticity
Causes of Arrhythmias
- Altered automaticity
- Disturbance of impulse conduction
Abnormal heart rhythm where the heart beats too slowly
Heart block
Diagnose of Arrhythmias is done through what?
- Auscultation
- Electrocardiography
Treatment for Bradyarrhythmias
- Atropine
- Propantheline bromide