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Pharmacology > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

1
Q

What drug class does Enalapril belong to?

A

ACE inhibitor

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2
Q

What is the mechanism of action of ACE inhibitors?

A

They prevent conversion of angiotensin I to angiotensin II via blocking angiotensin converting enzyme.

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3
Q

ACE inhibitors include which drugs used in veterinary species?

A

Benazepril, Enalapril

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4
Q

What drug is FDA approved for the treatment of heart failure in dogs?

A

Enalapril

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5
Q

What is the mechanism of action of Spironolactone?

A

Inhibits aldosterone by competitively binding to the receptor site in the distal convoluted tubules.

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6
Q

Adverse effects of spironolactone?

A

Hyperkalemia

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7
Q

Mechanism of action of Telmisartan?

A

Binds to angiotensin 1 receptor to inhibit activity of angiotensin

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8
Q

Effects of Telmisartan?

A

Reduced vasoconstriction and decreased blood pressure

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9
Q

Effects of ACE inhibitors?

A

Prevents vasoconstriction
Prevents the retention of Na+ and H2O
Counteracts hypertension

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10
Q

Effects of spironolactone

A

Increase excretion of Na+
Increase retention of K+

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11
Q

Another term for spironolactone’s drug class?

A

Aldosterone receptor blocker

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12
Q

What is the main effect of Aldosterone?

A

^sodium and chloride reabsorption
^potassium and calcium excretion

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13
Q

The use of spironolactone is contraindicated in what patients?

A

Dogs with hypoadrenocorticism

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14
Q

What drug is FDA approved for the treatment of hypertension in cats?

A

Telmisartan

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15
Q

Contraindications of Telmisartan

A

Pregnant women should avoid contact with the drug

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16
Q

What type of drug is Amlodipine?

A

Calcium channel blocker

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17
Q

Mechanism of action of Amlodipine

A

Inhibit movement of calcium ions through channels across myocardial cell membranes and vascular smooth muscle

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18
Q

Effects of Amlodipine

A

Vasodilation and decreased contractility

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19
Q

Adverse effects of Amlodipine

A

Hypotension, bradycardia, edema

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20
Q

What is the mechanism of action of beta blockers?

A

Blocks beta adrenergic receptors and prevents sympathetic cardiac effects

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21
Q

What are the intended effects of beta blockers?

A

Reduce heart rate and O2 demand of myocardium

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22
Q

What are the adverse effects of beta blockers?

A

Hypotension, decreased cardiac output, bronchospasms

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23
Q

Which beta blocker is used most often in veterinary medicine?

A

Atenolol

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24
Q

Which beta blocker is used in emergency situations?

A

Esmolol

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25
Q

What is atenolol indicated for?

A

Tachyarrhythmia and hypertension

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26
Q

What makes propranolol different from the other beta blocker drugs?

A

It blocks β1 and β2 receptors. The others block only β1

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27
Q

What adverse effect could you encounter if Amlodipine is used in conjunction with Enalapril?

A

Hypotension

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28
Q

Which drug is FDA approved for use in dogs for the management of congestive heart failure due to AV valvular insufficiency or dilated cardiomyopathy?

A

Pimobendan

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29
Q

What is the mechanism of action of pimobendan

A

Vasodilation by phosphodiesterase inhibition
Inotropy via sensitization of troponin to calcium

30
Q

What other drugs do you commonly prescribe with pimobendan?

A

ACE inhibitors, furosemide, spironolactone

31
Q

What region of the nephron does Furosemide directly act upon?

A

Loop of Henle- it is a loop diuretic

32
Q

What is the mechanism of action of furosemide?

A

Inhibit reabsorption of Na+ and Cl- in the ascending loop of Henle

33
Q

What adverse effect may you encounter with the use of furosemide?

A

Hypokalemia

34
Q

What specific use does Furosemide have in horses?

A

Alleviation of exercise induced pulmonary hemorrhage (EIPH)

35
Q

What is the mechanism of action for digoxin

A

Increased inotropy via inhibition of the Na/K pump, thereby increasing intracellular Ca2+ concentration.

Increases pressure sensitivity of baroreceptors in arteries which increases parasympathetic stimulation.

Slow conduction of contractile impulses through AV node

36
Q

Intended effects of digoxin?

A

Increased inotropy, decreased HR

37
Q

Contraindications of digoxin

A

Very narrow therapeutic index

38
Q

Adverse effects of digoxin

A

GI upset, Arrhythmias, heart block

39
Q

Mechanism of action of dobutamine

A

β1 receptor agonist

40
Q

Indicated effects of dobutamine

A

Increased HR and inotropy to increase cardiac output

41
Q

How is dobutamine typically administered?

A

Via CRI due to short half life

42
Q

Hydralazine has what indicated use

A

reduce after load and increase cardiac output via arteriole dilation

43
Q

Adverse effects of hydralazine

A

Hypotension

44
Q

Nitroglycerin is typically administered via

A

Topical routes— ointment

45
Q

Nitroglycerin is a ____ (MOA)

A

Venodilator

46
Q

Indicated use for nitroglycerin

A

Reduce pre load in right sided heart failure and reduce pulmonary edema by reducing pulmonary hypertension

47
Q

Contraindications of nitroglycerin

A

The person applying the drug needs to wear gloves.
This drug is a short term use drug due to rapid development of tolerance.

48
Q

Mechanism of action of clopidogrel

A

Inhibits ADP binding to platelets

49
Q

Indications of clopidogrel

A

Platelet aggregation inhibitor
-may prevent thrombi formation in cats

50
Q

Contraindications for darbepoietin/erythropoietin

A

Antibodies will eventually develop towards this drug when used repeatedly. Darbepoetin is potentially less immunologically reactive.

51
Q

What specific drug is useful for treatment of atrial fibrillation?

A

Diltiazem

52
Q

Diltiazem is a _______

A

calcium channel blocker

53
Q

Intended effects of Diltiazem

A

Vasodilation and decreased cardiac muscle activity

54
Q

Amlodipine is primarily used for its _________ effects, whereas Diltiazem is primarily used for its _______ effects

A

Vasodilation, cardiac

55
Q

What is the mechanism of action of lidocaine used for cardiac disease?

A

blocks influx of Na+ into the cell, thus stabilizing myocardium and preventing depolarization

56
Q

How is lidocaine typically used in the treatment of cardiac problems?

A

It is used IV to control PVCs and treat ventricular tachycardia

57
Q

What is considered the pacemaker of the heart

A

SA node

58
Q

The amount of blood ejected from the left ventricle per unit of time is called

A

Cardiac output

59
Q

The amount of pressure filling the heart is called:

A

Pre load

60
Q

The amount of pressure the heart must work against to empty is called

A

After load

61
Q

An increased afterload has what effects on stroke volume and work of the heart?

A

It decreases SV and increases the work of the heart

62
Q

Increased preload has what effect on stroke volume?

A

Increased

63
Q

What effect does sympathetic nervous system activation have on peripheral circulation?

A

It decreases peripheral circulation

64
Q

The release of renin and production of angiotensin I and II causes

A

Peripheral vasoconstriction

65
Q

Angiotensin II causes

A

Increased blood pressure and the release of aldosterone from the adrenal cortex

66
Q

Aldosterone causes

A

Increased sodium retention and therefore increased fluid retention at the level of the kidneys

67
Q

What are the objectives of drug therapy in heart failure

A

Improve cardiac output
Normalize BP
Maintain tissue perfusion
Minimize workload of the heart
Reduce clinical signs
Provide best possible QOL

68
Q

What problems might arise from long term RAAS activation due to chronic heart failure?

A

Long term Hypertension, which causes kidney disease and kidney failure due to damage to blood vessels and filters in the kidney.

69
Q

How does sympathetic activation affect GFR?

A

Reduce GFR and renal blood flow (while enhancing reabsorption of sodium and water from the tubules)

70
Q

Chronotropy

A

Heart rate

Pharmacology (3 decks)

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