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Pharmacology I > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

1
Q

Drugs used to tx CHF

A 
\+ inotropes
vasodilators
inodilators
diuretics
B blockers
Other agents in emergency
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2
Q

Positive inotropic drugs

A

Digitalis glycosides

B1 agonists

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3
Q

Mechanism of Action for Digitalis and B1 Agonists

A

Inhibition of NaKAtpase in myocardial cell membrane increases Na available for exchange with Ca
Results in increase in intracellular Ca which results in a + inotropic effect

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4
Q

Cardiovascular effect of Digitalis/B-1 Agonists

A

+ inotropic effect
Reduction in sinus rates/slow AV conduction
Prolonged PR in ECG
Increased mechanical efficiency of the failing heart
Normalization of blood pressure and peripheral resistance

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5
Q

Pharmacokinetics of Digitalis and B-1 Agonists

A

oral or slow IV in emergency
oral bioavailbitiy is more for elixir 75% than tablet 60%
half life depends on species, avg ~ 24 hrs
Small amount metabolized in liver
Undergoes enterohepatic recyclin
Excretion- renal in dogs and horses, renal and hepatic in cats

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6
Q

Theraputic uses of Digoxin and B-1 agonists

A

CHF

Atrial arrhythmias only in dogs

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7
Q

Toxcitiy with Digitalis/B-1 agonists

A 
Digitalis has a narrow safety margin
Cats more sensitive than dogs
Cardiac toxicity
GI toxcity
Other toxicity: hyperkalemia, chronic=hypokalemia
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8
Q

What are the ACE inhibitor drugs?

A

Captopril, enalipril, lisinopril, benzapril

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9
Q

How do ACE inhibitors work?

A

Block RAAS leading to vasodilation

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10
Q

What are the Inodilator drugs?

A

Pimobenden

Phosphodiesterase inhibitors- amrione, milrinone

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11
Q

How does Pimobenden work?

A

Sensitizes cardiac contractile apparatus to Ca by enhancing interaction between Ca and troponin C complex
May increase cardiac contractility and causes vasodilation by inhibiting PDE III and

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12
Q

What are the B blocker drugs ?

A

Carvediol

Metoprolol and Atenolol

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13
Q

What is the mechanism of action for Carvedilol? When is it used?

A

nonselective B blocker and a-1 blocker

used in early tx of CHF due to dilated cardiomyopathy to blunt the harmful effects of the SNS on the heart

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14
Q

Other agents to tx CHF?

A

Oxygen therapy
Morphine sulfate
Aminophylline-single dose inodilator
nebulization of ethanol (20%) antifrothing

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15
Q

Cardiac Stimulants

A

B1 agonists-epi/norepi, isoprotenerol, dopamine
Phosphodiesterase inhibitos- aminophylline
Glucagon
Ca salts

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16
Q

Pimobenden uses

A

tx CHF dogs
adjunctive therapy for dogs with dilated cardiomyopathy and chronic degenerative valvular dz
Can be used with furosemide, spironolactone or ACE in heart failure patients

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17
Q

Side effects of Pimobenden

A

Les arrhythmogenic than digitalis but may cause diarrhea, vomiting, inappetence, seizures and pu/pd

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18
Q

Pimobenden contraindications

A

don’t use in hypertrophic cardiomyopathy or clinical conditions where increase of cardiac output is not physically possible

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19
Q

Pharmacokinetics of Pimobenden

A

rapid oral absorption, 60% bioavailability
metabolically activated in liver
metabolites are excreted in feces with a half life of 2 hours
bound to plasma protiens

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20
Q

Vasodilators used for CHF

A

ACE inhibitors (drug of choice- Enalapril)
Hydralazine
Nitrates
Prazosin

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21
Q

Diuretics used in CHF

A

Furosemide
Hydrochlorothiazide, chlorothiazide
Spironolacton, tramterene, amiloride

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22
Q

Classification of Antiarrhythmic drugs

A

Class I- Na channel blockers
Class II- B blockers
Class III- Agents that prolong action potential duration (potassium channel blockers)
Class IV- Ca++ channel blockers

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23
Q

Drugs in Class IA

A

Quinidine

Procinamide

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24
Q

What is the drug of choice to tx atrial fibrulation in horses?

A

Quinidine

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25
What is the drug of choice to tx ventricular tachycardia/tachyarrhythmias in dogs?
Lidocaine
26
What do Class I B drugs do and what are they?
Class I B drugs shorten action potential and are only ventricular Lidocaine Phenytoin Mexiletine
27
Class II B blockers
Propanalol | Atenolol
28
What are Class IV Antiarrythymics and what do they do?
Verapamil Diltiazem Ca channel blockers, only supraventricular
29
Therapeutic use of Procainamide?
more effective for ventricular arrhythmias than atrial
30
What is the drug of choice for ventricular arrhythmias due to general anesthetics, sx, ischemia, and trauma? What species? Why can't you give it orally?
Lidocaine IV Only in dogs Systemic first pass effect
31
Why would you give Phenytoid IV
Digitalis-induced arrhythmias in dogs only
32
What drugs would you give to tx SVTs- atrial tachycardia in dogs?
Digoxin Procainamide, propanolol Quinidine, phenytoin
33
What drugs would you give to tx SVTs, atrial flutter in dogs?
Digoxin | Quinidine, procanimide, propanolol
34
What drugs would you give to tx SVT, atrial fibrillation in dogs?
Digoxin Propanalol Quinidine, procainamide
35
What is the drug of choice for both supraventricular and ventricular tachyarrhythmias in cats?
B blockers
36
Tx of ventricular tachyarrhythmias, VPCs in dogs?
Quinidine, procainamide, lidocaine phenytoin propanolol
37
Drugs that tx Ventricular tachycardia in dogs?
procinamide, lidocaine quinidine, phenytoin propranolol
38
Antiarrhythimic drugs for brady arrhythmias
Atropine Isoproterenol Epinephrine
39
Tx of Sinus bradycardia
atropine | isoproterenol
40
Tx for 2nd degree AV block?
Atropine Isoproterenol Glucagon
41
Drug of choice to tx incomplete AV block
atropine
42
Drug to tx cardiac asystole (cardiac resuscitation)
Epinephrine
43
Vasoconstrictors
nonselective a agonists: epinephrine, norepinephrine selective a1 agoinist: phenylephrine direct and indirect sympathomimetics: ephedrine, pseudoephedrine, PPA
44
Vasodilators
``` sympatholytic ACE inhibitos Angiotensin II antagonists Direct acting vasodilators Ca channel blockers ```
45
Prazosin is a
selective a1 blocker, sympatholytic vasodilator
46
What are the ACE inhibitor drugs?
Enalapril | Benazepril
47
MoA for Ace Inhibitors
Inhibition of angiotensin converting enzyme Inhibition of angiotensin II synthesis Inhibition of aldosterone Reflex increase in renin Increased bradykinin level (vasodilator and stimulated PGs- also vasodilators)
48
Therapeutic uses of ACE inhibitors
CHF- drug of choice Hypertension- drug of choice in dogs Chronic renal insufficiency in cats
49
ACE inhibitor Pharmacokinetics
Enalapril oral and parenterally but others only oral enalapril slow onset and long duration (compaired with captopril) benazepril long acting enalapril activatd in the liver benazeprili least likely to require dosage modification in renal failure patients because of significan excretion in bile 50%
50
Adverse effects of ACE inhibitors
hypotension | lower intraglomerular pressure decreasing GFR with animals with systemic hypertension and azotemia
51
Direct acting vasodilator
Hydralazine
52
MoA of Hydralazine
increases local conctrations of PGl2 May be inhibiting Ca influx into smooth muscles of arteries alteration of phosphorylation of proteins in smooth muscle and dephosphorylation of myosin light chain relaxation of smooth muscle of blood vessels
53
Amlodipine what is at and MoA?
Ca channel blocker Inhibits influx of extracellular Ca across myocardial and smooth muscle cell membranes The decrease in intracellular Ca inhibits myocardial contraction and results in dilation of the coronary and systemic arteries
54
Ca Channel block pharmacological effects on the heart
``` neg inotrope neg chronotrope increase o2 delivery to myocardial tissue decrease afterload coronary vasodilation ```
55
Ca channel blockers affect on blood vessels
decrease peripheral resistance | decrease systemic blood pressure
56
Ca Channel Blockers Therapeutic uses
Antiarrthymic Antihypertensive Myocardial hypertrophy Antianginal
57
Adverse effects of Ca Channel blockers
bradycardia and av block hypotension GI side effects elevated liver enzymes
58
Drug of choice for hypertension in dogs cats hyperthyroid cats
ACE inhibitors Anopholine B blockers
59
Emergency tx of Hypertension
hydralazine or Na nitroprusside IV Propraolol or acepromazine IV Phentolamine IV Oral Ca channel blockers, prazosine, or ACE inhibitors
60
Drug of choice for Pheochromocytoma induced hypertension?
Phenoxybenzamine

Pharmacology I (16 decks)

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