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Pharmacology Test 2 > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

1
Q

What are cardiac stimulants used to treat?

A

Cardiogenic shock

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2
Q

Beta 1 agonists are cardiac stimulants - list them in order of most potent to least.

A

Isoproterenol
Epinephrine
NE
Dopamine - safest

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3
Q

What is an example of a phosphodiesterase inhibitor that is a cardiac stimulant?

A

Aminophylline

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4
Q

T/F. Cardiac stimulants are positive chronotropes and positive inotropes.

A

True

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5
Q

What are the 4 big effects of CHF?

A

1) increased SNS (catecholamine release stimulated, increased heart rate, arrhythmias, vasoconstriction)
2) increase RAAS (angiotensin II - retain sodium and water - edema.)
3) increase ADH (more edema)
4) myocardial hypertrophy (heart is working really hard to pump blood)

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6
Q

T/F. In CHF, there is too much blood in the body.

A

False. The volume is adequate but it is not being distributed properly.

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7
Q

What are some ways to treat CHF without drugs?

A
  • decrease sodium intake

- decrease exercise

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8
Q

What is an example of a positive inotrope used to treat CHF? Route of administration?

A

Digitalis/Digoxin

per os, IV

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9
Q

How does Digitalis work?

A

increases calcium concentration in the myocardiocytes by inhibiting NaK ATPase and increasing sodium to exchange for Ca –> this gives heart more energy to contract

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10
Q

What is Digitalis used to treat? Why isn’t it used much anymore?

A
  • CHF and atrial arrhythmias in dogs

- narrow safety margin

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11
Q

What would you use in a case of Digoxin toxicity?

A

Digibind

fluorescent AB that binds to Digoxin in the blood so that it cannot be absorbed

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12
Q

As positive inotropes, when are Dopamine and Dobutamine used?

A

in emergencies –> 1 dose!

injection

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13
Q

What are 2 examples of injectable inodilators?

A

Inamrinone

Milrinone

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14
Q

Which is the most commonly used inodilator? Route of administration?

A

Pimobendan

oral

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15
Q

What is Pimobendan used for?

A

Treat CHF in DOGS (due to dilated cardiomyopathy of chronic degenerative valvular disease)

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16
Q

How does Pimobendan work?

A

sensitizes the heart to Ca by enhancing the interaction between Ca and troponin C

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17
Q

When should you NOT use Pimobendan?

A
  • if you can’t increase the CO (i.e., d/t physical abnormalities)
  • hypertrophic cardiomyopathy
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18
Q

T/F. ACE inhibitors are vasodilators.

A

True!

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19
Q

When would you use an ACE inhibitor?

A

-treat CHF in dogs

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20
Q

What are some examples of ACE inhibitors? Which is used in the US?

A

Enalapril, Benazapril, Captopril

US: Enalapril

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21
Q

Which diuretics are best to use to treat CHF? Why?

A
  • Potassium sparing diuretics
  • because you don’t want to add a K imbalance (like with loops and thiazides) since the heart is already having problems
  • also these drugs antagonize Aldosterone and stop the potential issue with RAAS d/t CHF
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22
Q

Which diuretics should you NOT use with CHF?

A

osmotics (used for LOCALIZED edema)

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23
Q

Which beta blocker is best to use for CHF?

A

Carvedilol (nonselective Beta and alpha 1 blocker) - inhibits renin in RAAS

  • prolongs lifespan of heart failure patients
  • used in early CHF to block harmful SNS effects on heart
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24
Q

T/F. Oxygen and nebulizer can be considered drug treatments for CHF.

A

True

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25
Q

What is an arrhythmia?

A

An abnormality in the heart rate and rhythm

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26
Q

What are some causes of arrhythmia?

A
  • innervation imbalance (psns vs sns)
  • electrolyte imbalance (K, Ca, Mg)
  • hypoxemia
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27
Q

Sodium channel blockers are class ___ antitachyarrhythmics.

A

I

28
Q

What do antitachyarrhythmic class IA do and which drugs does the class include? IB? IC?

A

IA - prolongs AP - Quinidine
IB - shortens AP - Lidocaine
IC - not important

29
Q

T/F. Class I antitachyarrhythmics can affect both atria and ventricles, but MOSTLY does atria.

A

FALSE. Mostly does ventricle

30
Q

What is Quinidine used to treat? What antitachyarrhythmic drug class does it belong to?

A

-ventricular arrhythmias
ATRIAL FIBRILLATION IN HORSES
Class IA

31
Q

What is Lidocaine used for? What antitachyarrhythmic drug class does it belong to?

A
  • drug of choice for ventricular arrhythmias d/t anesthesia/surgery
  • Class IB
32
Q

What is Phenytoin used for? What antitachyarrhythmic drug class does it belong to?

A
  • treat digitalis-induced arrhythmias in dogs

- Class IB

33
Q

Which Class II antitachyarrthmic drug is used to treat sudden onset supra ventricular tachycardia?

A

Propanolol

34
Q

Which type of tachyarrhythmias do Beta Blockers treat?

A

supra ventricular and ventricular

35
Q

What is Bretylium used for? What antitachyarrhythmic drug class does it belong to?

A
  • treat recurrent tachyarrhythmias that do not respond to other drugs –> usually used just by cardiologists
  • Class III
36
Q

What are Verapamil and Diltiazem used for? What antitachyarrhythmic drug class does it belong to?

A
  • treat supra ventricular tachyarrhythmias, myocardial hypertrophy in cats
  • Class IV
37
Q

Which Antitachyarrhythmic drugs only treat atrial arrhythmias?

A

Class IV

38
Q

What are the MOA of the 4 classes of antitachyarrhythmic drugs? An examlple of each? What type of arrhythmias they are used for?

A

Class I: Na channel blockers (IA: prolong AP, Quinidine, supra ventricular and ventricular; IB: shortens AP, Lidocaine/Phenytoin, ventricular)
Class II: Beta blockers, Propanolol, supraventricular and ventricular
Class III: K-channel blockers, Bretylium, ventricular (mainly)
Class IV: Ca-channel blockers, Verapamil/Diltiazem, supraventricular

39
Q

What are the main drugs you would use to treat atrial tachyarrhythmias?

A

Digoxin, Ca-channel blockers

40
Q

What is the main drug you would use to treat ventricular tachyarrhythmia?

A

Lidocaine

41
Q

What is the drug of choice to treat supra ventricular and ventricular tachyarrhythmias in CATS?

A

beta blockers

42
Q

Which drugs are used to treat bradyarrhythmias? Which degrees of bradyarrhythmia?

A

1) Incomplete AV block: Atropine or Isoproterenol
2) Sinus bradycardia: Atropine or Isoproterenol
3) Complete AV block: epinephrine

43
Q

Your patient has an incomplete AV block causing bradyarrhythmia and also has low blood pressure, which drug should you treat them with?

A

Atropine

NOT Isoproterenol because of the low BP (has strong B2 effects)

44
Q

What are the #1, #2, and #3 vasoconstrictors?

A

1- phenylephrine (selective alpha 1 agonist)
2 - NE (nonselective alpha agonist)
3 - Epinephrine (nonselective alpha agonist)

45
Q

What direct and indirect sympathomimetics are vasoconstrictors?

A

ephedrine
pseudoephedrine
phenylpropanolamine (PPA)

46
Q

When should you use nonselective alpha blockers as vasodilators?

A

emergency hypertension - 1 dose

penotalmine, phenoxybenzamine

47
Q

Selective alpha blocker: ________

Vasodilator or Vasoconstrictor?

A

Prazosin

vasodilator

48
Q

Presynaptic alpha 2 agonist: ______________

does it increase or decrease BP?

A

Clonidine

decreases BP

49
Q

Nonselective Beta locker used as a vasodilator

A

Propanolol

50
Q

A beta and alpha 1 blocker that is used as a vasodilator

A

Carvedilol

51
Q

A selective beta1 blocker used as a vasodilator

A

Atenolol

52
Q

Which ACE inhibitor is available in the USA?

Is it long or short acting?

A

Enalapril

short acting

53
Q

What is the route of administration for ACE inhibitors?

A

oral or injectable

54
Q

What are ACE inhibitors used to treat?

A

CHF
long term hypertension
chronic renal insufficiency

55
Q

What are some adverse effects of ACE inhibitors?

A

hypotension
decreased GFR
Captopril may cause idiosyncratic glomerular disease in some dogs

56
Q

What is Losartan?

A

an angiotensin II antagonist

57
Q

T/F. Hydrazine only dilates arteries.

A

True

58
Q

What are 2 direct acting vasodilators?

A

Hydralazine

Nitrates (make NO)

59
Q

Verapamil, Diltiazem, Amlodipine, Nifedipine are…

A

Calcium channel blockers

60
Q

How do calcium channel blockers act on blood vessels?

A

direct vasodilators by inhibiting myocardial contraction

61
Q

Verapamil is a (+/-) chronotrope and a (+/-) inotrope.

A

negative chronotrope

negative inotrope

62
Q

What are calcium channel blockers used to treat?

A

tachyarrhythmia
hypertension
myocardial hypertrophy (Ditiazem)
antianginal

63
Q

Which drugs are best to use for treating hypertension in cats that do NOT have hyperthyroidism?

A

Calcium channel blockers (verapamil, diltiazem, amlodipine, nifedipine)

64
Q

Which drugs should you use to treat a hypertensive cat with hyperthyroidism?

A

Beta blockers

65
Q

Which calcium channel blocker is the best to treat myocardial hypertrophy?

A

Dilitiazem

66
Q 
Systolic and Diastolic
Which do...
Beta blockers treat?
Calcium channel blockers treat?
ACE inhibitors treat?
A

B-blockers: systolic and diastolic
Ca channel blockers: systolic and diastolic
ACE inhibitors: diastolic ONLY

Pharmacology Test 2 (6 decks)

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