Cardiovascular modulators

Question 1

What are the compensatory mechanisms of cardiac disease?

Answer 1

Activation of sympathetic nervous system

Renin-angiotensin-aldosterone system (RAAS)

Question 2

How does the sympathetic nervous system affect cardiac disease?

Answer 2

Increases HR and contractility - beta receptors

Vasoconstriction - alpha receptors

Question 3

How does the renin-angiotensin-aldosterone system (RAAS) affect cardiac disease?

Answer 3

Increased water retention
Increased blood volume - preload
Vasoconstriction - afterload

Question 4

What is the main loop diuretic drug?

Answer 4

Furosemide

Question 5

What do loop diuretics (furosemide) act on?

Answer 5

Inhibit NaKCl symport at the loop of henle

Question 6

What effect do loop diuretics have on the body?

Answer 6

Inhibit resorption of Na
VASODILATION
Activate RAAS
Reduces preload Stabilises

Question 7

What is a side effect of loop diuretics?

Answer 7

Extreme loss of electrolytes

Question 8

What is an alternative to furosemide?

Answer 8

Torasemide

Question 9

What is the main drug of thiazide diuretics?

Answer 9

Hydrochlorothiazide

Question 10

What do thiazide diuretics act on?

Answer 10

Inhibit KCl symport at distal convoluted tubule

Question 11

What effect do thiazide diuretics have on the body?

Answer 11

Inhibit resorption of Na but increase K excretion

Question 12

What are side effects of thiazide diuretics?

Answer 12

Hypokalaemia

Hypercalcemia

Question 13

What is the main potassium-sparing diuretic 1 drug?

Answer 13

Spironolactone

Question 14

What do potassium-sparing diuretics 1 act on in the body?

Answer 14

Mineralocorticoid receptor inhibiting aldosterone

Question 15

What effect do potassium-sparing diuretics 1 have on CHF?

Answer 15

Acts on myocardium to inhibit aldosterone-mediated fibrosis and remodelling
ANTI-REMODELLING
Weak diuretic effect

Question 16

What are the side effects of potassium sparing diuretics 1?

Answer 16

Hyperkalaemia
Hyponatremia
Reduced ECF volume

Question 17

What is the main potassium-sparing diuretic 2 drug?

Answer 17

Amiloride

Question 18

What do potassium-sparing diuretics 2 act on in the body?

Answer 18

Inhibit renal epithelial sodium channel

Question 19

What effect do potassium-sparing diuretics 2 have on CHF?

Answer 19

Inhibit NaCl resorption, stimulate K+ retention

Question 20

What are the side effects of potassium sparing diuretics 2?

Answer 20

Hyperkalaemia

Question 21

What are carbonic anhydrase inhibitors used for?

Answer 21

Glaucoma

Question 22

What are osmotic diuretics (mannitol) used for?

Answer 22

Increased intracranial pressure

Question 23

What is the main positive inotropic drug?

Answer 23

Pimobendan

Dobutamine

Question 24

What method of action does pimobendan/positive ionotropic drugs have?

Answer 24

Sensitises troponin to calcium - increases CONTRACTILITY

Vasodilation

Question 25

What is pimobendan used for?

Answer 25

Congestive heart failure
Mitral valve disease
Dilated cardiomyopathy

Question 26

What is dobutamine used for?

Answer 26

Severe CHF with hypotension

Question 27

What is the main RAAS modulator?

Answer 27

Benazepril

Question 28

What are RAAS modulators mode of action?

Answer 28

ACE inhibitors
Reduce preload/afterload***
Anti-remodelling
Anti-adrenergic

Question 29

What are the side effects of ACE inhibitors?

Answer 29

Azotemia, hyperkalaemia, hypotension

Question 30

What is the main beta blocker?

Answer 30

Atenolol

Question 31

What mode of action do beta blockers have?

Answer 31

Reduce HR and Contractility – reduce tachycardia and arrhythmias

Question 32

When are beta blockers used?

Answer 32

Obstruction of ventricular outflow

Question 33

What are the 4 main drugs for congestive heart failure?

Answer 33

Furosemide
Spironolactone
Pimobendan
Benazepril

Question 34

What drug is used just for vasodilation?

Answer 34

Hydralazine