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Clinical Pharmacology > Cardiovascular Pharmacology > Flashcards

Cardiovascular Pharmacology Flashcards

1
Q

what is stage A of congestive heart failure?

A

patients at risk: breed predisposition
no clinical signs

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2
Q

what is stage B of congestive heart failure?

A

pre-clinical, asymptomatic heart disease

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3
Q

what is stage C of congestive heart failure?

A

patients with past or current clinical signs of heart failure associated with structural heart disease

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4
Q

what is stage D of congestive heart failure?

A

end-stage heart failure

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5
Q

what dose should you not exceed in acute therapy with furosemide?

A

8 mg/kg over 4 hr

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6
Q

what is the immediate effect of furosemide related to?

A

prostaglandin-dependent venodilation

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7
Q

what can ACE inhibitors do with furosemide?

A

may enhance effects of furosemide and necessitate a decrease in dose of furosemide

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8
Q

what can you use in acute IV therapy for increasing inotropy?

A

dobutamine or dopamine

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9
Q

how is pimobendan an inodilator?

A

calcium sensitizer
phosphodiesterase III inhibitor

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10
Q

what are some ACE inhibitors?

A

enalapril
benazepril
lisinopril

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11
Q

do ACE inhibitors have a preventative effect prior to actual CHF?

A

no

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12
Q

do ACE inhibitors increase lifespan in CHF?

A

yes: 50%

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13
Q

why are ACE inhibitors not for acute therapy?

A

delayed time to maximum effect: 7-10 days

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14
Q

what does digoxin do?

A

inhibits Na/K ATPase pump on cardiac myocytes
increases vagal tone

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15
Q

what does quinidine do?

A

blocks open Na channels and has a slow off rate
alpha 1 blocker, vagolytic effect, increases end refractory potential

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16
Q

what is phase 0 of the cardiac action potential in a myocyte and nodal tissue?

A

myocyte: rapid Na influx
nodal: calcium influx

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17
Q

what increases in heart disease that leads to decreased cardiac output?

A

total peripheral resistance (afterload)
sympathetic and other hormonal input
preload

18
Q

what is stage B1 of heart disease?

A

no radiographic or echocardiographic signs

19
Q

what is stage B2 of heart disease?

A

pre-clinical: changes are balanced by compensatory mechanisms

20
Q

what is recommended for cats with HCM in stage B2?

A

no clear recommendations

21
Q

what should you do for dogs with myxomatous mitral valve disease and dilated cardiomyopathy in stage B2?

A

start pimobendan
mild sodium restriction in diet

22
Q

what is the immediate effect of furosemide from?

A

prostaglandin-dependent venodilation
diuretic effect 20-30 minutes later

23
Q

why might torsemide be slightly advantageous to furosemide with chronic therapy?

A

may also inhibit aldosterone

24
Q

how can NSAIDs interact with furosemide?

A

might block some of its diuretic effects

25
Q

who can you use spironolactone in?

A

dogs only

26
Q

is pimobendan part of standard therapy for familial hypeertrophic cardiomyopathy (FHCM)?

A

not unless severe CHF

27
Q

is there synergism with ACE inhibitors and pimobendan for myxomatous mitral valve disease?

A

not with lifespan

28
Q

in which cats may pimobendan have a positive effect?

A

cats with overt heart failure

29
Q

what can be used for acute vasodilation?

A

nitroglycerin
sodium nitroprusside

30
Q

what can be used for chronic vasodilation (decrease afterload)?

A

pimobendan
ACE inhibitors
amlodipine
prazosin
hydralazine

31
Q

do ACE inhibitors have an additive effect with pimobendan with CHF from MMVD and DCM?

A

no

32
Q

what are the pharmacokinetics of ACE inhibitors?

A

the drugs are pro-drugs
enalaprilat cleared by renal
benazeprilat cleared by hepatic

33
Q

why are ACE inhibitors not for acute therapy?

A

delayed time to maximum effect

34
Q

what are the adverse effects of ACE inhibitors?

A

hypotension
exacerbate renal insufficiency
decreased aldosterone
rare idiosyncratic reactions

35
Q

what are the contraindications for ACE inhibitors?

A

severe hypotension
sinus node dysfunction
concurrent pulmonary congestion or edema
acute myocardial infarction
hypersensitivity

36
Q

what does digoxin increasing the vagal tone do?

A

helps to correct sympathetic:parasympathetic imbalance in heart
decreases rate of SA node and decreases AV conduction

37
Q

when is a loading dose of digoxin used?

A

when rapid onset is needed

38
Q

what are the potential adverse effects of quinidine?

A

anaphylactoid reaction in horse
hypotension
paradoxical ventricular tachycardia in horse

39
Q

what is quinidine?

A

class Ia antiarrhythmic

40
Q

what is the drug of choice for oral increasing inotropy?

A

pimobendan

41
Q

when should you delay initiation of ACE inhibitors?

A

pre-renal azotemia
dehydration
hypothermia
hypotension

42
Q

what does digoxin do?

A

inhibits Na/K ATPase pump on cardiac myocytes

Clinical Pharmacology (19 decks)

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