Cardiovascular Pharmacology

Question 1

what is stage A of congestive heart failure?

Answer 1

patients at risk: breed predisposition
no clinical signs

Question 2

what is stage B of congestive heart failure?

Answer 2

pre-clinical, asymptomatic heart disease

Question 3

what is stage C of congestive heart failure?

Answer 3

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

Question 4

what is stage D of congestive heart failure?

Answer 4

end-stage heart failure

Question 5

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

Answer 5

8 mg/kg over 4 hr

Question 6

what is the immediate effect of furosemide related to?

Answer 6

prostaglandin-dependent venodilation

Question 7

what can ACE inhibitors do with furosemide?

Answer 7

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

Question 8

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

Answer 8

dobutamine or dopamine

Question 9

how is pimobendan an inodilator?

Answer 9

calcium sensitizer
phosphodiesterase III inhibitor

Question 10

what are some ACE inhibitors?

Answer 10

enalapril
benazepril
lisinopril

Question 11

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

Answer 11

no

Question 12

do ACE inhibitors increase lifespan in CHF?

Answer 12

yes: 50%

Question 13

why are ACE inhibitors not for acute therapy?

Answer 13

delayed time to maximum effect: 7-10 days

Question 14

what does digoxin do?

Answer 14

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

Question 15

what does quinidine do?

Answer 15

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

Question 16

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

Answer 16

myocyte: rapid Na influx
nodal: calcium influx

Question 17

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

Answer 17

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

Question 18

what is stage B1 of heart disease?

Answer 18

no radiographic or echocardiographic signs

Question 19

what is stage B2 of heart disease?

Answer 19

pre-clinical: changes are balanced by compensatory mechanisms

Question 20

what is recommended for cats with HCM in stage B2?

Answer 20

no clear recommendations

Question 21

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

Answer 21

start pimobendan
mild sodium restriction in diet

Question 22

what is the immediate effect of furosemide from?

Answer 22

prostaglandin-dependent venodilation
diuretic effect 20-30 minutes later

Question 23

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

Answer 23

may also inhibit aldosterone

Question 24

how can NSAIDs interact with furosemide?

Answer 24

might block some of its diuretic effects

Question 25

who can you use spironolactone in?

Answer 25

dogs only

Question 26

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

Answer 26

not unless severe CHF

Question 27

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

Answer 27

not with lifespan

Question 28

in which cats may pimobendan have a positive effect?

Answer 28

cats with overt heart failure

Question 29

what can be used for acute vasodilation?

Answer 29

nitroglycerin sodium nitroprusside

Question 30

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

Answer 30

pimobendan ACE inhibitors amlodipine prazosin hydralazine

Question 31

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

Answer 31

no

Question 32

what are the pharmacokinetics of ACE inhibitors?

Answer 32

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

Question 33

why are ACE inhibitors not for acute therapy?

Answer 33

delayed time to maximum effect

Question 34

what are the adverse effects of ACE inhibitors?

Answer 34

hypotension exacerbate renal insufficiency decreased aldosterone rare idiosyncratic reactions

Question 35

what are the contraindications for ACE inhibitors?

Answer 35

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

Question 36

what does digoxin increasing the vagal tone do?

Answer 36

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

Question 37

when is a loading dose of digoxin used?

Answer 37

when rapid onset is needed

Question 38

what are the potential adverse effects of quinidine?

Answer 38

anaphylactoid reaction in horse hypotension paradoxical ventricular tachycardia in horse

Question 39

what is quinidine?

Answer 39

class Ia antiarrhythmic

Question 40

what is the drug of choice for oral increasing inotropy?

Answer 40

pimobendan

Question 41

when should you delay initiation of ACE inhibitors?

Answer 41

pre-renal azotemia dehydration hypothermia hypotension

Question 42

what does digoxin do?

Answer 42

inhibits Na/K ATPase pump on cardiac myocytes