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Pharmacology > cardiovascular system drugs and diuretics > Flashcards

cardiovascular system drugs and diuretics Flashcards

1
Q

what is the cardiovascular system composed of (3)?

A
  • heart
  • blood vessels
  • blood
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2
Q

what are the stages of heart function?

A

contraction (systole)
relaxation (diastole)

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3
Q

contraction and relaxation of the heart are directly or indirectly dependent on what?

A

the transmission of impulses throughout the heart

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4
Q

when is heart pumping efficiency decreased?

A
  • when the flow of impulses is interrupted by non-connective tissue (eg scar tissue)
    or
  • when there is a break in coordination between the SA and AV nodes
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5
Q

what is normal heart rhythm called?

A

sinus rhythm

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6
Q

why is normal heart rhythm called sinus rhythmia?

A

because it begins at the SA node

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7
Q

describe cardiac arrhythmia (2)

A
  • if the SA node is not functioning properly, other areas of the heart may take over and initiate the heartbeat
  • spontaneous depolarization of cardiac muscle or abnormalities of conduction
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8
Q

describe a heart murmur

A
  • leaky valve
  • not fully oxygenated blood circulating due to mixing
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9
Q

what primarily controls the heart rate (controls the SA node)?

A

the autonomic nervous system
(parasympathetic and sympathetic) via receptors on cardiac cells

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10
Q

how does sympathetic stimulation affect the refractory period?

A

sympathetic stimulation will reduce the time between nerve impulses and thus reduces the refractory period

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10
Q

what is cardiac output

A
  • the workload of the heart
  • is divided into preload and afterload
  • (stroke volume X heart rate)
  • is how much blood actually leaves the heart over a specific time
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10
Q

what are the common clinical signs of cardiac disease?

A
  • pulmonary edema
  • coughing
  • ascites
  • syncope
  • weight loss
  • cyanosis
  • lethargy
  • dyspnea
  • exercise intolerance
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10
Q

define diastole

A
  • the heart chambers are filling with blood
  • the chamber is relaxed
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11
Q

define systole

A
  • contraction of the heart chambers
  • pumping of the blood
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12
Q

define preload

A
  • the stretching of the ventricles prior to contraction (filling pressure)
  • the amount of blood that enters the right side of the heart
  • associated problems are referred to a right-sided heart disease
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13
Q

define afterload

A

the force needed to push the blood out of the ventricles with systole (contracting pressure)

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14
Q

define stroke volume

A
  • the amount of blood ejected by the left ventricle with each beat of the body
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15
Q

describe the SA node

A

specialised cells in the right atrium the coordinates the electrical activity the causes the heart to contract

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16
Q

describe depolarisation

A
  • neutralizing the polarity of a cardiac cell by an inflow of SODIUM IONS
  • results in contraction of the cardiac cell and rendersit incapable of further contraction until repolarization occurs
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17
Q

describe repolarization

A
  • the return of the cell membrane to its resting polarity after depolarization
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18
Q

define chronotropic

A

affecting the heart rate

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19
Q

defines inotropic

A

affecting the force of heart muscle contractions

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20
Q

what affects contractile output? (6)

A

-preload
-afterload
-contractility
-heart rate
-Ability of heart muscle walls to distend
-synergy of contraction

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21
Q

Cardiovascular drugs can:

A
  • control the primary disease
  • control potential secondary effects
  • increase or decrease either the rate or the force of heart contractions
  • control rhythm disturbances
  • Increases oxygenation of the blood
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22
what are secondary heart conditions
- fluid imbalance - responsive compensatory mechanisms of the body such as vasoconstriction
23
What are the categories of cardiovascular drugs? (4)
- Positive inotropic agents - vasodialators - antiarrhythmic drugs - diuretics
24
Describe positive inotropic agents
- Stimulates the heart by increasing the strength and force of cardiac muscle contractions
25
what are the clinical uses of digitalis
treatment of: - CHF - atrial fibrilation - Supravenous tachycardia
26
What are the signs of toxicity of cardiac glycosides? (5)
- anorexia - vomiting and diarrhea - muscle weakness - CNS depression and confusion - cardiac arrhythmia
27
describe catecholamines
- type of positive inotropic drugs - are adrenergic agents - are synthetic forms of naturally-occurring neurotransmitters - is only used as an emergency drug (no long-term use)
28
what drugs are in the class catecholamines
- epinephrine - dopamine - dobutamine
29
when should epinephrine be used
- emergencies only - Give IV only if the heart has stopped - typically given as a single or repeated intravenous injection during cardiopulmonary resusitation
30
How would dopamine or dobutamine be administered?
- IV constant rate infusion to treat perfusion or cardiac disorders during anesthesia or in a critical care unit setting
31
Fluid in the abdomen
ascites
32
fainting
syncope
33
turning blue
cyanosis
34
difficult breathing
dyspnea
35
sign
can be measured or seen
36
simptom
description of what's going on (eg. hurting to urinate) but animals can't talk
37
What does an intrope affect?
the force of contraction
38
What does a chronotrope affect?
the rate of contraction but not the force
39
What receptors do catecholamines act on?
- beta receptors - adrenergic receptors
40
What effects do catecholamines have on heart function?
- Strengthen heart contraction - increase heart rate - increase blood pressure
41
What effects does parasympathetic stimulation result in?
- negative chronotropic effects (decrease HR) - negative inotropic effects (decrease force) - Cholinergic nerve ending in the SA node are stimulated - acetylcholine is released at the junction of the nerve and cardiac muscle
42
What effects does sympathetic stimulation result in?
- Positive chronotropic effects (increase HR) - Positive inotropic effects (increase force) - adrenergic nerves in the heart are stimulated - norepinephrine (and epinephrine) is released This decreases the time between nerve impulses and, therefore, decreases the refractory period
43
compensatory mechanisms for decreased heart function (4)?
- increase HR - increase stroke volume - decrease vasculature tone to maximize muscular efficiency - increased heart size in an attempt to pump more blood (chamber dilation or myocardial thickening)
44
Describe sympathetic stimulation as a compensatory mechanism for heart failure
- the receptors in vessels detect the decrease in BP and tissue perfusion - EPINEPHRINE is released - Epinephrine causes an increase in HR and causes peripheral vasoconstriction to increase BP
45
list the groups of positive inotropes (4)
- cardiac glycosides - catecholamines - benzimidazole pyridazinones - methyxanthines
46
what drug is in the group cardiac glycosides?
Digoxin
47
Describe cardiac glycosides (6)
- digitalis compounds (DIGOXIN) - a steroid - Affects MECHANICAL and ELECTRICAL cardiac activity - relatively toxic - Enhance the ability of the myocardium to respond to electrical stimuli - Increases the automaticity of all areas of the heart muscle (especially the ventricle)
48
How do cardiac glycosides strengthen myocardial contraction
- blocks the enzyme that decreases cellular release of calcium ions during repolarisation (blocks the blocker) - This increases the number of calcium ions for depolarization, resulting in a stronger contraction
49
Cardiac glycoside side effects
- vomiting - diarrhea - arrhythmias - muscle weakness - CNS depression and confusion - anorexia
50
The increased rest time of a heartbeat helps with what (4)?
- lets the chambers fill - sustain BP - Avoid edema - ensure adequate oxygen perfusion of all the tissue
51
What are cardiac glycosides used for?
- CHF - atrial fibrilation - Supravenous tachycardia
52
What type of compounds are catecholamines?
adrenergic compounds
53
describe catecholamines
- are synergistic forms of naturally-occuring neurotransmitters that act on BETA and ADRENERGIC receptors - short term use only
54
What effect does chatecholamines have
increases: - the strength of heart contraction - HR - BP
55
What drugs are in the class catecholamines
- epinephrine - dopamine - dobutamine
56
What is dopamine and dobutamine used to treat?
perfusion OR cardiac disorders during anesthesia OR in a critical care unit setting
57
what are the characteristics of Benzimidazole Pyridazinones?
- Inodialator: has both a positive inotropic and vasodialator effect. This increases the sensitivity of the cardiac muscle to calcium, which enhances contractility without increasing myocardial oxygen consumption - Negative chronotrope: decreases HR in animals with CHF positive inotropic negative chronotropic
58
side effects of Benzimidazole Pyridazinones (3)
- anorexia - lethargy - diarrhea
59
what effects do methylxanthines have (5)
- increase the strength and rate of heart muscle contractions - has a diuretic effect - smooth muscle relaxation (vasodilation and bronchodilation) - MILD positive inotropic effects - is a positive bronchodilator
60
How do Methylxanthines work?
- stops the stopper - Inhibits the enzyme in smooth muscle cells that suppress the compounds that complete the relaxation response
61
what are the clinical uses of methylxanthines?
- chronic respiratory disease - respiratory support to allow greater oxygenation in the treatment of CHF
62
What is the common Benzimidazole Pyridazinones drug?
Pimobendan
63
describe Theophylline
- in the class methylxanthines - is the human version of the drug - extra label use in animals for the management of cough due to bronchospasm
64
list the methylxanthine drugs
- theophylline - aminophylline
65
describe aminophylline
- in the class methylxanthine - for veterinary use - formulated in various combinations with compounds - oral expectorant - broncholinator - anti-inflamatory agent
66
when are antiarrhythmic drugs used
- are used to restore normal heart rate and rhythm (corrects arrhythmia, decreases abnormally rapid HR)
67
How do antiarrhythmic drugs restore normal HR and rhythm (2)?
- corrects arrhythmia - decreases abnormally rapid HR
68
What do antiarrhythmic drugs affect
ion channels - this corrects electrical disturbances within the nodes of the heart
69
what are the classes of antiarrhythmic drugs (4)?
- lA antiarrhythmics - lB antiarrhythmics - ll Antiarrhythmics: beta-blockers - lV anthiarrhythmics: calcium beta-blockers -lll
70
Describe class lA antiarrhythmics (4)
- used to treat ventricular and atrial arrhythmias - decreases myocardial excitability - may be administered orally long term - should not be combined with other antiarrhythmic
71
List the lA antiarrhythmic drugs
- quinidine - procainimide
72
Describe lB antiarrhythmics
- are membrane-stabilizing antidysrrhythmic agents - act to stabilize myocardial cell membranes, thereby blocking the entry of sodium (preventing depolarization)
73
what are lB antiarrhythmics used to treat
given IV in emergencies - ventricular tachycardia - Ventricular premature complexes
74
What does lidocaine neat mean?
without epinephrine
75
Describe lidocain as an antiarrhythmic drug
- Class lB antiarrhythmic - only administer neat IV - also used as a local anesthetic - prevents the ventricle from prematurely contracting - can give as a bolus or a CRI
76
What is class ll antiarrhythmics called?
beta blockers
77
what are beta blockers used to treat?
- atrial and ventricular arrhythmias by blocking the action of the sympathetic NS on the heart - a competitive antagonist
78
Effects of beta blockers
negative inotrope negative chronotrope
79
Side effects of beta blockers
- Stimulation of Beta-l receptors causes the heart to beat faster with greater force - This sympathetic stimulation can also make the heart more electrically unstable - allows abnormal sources of impulses to appear and arrhythmias to occur (particularly problematic in a diseased heart) also - Sympathetic stimulation impacts adequately move blood throughout the body - decreases in contractile force caused by these drugs
80
define tissue ischemia
- inadequate blood supply
81
describe beta-blockers
- negative inotropes and chronotropes - decrease the HR and force of muscle contraction - resulting in decreased myocardial oxygen demand - decrease the BP all over the body - Blocks beta-1 sympathetic stimulation, which decreases abnormal impulses and arrhythmias
82
which node do beta blockers slow down?
the SA node
83
what do beta blockers block
- adrenaline - noradrenaline
84
Which receptors do beta blockers affect?
- the receptors in the heart and blood vessels
85
what is the ending of the drugs in the class beta blockers
-olol
86
What is class lV antiarrhythmics also called
calcium channel blockers
87
How do calcium channel blockers work and what effect does it have?
- They block the channels that allow calcium ions to enter the cardiac cell membranes - this causes a decrease in the impulse transmission, which depresses the mechanisms of the heart
88
what are calciun channel blockers used to treat?
- supraventricular arrhythmias - hypertension
89
describe amlodipine
- a class lV antiarrhythmic: calcium channel blocker - Acts to slow the rate at which calcium moves into the heart and blood vessel walls (enables blood vessels to relax, resulting in better blood flow throughout the body)
90
What is amlodipine used for?
- used to treat hypertension (high BP) (commonly secondary to chronic renal failure)
91
describe Diltiazem
- a class lV antiarrhythmic: calcium channel blocker - used to treat hypertrophic cardiomyopathy in cats
92
What do vasodilators do?
- help decrease the afterload and improve cardiac output by acting to dilate veins, arteries, or both
93
how can vasodilators work (3)
- direct action on the smooth muscle of the blood vessels - blocking sympathetic stimulation - preventing conversion of angiotensin l to angiotensin ll
94
describe hydralazine
- a vasodilator - atriolar dilator - decreases resistance resulting in improved cardiac output - works on the muscles
95
What are the side effects of hydralazine
- hypotension - vomiting
96
describe nitroglycerine
- topical venodilator (on the inner ear) (wear gloves) - decreases the pre load - works on the muscles
97
describe prazosin
- acts by blocking alpha-adrenergic receptors (this decreases peripheral vasoconstriction, and decreases BP) - is also used to treat urinary retention in cats - works on the muscles
98
describe ACE inhibitors
- block ACE threfore causes vasodilation - good for treating CHF and systemic hypertension - prevents angiotensin l from converting into angiotensin ll
99
what ACE inhibitors are approved in dogs
- Enalapril - Benzepril
100
what is the ending of ACE inhibitors
-pril
101
describe Enalapril and Benzepril
- potent vasodilators - decreases BP - side effect of hypotension
102
describe diuretics (3)
- helps promote the excretion of water and salts through diuresis - Helps decrease the harmful side effects of CHF (pulmonary edema, ascites, increased preload) - most work by decreasing resorption of Na and water in the loop of Henle or the distal tubules of the kidney
103
describe furosimide
- a diuretic - reduces resorption of sodium in the loop of Henle (results in an incredible excretion of electrolytes) - This results in a large volume of dilute pee - rapid onset, short duration
104
What is furosimide good at treating?
- edema - effusion
105
what species can furosimide be used in?
- cats - dogs - horses - cattle
106
Side effect of furosimide
Hypocalcemia (low potassium)
107
List the diuretic drugs
- furosemide - spironolactone -mannitol
108
define effusion
fluid around something
109
When should spironolactone be used?
- if hypocalcemia (K) is already a problem because it is potassium sparing
110
describe spironolactone
- potassium sparing diuretic - Inhibits aldosterone (this therefore stops the tubules from retaining water and sodium) - Increases the exction of water and sodium - decreases the excretion of potassium - more expensive than furosimide
111
describe aldosterone
a hormone that causes the tubules of the kidney to retain sodium and water
112
What is Spirolactone used to treat?
- edema - CHF - High BP - potassium deficiency - hyperaldosteronism
113
describe mannitol
- an osmotic diuretic - promotes dieresis by exerting high osmotic pressure in the kidney tubules and limiting tubular reabsorption - Water is drawn into the glomerular filtrate, decreasing reabsorption and increasing the excretion of water - administer IV
114
What is mannitol used to treat
- intracranial pressure after head trauma - oliguric acute renal failure
115
Signs of stage 1 heart failure
none
116
Signs of stage 2 heart failure
cough
117
Signs of stage 3 heart failure
- cough - reduced exercise tolerance
118
Signs of stage 4 heart failure
- dyspnea at rest - are uncomfortable
119
when do you start treating heart failure?
- stage 2
120
list the ancillary heart drugs
- aspirin - oxygen - sedation - thoracocentesis or abdominocentesis
121
describe asprin
- used to prevent clot formation in HCM cats - is a blood thinner - Use the appropriate dose because we don't want them to bleed out

Pharmacology (7 decks)

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