Ch. 7 Cardiovascular Drugs Flashcards by Dana Dyches

Basic functions of the cardiovascular system

delivery of oxygen, nutrients, and hormones to the various parts of the body

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Cardiovascular system also transports _ products to the appropriate waste removal system

waste

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3 major types of blood vessels

arteries, veins, capillaries

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Capillaries are single-cell-thick vessels that connect the _ and _ systems

arterial and venous

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The electrical impulses of the heartbeat originate in the _ _

sinoatrial node (SA node)

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Heart rate is controlled primarily by the _ nervous system

autonomic

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Systole is contraction of

heart chambers

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diastole is relaxation of heart chamber while they

fill with blood

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normal heart beat is called

normal sinus rhythm

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Cardiac output =

SV x HR

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Stroke volume is the amount of blood

pumped out of the heart (left ventricle to the body) during each contraction measured in mL/beat

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Preload is the amount of blood that fills the _ during diastole

ventricles (volume of blood entering the right side of the heart)

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Afterload is

the arterial resistance that the ventricle must pump against (force needed to push blood out of the ventricles)

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SV is determined by

preload and after load

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Blood pressure is determined by

heart rate, stroke volume, peripheral resistance

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Compensatory mechanisms

-increase hr (increases CO)
-increase stroke volume
-increase efficiency
-enlarge itself (compensatory hypertrophy)

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CVS diseases fall into what 4 basic categories

-valvular dz
-myocardial dz
-arrhythmias
-other (congenital, infectious)

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Congestive heart failure is a syndrome that can occur with any disorder that

damages or overworks the heart muscle

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Conditions that lead to CHF

-cardiomyopathy
-hypertension
-valvular disease

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Arrhythmias interfere with the work of the heart and can disrupt

cardiac output

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Arrhythmias can be caused by changes in the

rate, stimulation from an ectopic focus, or by alterations in conduction of the muscle

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Alterations in blood pressure may result in _ or _

hypertension and hypotension

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Hypertension results in prolonged force put on the vessels of the vascular system and leads to

left ventricle thickening

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Hypotension results in the tissues of the body not receiving sufficient amount of oxygenated blood which allows

wasted products to accumulate and cells to die from lack of oxygen

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Stages of cardiac disease and symptoms

I: none/mumur II:cough III: cough, exercise intolerance IV: dyspnea at rest

Positive inotropes increase the force of

myocardial contraction (Ex: digitalis glycosides and catecholamines digitalis glycosides= narrow TI)

Positive inotropes improve the _ of contraction (by increasing Ca++), _ the rate of contraction (increases PNS)

strength; rate

Uses for positive inotropes

atrial fibrillation, CHF, supra ventricular tachycardia

Cautions with all positive inotropes

-increases oxygen demand of the cardiac muscle -this may lead to arrhythmias by damaging the contractile apparatus -use is controversial

Cardiac glycosides increase the strength of _ _ , decrease _ _ , have anti arrhythmic effect, and decrease signs of dyspnea

cardiac contractions; heart rate

Side effects of cardiac glycosides

anorexia, V+ ,D+, and cardiac arrhythmias

Examples of cardiac glycosides

digoxin and digitoxin

Catecholamines (sympathomimetic): increase the _ and _ of myocardial contraction, constrict peripheral blood vessels, and increase blood glucose levels

force and rate

Examples of catecholamines

epinephrine, dopamine, dobutamine, isoproterenol

Catecholamines have short _-_ which make them most suited for _-_ use

half-lives; short term

Common catecholamines and their uses

Epi- cardiac resuscitation Dobutamine- hypotension under anesthesia Isoproterenol- atropine resistant bradycardia Dopamine- hypotension under anesthesia (also increases renal perfusion by dilating renal vascular beds), shock

Dopamine and Dobutamine must be _ before use and are given as a CRI

diluted

Bipyridine Derivatives increase the force of contraction by

inhibiting enzymes that lead to Ca++ influx into the cell (ex: amrinone, milrinone)

Inotropic, _ dilator

mixed

Pimobenden (vermedin) uses

AV valve insufficiency, DCM, CHF

Side effects of pimobendan

anorexia, vomiting, diarrhea

Contraindications of pimobendan

HCM, Aortic stenosis

Antiarrhythmic drugs are used to correct variation in the

normal beating of the heart (which can lead to reduced cardiac output)

Types of anti arrhythmic drugs include

local anesthetics, membrane stabilizers, beta-adrenergic blockers, action potential prolongation drugs, and calcium-channel blockers

_ are used to correct constriction. They dilate arteries and/or veins which alleviates vessel contraction and improves cardiac output

vasodilators

Examples of vasodilators

-Hydralazine, Nitroglycerin, Prazosin -ACE inhibitors (EnalaPRIL, BenazePRIL)

Diuretics are drugs that increase the volume of

urine excreted by the kidneys and thus promote the release of water from the tissues (lowers fluid vol. in tissue)

Diuretics are used in the tx of _

hypertension

Examples of diuretics

Furosemide, Sprionolactone, Thiazide

Dietary management of CVS is best begun _ to onset of CS

prior

Goal of dietary management of CVS disease

sodium restriction and maintain ideal BCS

Ancillary tx is aimed at alleviating

clinical signs

Ancillary tx types

-brochdilators -oxygen therapy -sedation -aspirin -thoracocentesis or abdominocentesis

Anticoagulant drugs inhibit clot formation by

inactivating one or more clotting factors

Examples of anticoagulants

heparin, EDTA, coumarin derivatives, aspirin, and blood transfusion anticoagulants

Clopidogrel bisulfate is an oral _ _ _

platelet aggregation inhibitor

Clopidogrel bisulfate in cats

may prevent thrombi, improves circulation following an embolic event

Hemostatic drugs help promote

clotting of blood

Left sided heart failure causes

pulmonary edema

Right sided heart failure causes

ascites

Parenteral hemostatic drugs

Vitamin K, Protamine sulfate

Topical hemostatic drugs

silver nitrate, hemostat powder, gel foam gelatin sponges, thrombogen topical thrombin solution

Blood enhancing drugs affect

production or quality of RBCs

Examples of blood enhancing drugs

iron , erythropoietin

Erythropoietin is a protein made by the kidneys that stimulates the

differentiation of bone marrow stem cells to form red blood cells

Erythropoietin is used to treat _ in animals with chronic renal failure

anemia

Cautions for erythropoietin

allergic reactions sometimes seen , products must be refrigerated

Cyanocobalamine is B12 and is used to tx _ _. Oral forms are not appropriate for small animals

B12 deficiencies

Folic acid is a B vitamin needed for normal _

erythropoiesis