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Year 2 Pharmacology > CV pharmacology 1 intro > Flashcards

CV pharmacology 1 intro Flashcards

1
Q

What may we want to affect?

A
  1. Heart rate/ rhythm
  2. Contractility of cardiac muscle
  3. Relaxation of ventricles
  4. Preload
  5. Afterload
  6. Perfusion
  7. Arterial pressure
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2
Q

How could we affect:

  1. Heart rate/ rhythm
  2. Contractility of cardiac muscle
A
  1. Length of refractory period and Conduction of action potentials
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3
Q 
How could we affect 
Preload
Afterload
Perfusion
Arterial pressure
A

Preload - change circulating volume
Afterload - change the vascular resistance
Perfusion - Compensatory vasoconstriction of organs
Arterial pressure - Resetting of baroreceptors

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4
Q

What drugs can we use to act on the heart

A
  1. Positive inotropes
  2. Negative inotropes
  3. Positive chronotropes
  4. Negative chronotropes
  5. Positive lusiotroph
  6. Negative lusiotroph
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5
Q

What affect do those 6 types of drugs have on the heart?

A
  1. Positive inotropes - INC contractility
  2. Negative inotropes - DEC contractility
  3. Positive chronotropes - INC HR
  4. Negative chronotropes - DEC HR
  5. Positive lusiotroph - INC relaxation
  6. Negative lusiotroph - DEC relaxation
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6
Q

Dog presents with dilated cardiomyopathy. What type of drug are you going to use and why?

A
  1. Positive inotroph
  2. to INC contractility
  3. DCM is characterised by dilation of V due to V wall thinning, subsequently DECREASING contractility.
  4. If untreated fluid accumulation occurs and Congestive HF (backwards HF)
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7
Q

Dog presents with hypertrophic cardiomyopathy. What type of drug are you going to use and why?

A
  1. Positive Lusiotroph
  2. To INC relaxation
  3. Hypertrophic cardiomyopathy - cardiac muscle contracts harder, walls become thicker than normal and inc stiffness.
  4. Reduced compliance and thicker walls means not enough space for heart to fill
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8
Q

If a dog presented with Atrial Fibrilation, what drug would you use and why?

A
  1. Negative chronotrope

2. AF caused irregular and abnormally fast HR so want to decrease it again

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9
Q

What is heart rate determined and altered by?

A

o Electrical potential generated at SAN

o The autonomic nervous system under the governance of the CV centre in the medulla oblongata (brain stem)

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10
Q

What is conduction of the action potential reliant on?

A
  1. cations - normal intracellular and extracellular levels
  2. The normal activity of these cation channels - Na+, K+, Ca2+
  3. correct function of intercalated discs
    Basically anything affecting Na+, K+ and Ca2+ and intercalated discs will affect conduction of the AP
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11
Q

Tachy cardia vs tachyarrhythmia

A

OVerall HR that exceeds the normal.

Tachycardia is the rapid heart rate itself whereas tachyarrhythmia is the pathological cause

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12
Q

Why is tachyarrhythmia a problem?

A

Results in:

  1. Decreased (shorter) diastolic filling time =
  2. Decreased EDVV =
  3. decreased Stroke Volume
  4. OVERALL decreases cardiac output
  5. So the heart compensates by trying to work harder leading to myocardial hypertrophy.
  6. can be severe enough to cause sudden death and syncope
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13
Q

What is paroxysmal atrial tachycardia?

A
  1. type of arrhythmia whereby an episode begins and ends abruptly
  2. show up with normal heart beat, can’t pick up, other times have severe heart rate – can die suddenly. If you suspect this you could consider using a 24-28hr ECG to monitor it
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14
Q

Aim when treating tachyarrhythmias

A

o Reduce firing rate of pace maker cells

o Slow conduction of impulses

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15
Q

What physiology could we alter to slow the heart rate down?

A
  1. Reduce ion channel activity

2. Reduce nerve impulses to nodes (sympathetic nervous system)

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16
Q

Definition of arrhythmogenic

A

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disease of the heart muscle. In this disease, fatty fibrous tissue replaces normal heart muscle. This interrupts normal electrical signals in the heart and may cause irregular and potentially life-threatening heart rhythms.

17
Q

Name of a broad category of medications that ameliorate the spectrum of cardiac arrhythmias to maintain normal rhythm and conduction in the heart.

A
  1. Antidysrhythmics
  2. All Antidysrhythmics are arrhythmogenic
  3. Vaughan-Williams classification
18
Q

Talk about the Vaughan-Williams classification

A

The more we learn about these categories then the more they don’t fit, but still useful to learn!

  1. I- drugs that block Na+ channels
  2. II- β blockers
  3. III- drugs that prolong AP by blocking some K+ channels
  4. IV- drugs that block Ca2+ channels
  5. Class 5 - miscellaneous
19
Q

Why is it important to be careful when prescribing ANTIDYSRHYTHMICS

A

All drugs that alter the rhythm of heart can by itself cause arrhythmias. NEVER give to animals that don’t need or aren’t sure if they need or not. Must diagnose propery!!!!!!!!!!!! ALL ANTIDYSRHYTHMICS ARE PRO-ARRHYTHMOGENIC

Year 2 Pharmacology (21 decks)

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