drugs acting on vascular tone Flashcards

1
Q

groups of drugs acting on vasoregulation

A
organic nitrates
Ca channel blockers
alpha1 agonists
Hydralazin
PDE inhibitors
RAA system blockers
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2
Q

name an organic nitrate

A

nitroglycerin

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3
Q

effects of nitroglycerin

A

pronounced arterial and venous dilation - dilation of mesenterial veins -> shift from pulmonary circulation

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4
Q

what does nitroglycerine do to the preload and afterload

A

decreases them

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5
Q

what does nitroglycerine do to the coronary arteries

A

dilates them

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6
Q

nitroglycerine admin route

A

first pass effect orally -> Iv and sublingual

transdermal patch, ointment -> quick effect->acute heart failure or decompensated heart failure

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7
Q

nitroglycerine half life

A

short

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8
Q

nitroglycerin habituation

A

quick

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9
Q

two groups of Ca channel blockers

A

dihyropyridines

non-dihydropyridines

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10
Q

which Ca channel blockers can be used to affect vasodilation

A

amlodipine

diltiazem, verapemail

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11
Q

amlodipine effect

A

arterial vasodilation

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12
Q

amlodipine admin route

A

orally

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13
Q

amlodipine indications

A

cat hypertension

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14
Q

diltiazem, verapamil indications

A

antiarrhythmic drugs that also have some effect on hypertension, but low vessel/heart selectivity

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15
Q

name two alpha1 antagonists that can be used to affect vasodilation

A

prazosin, doxasozin

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16
Q

hydralazin effect

A

arterial vasodilator

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17
Q

hydralazin admin route

A

orally

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18
Q

PDE inhibitors that could be used as vasodilators

A

pimobendan, sildenafil

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19
Q

three groups of diuretics

A

cardial diuretics
osmotic diuretics
natiuretics

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20
Q

cardial diuretics

A

digoxin
xanthine derivatives
ACE inhibitors

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21
Q

four types of natiuretics

A

carboanyhydrase inhibitors
loop diuretics
thiazides
potassium sparing diuretics

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22
Q

which type of natiuretic has the best effect

A

loop diuretics - the loop of henle is where 80% of H2O is excreted

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23
Q

osmotic diuretics list

A

mannitol

glycerine

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24
Q

how is mannitol administered

A

IV

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25
Q

does mannitol penetrate across membranes

A

no

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26
Q

is mannitol reabsorbed

A

no, just filtration

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27
Q

mannitol indications

A

life threatening oedemas
acute renal failure
opthalmology - glaucoma

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28
Q

carbanhydratase inhibitors mechanism of action

A

they block the Na-H pump - H in cells and Na in urine -> acidosis in cells and alkalosis in urine

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29
Q

where do carbanyhydratase inhibitors have their action

A

proximal tubule

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30
Q

carbanyhydratase inhibitors indications

A

heart failure
glaucoma
alkalising urine

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31
Q

carbanyhydratase inhibitors side effects

A

metabolic acidosis, other uroliths

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32
Q

carbanhydratase inhibitors for systemic use against glaucoma

A

acetolamide

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33
Q

carbanhydratase inhibitors for local use against glaucoma

A

dorzolamide, brinzolamide

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34
Q

loop diuretics mechanism of action

A

NKCC2 inhibition -> Na and K excretion

Mg and Ca excretion increased

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35
Q

where do loop diuretics have their effect

A

loop of henle

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36
Q

name two loop diuretics

A

furosemide, torsemide

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37
Q

furosemide half life

A

very short, must be applied very frequently

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38
Q

furosemide indications

A

heart failure
oedemas
oliguria, anuria

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39
Q

furosemide side effects

A

hypokalaemia, metabolic alkalosis, hypotension, ototoxicity

40
Q

why should furosemide be used in combinations

A

aldosterone escape

41
Q

can we combine furosemide with aminoglycoside ABs

A

no autotoxicity

42
Q

why should we adjust the dose of furosemide when combined with ACE inhibitors

A

bc they decrease the blood pressure

43
Q

something important to check before administering furosemide in the case of acute renal failure

A

must make sure animal is well hydrated

44
Q

thiazides mechanism of action

A

NCCT inhibition -> Na and water excretion

K excretion incr, Ca excretion decr

45
Q

where do thiazides have their effect mostly

A

distal tubule

46
Q

do we use thiazides in the case of Ca oxalate urolithiasis

A

yes, rarely

47
Q

do we use thiazides in combo

A

yes rarely

48
Q

name two thiazides that can be used as diuretics

A

chlorothiazide, hydrochlorothiazide

49
Q

potassium sparing diuretics list

A

amiloride, triameterine

aldosterone antagonists

50
Q

what kind of antagonists are aldosterone antagonists

A

competitive

51
Q

aldosterone antagonists mechanism of action

A

ENaC and Na/K ATPase protein expression decr, incr Na excretion, K excretion unchanged

52
Q

name the main aldosterone antagonist

A

spironolactone

53
Q

spirinolactone indications

A

antagonising aldosterone in CHF
preventing diuretic induced aldosterone escape
hyperaldosteronism

54
Q

spirinolactone side effects

A

hyperkalamia - not very severe

55
Q

spirinolactone dosage Car

A

1-2mg/kg PO

56
Q

options for combined treatment of CHF in dogs

A

pimobendan+furosemide+spirinolactone
ACE inhibitor+furosemide+spironolactone
Pimobendan+ACE inhbitor

57
Q

option for combined treatment of CHF in cats

A

furosemide

58
Q

combined treatment for hypertension

A

amlodipine+ACE inhibitor+AT-II antagonist

59
Q

name the four phases of blood clotting

A

local vasoconstriction
platelet aggregation
coagulation cascade
thrombolysis

60
Q

two groups of antiplatelet agents

A

cyclooxygenase inhibitors

ADP receptor inhibitors

61
Q

antiplatelet COX inhibitors

A

acetylsalicylic acid

62
Q

acetylsalicilylic acid species

A

dog, human

63
Q

acetylsalicilylic acid duration

A

long

64
Q

antiplatelet ADP receptors

A

clopidorgel

65
Q

clopidogrel side effects

A

less frequent, inappetance, GI -> give food if GI symptoms

66
Q

clopidogrel is a prodrug, in which organ is it metabolised

A

liver

67
Q

clopidogrel half life

A

SID, half life huge

68
Q

anticoagulants

A

VitK antagonist, warfarin

heparin

69
Q

what does warfarin inhibit by antagonising vit K

A

ii, vii, ix, x clotting factor activation

70
Q

warfarin onset of action

A

18-24 hours

71
Q

warfarin admin route

A

orally, iv, im

72
Q

warfarin, does it have protein binding

A

extensive, interactions

73
Q

warfarin side effects

A

bleedings

pregnancy - malformations, neg effects on development

74
Q

where is heparin produced

A

mast cells

75
Q

heparin is acidic?

A

yes

76
Q

two forms of heparin as a drug

A

heterogenic substance btwn 1-30kDa

low molecular weight heparin

77
Q

which of the two forms of heparin is the safest

A

low molecular weight heparin

78
Q

why is the LMWH safer to use

A

inhibition of thrombin is based on molecular weight
has better selectivity
larger therapeutic index

79
Q

which bleeding parameter is the most important to check when adjusting the dose of heparin

A

APTT

80
Q

heparin mechanism of action

A

antithrombin - thrombin, vii, is, x and xii clotting factors inactivation

81
Q

non fractionated heparin substances

A

Na heparin, Ca heparin

82
Q

LMWH substances

A

dalteparin
fraxiparin
enoxaparin

83
Q

can heparin be given orally

A

no, give as inj

84
Q

heparin indications

A

feline HCM thromboembolism
DIC
heartworm

85
Q

thrombolytic agents

A

streptokinase

86
Q

where is streptokinase produced

A

by streptococcus sp

87
Q

possible side effects of streptokinase

A

immune response, anaphylaxis
non selective for thrombi - bleedings
reperfusion

88
Q

due to the anaphylaxis how many times should we apply streptokinase

A

only once or twice at most

89
Q

how should streptokinase be applied

A

parenterally

90
Q

whats protamine

A

chemical antagonist of heparin

91
Q

on which type of heparin does protamine have a greater effect

A

standard

92
Q

protamine dosage

A

50% of heparin dosage

93
Q

how should protamine be administered

A

iv, slow infusion

94
Q

effects of etamsylat

A

decr bleeding time, but PT and APTT stay the same

95
Q

etamyslat side effects

A

rare, large therapeutic index

96
Q

etamyslat admin route

A

po, im, iv