Drugs affecting cardiovascular system Flashcards

1
Q

Division of drugs used to treat heart and blood disorders:

A
  1. Positive inotropes
  2. Antihypertensives and vasodilators
  3. Antianemic agents
  4. Agents influencing the blood coagulation
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2
Q

Positive inotropes function:

A

increase the strength of cardiac muscle contraction by increasing the quantity of intracellular calcium available for binding by muscle proteins.

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3
Q

Positive inotropes division:

A

I. Cardiac glycosides: digoxin
II. Phosphodiesterase inhibitors: pimobendan - congestive heart failure due to dilated cardiomyopathy and chronic degenerative mitral valvular disease in dogs

III. Catecholamines (b-adrenergic agonists): dopamine, dobutamine, epinephrine and isoproterenol

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4
Q

Antihypertensives and vasodilators division:

A

I. Angiotensin converting enzyme (ACE) inhibitors
II. Calcium channel blockers
III. beta-blockers
IV. alpha-blockers
V. Diuretics

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5
Q

ACE inhibitors

A

enalapril, benazepril, captopril, lisinopril, ramipril
- chronic congestive heart failure in dogs
- manage systemic hypertension in dogs and cats

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6
Q

Calcium channel blockers

A

amlodipine, diltiazem
- vasodilators

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7
Q

Beta-blockers

A

atenolol (propranolol, metoprolol, esmolol)
- slow heart rate and reduce myocardial O2 consumption

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8
Q

Alpha-blockers

A

prazosin (a1-adrenergic receptor blocker)
- mixed vasodilator

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9
Q

Diuretics

A
  • Congestive heart failure characterized by cardiogenic pulmonary edema, pleural effusion, ascites or combination of these signs
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10
Q

Four classes of diuretics used to treat congestive heart failure in dogs and cats

A

I. loop diuretics - furosemid
II. thiazide diuretics - chlorothiazide
III. potassium-sparing diuretics - spironolactone
IV. other hypotensives - vasodilators - nitroglycerin

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11
Q

Antianemic agents

A

Treat anemia by providing components needed for red blood cells production, including hemoglobin synthesis, and by stimulating bone marrow formation of RBC

  • vitamin B12, folic acid and iron (ferrum)
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12
Q

Agents influencing the blood coagulation:

A

Anticoagulants
- affect blood clotting
- interfere with clotting cascade by blocking synthesis of clotting factor VII (prothrombin, thrombin) or block the formation of fibrinogen

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13
Q

Name phases of the coagulation process:

A
  1. Activation of prothrombin
  2. The own clotting phase
  3. The retraction phase
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14
Q

Characterize first phase of the coagulation process

A

Activation of prothrombin:
- response to trauma on blood vessels and tissues
- releasing of thrombokinase from platelets and damaged vascular endothelium, with calcium ions catalyzes conversion of prothrombin into thrombin

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15
Q

Characterize the second phase of the coagulation cascade

A

The own clotting phase:
Thrombin converts fibrinogen into a meshwork of fibrin, forming a clot

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16
Q

Characterize the third phase of the coagulation cascade:

A

The retraction phase:
The fibrin chains are stabilized and strengthened. Final clot retraction and serum extrusion.

17
Q

Name the two ways in which anticoagulants are used?

A
  1. In vivo - directly into the body or on body surface
  2. In vitro - added to blood in laboratory to facilitate experimental and diagnostic investigations
18
Q

How are blood samples examined?

A
  1. the coagulated blood
    - serum - serological surveys for diagnostic identification of antibodies that are formed as a response to disease
  2. the uncoagulated blood and plasma
    - laboratory examinations and determination
19
Q

What do we determine with uncoagulated blood and plasma?

A

Noncellular blood components: concentration of catecholamines, hormones, vitamins, mineral substances, enzymes

Cellular blood components: blood cell counts and hematogrammes, agglutination, hemagglutination, various tests

Plasma components: enzyme activities, coenzymes, mineral substances, metabolites and protein etc.

Anticoagulants are necessary!

20
Q

Divide anticoagulants:

A
  1. Inhibitors of clotting factors
  2. Vitamin K antagonists
  3. Calcium chelators - in vitro anticoagulants
  4. Enzymes
21
Q

Inhibitors of clotting factors:

A

Heparin
- antithrombin III inhibits the proteolytic action of clotting factors IX, X, XI, XII and thrombin
- binds to the wall of endothelial cells and interferes with platelet aggregation and their adhesion
- prevents thrombosis and embolism
- obtained from bovine liver and lung tissue or porcine intestinal mucosa
D: 50-100 IU/kg up to 400 IU/kg

22
Q

Name anticoagulants in the heparin group (6):

A

dalteparin, enoxaparin, nadroparin, parnaparin, reviparin and sulodexide

23
Q

Vitamin K antagonists:

A
  • Vitamin K is responsible for blood clotting, to stop bleeding!

Antagonists interfere with vitamin K-dependent clotting factors (II, VII, IX, X) in hepatic synthesis of vit K
- in vivo
- coumarin anticoagulants
- indandione anticoagulants

24
Q

Name types of coumarin anticoagulants

A
  • Vit. K antagonist
  • warfarin - sodium warfarin is most commonly used! - prevention
  • dicumarol
  • phenprocoumon
  • acenocoumarol
  • ethyl tioklomarol
  • biscoumacetate - ethyl biscoumacetate for prophylaxis of thrombosis and embolism
25
Q

Name types of indandione anticoagulants

A
  • Vit. K antagonists
  • phenindione
  • klorindion
  • diphenadione
26
Q

Characterize and name types of calcium chelators - (In vitro anticoagulants)

A
  • chelated calcium + coagulation factors catalyze conversion of prothrombin into thrombin
  • Sodium citrate - bind calcium ions required for the conversion of prothrombin into thrombin
  • Sodium oxalate
  • Edetate Calcium disodium (EDTA)
27
Q

Enzymes function and examples:

A
  • dissolve blood clots
  • inactivate fibrinogen and fibrin
  • streptokinase, alteplase, urokinase, fibrinolysine
28
Q

What is the function of enzyme streptokinase?

A

Catalyze the conversion of plasminogen to plasmin - prevent formation of blood clots or dissolve already formed clots

29
Q

Drugs used to treat bleeding:

A

Hemostatics - help the blood clot
- Lyophilized concentrates - skin
- Adstringents - site of bleeding
- Epinephrine and norepinephrine constrict blood vessels and decrease blood flow to tissues