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SA DX & TX I > Exam 4 - Cardiovascular Pharmacology > Flashcards

Exam 4 - Cardiovascular Pharmacology Flashcards

1
Q

electrical malfunction - _________
valve leakage - _______ _______
pump failure (cold) - ______________
congestive heart failure - ________
vessel abnormalities (narrow or blocked) - ________

A

electrical malfunction - arrhythmias
valve leakage - valve disease
pump failure (cold) - cardiomyopathy
congestive heart failure - drowning
vessel abnormalities (narrow or blocked) - hypertension

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2
Q

what are the goals in using drugs to treat cardiovascular disease?

A

control arrhythmias, resolve congestion, improve contractility, resolve clinical signs, & maintain/improve quality of life

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3
Q

T/F: drug interactions are possible & likely in cardiovascular drugs

A

true

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4
Q

what is preload?

A

pressure stretching the ventricle of the heart after passive filling of the ventricle & subsequent atrial contraction (volume)

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5
Q

what are some drugs that are preload reducers?

A

diuretics!!!!

nitroglycerine paste & ace inhibitors

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6
Q

what is the difference in clinical signs between left & right sided heart failure?

A

left sided - pulmonary edema

right sided - ascites

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7
Q

what is the mechanism of action of loop diuretics?

A

inhibit the highly reabsorptive NaKCl co-transporter in the ascending limb of the loop of henle & cause potassium wasting

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8
Q

what are the adverse effects of loop diuretics?

A

dehydration & electrolyte abnormalities

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9
Q

what drugs are commonly used loop diuretics for cardiac disease?

A

furosemide & torsemide

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10
Q

what kind of drug is spironolactone?

A

aldosterone receptor antagonist

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11
Q

what is the mechanism of action of spironolactone?

A

blocks Na & K transport in the distal tubule & collecting ducts leading to Na excretion

antifibrotic effect by blocking RAAS

potassium sparing

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12
Q

what is the diuretic effect of spironolactone?

A

minimal

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13
Q

what is the mechanism of action of hydrochlorothiazide?

A

inhibits the reabsorption of Na & Cl in the distal tubule & causes potassium wasting

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14
Q

what are the adverse effects associated with hydrochlorothiazide?

A

dehydration & electrolyte abnormalities

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15
Q

label the drugs that work at each number

A
  1. loop diuretics
  2. thiazides
  3. spironolactone
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16
Q

what is an inotrope?

A

agent that alters the force of the heart muscle contraction

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17
Q

what do negative inotropic agents do?

A

decrease the force of muscular contraction

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18
Q

what do positive inotropic agents do?

A

increase the strength of muscular contraction

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19
Q

what are some examples of negative inotropic drugs?

A

beta blockers & calcium channel blockers

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20
Q

what are some examples of positive inotropic drugs?

A

dobutamine!! - IV

pimobendan! - PO

digoxin - PO

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21
Q

what is the mechanism of action of pimobendan?

A

positive inotrope - calcium sensitization & PDE III inhibitor that causes balanced arterial & venous vasodilation

leads to improved forward blood flow

22
Q

what is afterload?

A

pressure the left ventricle has to generate in order to eject blood into the aorta - the pressure in the ventricle must be greater than the systemic pressure in order to open the aortic valve

23
Q

what are some examples of drugs that are afterload reducers?

A

amlodipine & telmisartan

hydralazine

ace inhibitors

24
Q

what is the ideal blood pressure?

A

110-120 mmHg

25
Q

what happens if you have a blood pressure < 90 mmHg?

A

clinical evidence of low cardiac output, weak & lethargic animal, & need to use careful administration of any afterload reduced

26
Q

what happens if you have a blood pressure > 160 mmHg?

A

monitor patient for evidence of end organ damage & afterload reduction

27
Q

what is the primary effect of antihypertensive medications?

A

lower blood pressure

28
Q

what drug is used in both dogs & cats to lower blood pressure?

A

amlodipine - calcium channel blocker

29
Q

what drug is used in cats to lower blood pressure?

A

telmisartan - semintra, angiotensin II receptor blocker

30
Q

what drug is used in dogs to lower blood pressure?

A

hydralazine

31
Q

what is the equation of blood pressure?

A

blood pressure = cardiac output X systemic vascular resistance

32
Q

T/F: pimobendan is an antihypertensive medication

A

false - positive inotrope & vasodilator

33
Q

what drug is commonly used as an additional effect for antihypertension?

A

ace inhibitors - enalapril & benazepril

may decrease BP by 5-10 mmHg, but it’s not typically used as a monotherapy for systemic hypertension

34
Q

when looking at calcium channel blocking drugs, between DHPs & NON-DHPs, which is more vascular selective?

A

DHPs - more vascularly selective

NON-DHPs - act equally on the heart & the arterioles

35
Q

what are examples of DHPs & NON-DHPs drugs?

A

DHPs - amlodipine

NON-DHPs - diltiazem

36
Q

what neuroendocrine response does the body have to cardiac disease?

A

maladaptive response from the RAAS cascade & sympathetic nervous system

37
Q

what is the RAAS cascade?

A

hormone system that regulates blood pressure & water balanced with end products of angiotensin II & aldosterone

promotes vasoconstriction & sodium/water retention

38
Q

what drugs are used as a blockade to the RAAS cascade?

A

ace inhibitors, anti-aldosterone, & angiotensin II blockers

39
Q

what effects are seen in the sympathetic nervous system in response to cardiac disease?

A

constant adrenergic stimulation to the heart - B1 down regulates, but B2>B1

becomes counter productive in heart failure - b mediated tachycardia & a mediated vasoconstriction

40
Q

what drugs are used for a blockade of the sympathetic nervous system when a maladaptive response is present due to cardiac disease?

A

selective (atenolol) beta blockers or non-selective

negative chronotropes/inotropes

only use these in STABLE PATIENTS

41
Q

what are chronotrophic drugs?

A

drugs that change the heart rate and/or rhythm

42
Q

what do positive chronotropes do?

A

increase heart rate - anticholinergics (atropine, glycopyrrolate)

43
Q

what do negative chronotropes do?

A

decrease heart rate & reduce arrhythmias - beta blockers & calcium channel blockers

these drugs typically have other important effects (negative inotrope)

44
Q

do patients with DCM have a decrease or increase in ventricular muscle contractility?

A

decrease - need a positive inotrope

45
Q

where do patients with left-sided heart failure accumulate fluid?

A

pulmonary edema - need a drug to reduce preload

46
Q

what neuroendocrine system are activated in heart failure?

A

RAAS - need to block RAAS activation

47
Q

what is congestive heart failure?

A

condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body

48
Q

what is DCM?

A

condition in which the heart becomes weakened, enlarged, & cannot pump blood efficiently

49
Q

what drugs are useful for ventricular arrhythmias?

A

lidocaine, procainamide, sotalol, & amiodarone

50
Q

what drugs are useful for both supraventricular & ventricular arrhythmias?

A

procainamide & quinidine

SA DX & TX I (59 decks)

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