Heart failure

Question 1

Digoxin

Answer 1

Cardiac glycoside- inhibits Na+/K+/ATPase pump, thus reducing drivng force for Ca++ extrusion by the Na+/Ca2+ exchanger

Question 2

Digitoxin

Answer 2

Cardiac glycoside- inhibits Na+/K+/ATPase pump, thus reducing drivng force for Ca++ extrusion by the Na+/Ca2+ exchanger

Question 3

Ouabain

Answer 3

Cardiac glycoside- inhibits Na+/K+/ATPase pump, thus reducing drivng force for Ca++ extrusion by the Na+/Ca2+ exchanger
Too powerful to be used clinically

Question 4

Dobutamine

Answer 4

β1 agonist
Analogue of dopamine
Can be used intravenously for rapid effect
Positive ionotropic effect > chronotropic
Uses:
-Shock
-Improve CO after open heart surgery
- Heart failure in the absence of hypertension

Question 5

Bisoprolol

Answer 5

Third generation β1 antagonist

Question 6

Carvedilol

Answer 6

Third generation β1 antagonist

Question 7

Milrinone

Answer 7

Inodilator
PDE type III inhibitor
Limited use: sometimes produces dysrhythmias. Confined to short-term treatment of sever heart failure unresponsive to more conventional therapy.

Question 8

Dipyridamole

Answer 8

Inodilator

PDE type V inhibitor

Question 9

Sildenafil

Answer 9

Inodilator

PDE type V inhibitor

Question 10

Caffeine

Answer 10

A methyxanthine
Non-selective PDE inhibitor
Adenosine A1 and A2 antagonist
At high concentrations cause release of Ca2+ from intracellular stores

Question 11

Theophylline

Answer 11

A methyxanthine
Non-selective PDE inhibitor
Adenosine A1 and A2 antagonist
At high concentrations cause release of Ca2+ from intracellular stores

Question 12

Pimobendan

Answer 12

Inodilator
‘Calcium sensitiser’
Treatement of canine dilated cardiomyopathy (esp in Dobermanns)

Question 13

Levosimendan

Answer 13

Inodilator

‘Calcium sensitiser’

Question 14

Captopril

Answer 14

ACE inhibitor

Question 15

Enlapril

Answer 15

ACE inhibitor