Heart Failure Drugs

Question 1

what is acute HF?

Answer 1

NO warning
severe pulmonary edema

Question 2

what is chronic HF?

Answer 2

pleural effusion
large volume ascites

Question 3

what is hypertrophic cardiomyopathy?

Answer 3

impairs ventricle filling
Tx with ACEi

Question 4

what is cardiac tampanode?

Answer 4

hole in ventricle so blood goes into pericardium

Question 5

Furosemide indications

Answer 5

ACUTE HF
cardiogenic edema/effusion

Question 6

Furosemide effect on PG synthesis and heart filling

Answer 6

increased PG synthesis -> dilate reservoir veins, decreased P on heart filling

*faster than removing fluid

Question 7

adverse effect of Furosimide

Answer 7

excessive fluid loss

Question 8

contraindications for Furosimide

Answer 8

chronic HF (cannot be only drug to Tx)

Question 9

Spironolactone indications

Answer 9

CHRONIC HF
NOT acute

Question 10

what type of diuretic is Spironolactone?

Answer 10

K sparing

Question 11

Spironolactone adverse effects

Answer 11

excess K retention
GI disturbance
hyperkalemia when mixed with ACEi

Question 12

Spironolactone contraindication

Answer 12

hyperkalemic pts
causes arrhythmia

Question 13

thiazide diuretics (for HF) indications

Answer 13

pt’s that have become tolerant to furosemide
OR
adjunctive Tx to hyperkalemic periodic paralysis (HyPP) in horses

Question 14

ACEi is a vaso___

Answer 14

DILATOR

Question 15

ACEi indications

Answer 15

manage chronic HF
Tx systemic arterial hypertension
dog/cat
help slow down renal failure

Question 16

most ACEi’s are ___

Answer 16

prodrugs

Question 17

ACEi adverse effects

Answer 17

hypotension (NO reflex tachy)
renal function deterioration
hyperkalemia

Question 18

what are the four ACEi’s to know by name

Answer 18

Enalapril
Benazepril
Lisinopril
Rampiril

Question 19

Pimobendan is a ___ sensitizer

Answer 19

Ca2+

Question 20

Pimobendan indications

Answer 20

dogs with HF from dilated CM or chronic mitral valve disease
USE WITH DIURETIC

Question 21

Pimobendan ___ myocardial contractions by ___ Ca2+ myofilament sensitivity

Answer 21

INCREASES BOTH

Question 22

Pimobendan effect on PDE, and how that affects cAMP and Ca2+

Answer 22

inhibits PDE _. increase cAMP -> increase betas -> dilation
increase Ca2+ influx -> stronger contraction

Question 23

Digoxin is a competitive ___ inhibitor

Answer 23

Na/K ATPase

Question 24

Digoxin indications

Answer 24

arrhythmia
atrial fibrillation due to DCM in DOBERMANS

Question 25

Digoxin effect on Ca2+, contractility

Answer 25

increases Ca, so increases contractility

Question 26

how does Digoxin effect baroreceptor?

Answer 26

baroreceptor sensitivity to increased vagal activity in HF

Question 27

Digoxin adverse effect

Answer 27

cardiac toxicity
sinus bradycardia
AV block
hypokalemia

Question 28

Dopamine and Dobutamine indications

Answer 28

myocardial failure
short term use for hypotension
Tx acute oliguric renal failure

Question 29

Dopamine and Dobutamine adverse effects

Answer 29

arrhythmia, increased myocardial O2 demand, tachycardia (since increases contraction)

Question 30

Dopamine receptors

Answer 30

DA > B > a

Question 31

Dobutamine is a ___ agonist

Answer 31

B1