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PHARMACOLOGY > SMALL ANIMALS DRUGS FOR TREATING CARDIAC DISEASE > Flashcards

SMALL ANIMALS DRUGS FOR TREATING CARDIAC DISEASE Flashcards

1
Q

drugs for treating heart failure

A

-decrease preload
-decrease afterload
-enhance inotropic function

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2
Q

drugs that decrease preload, indication; excessive preload-signs of

A

congestion: pulmonary edema, pleural effusion, ascites
>diuretics
>venodilators

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3
Q

drugs that decrease preload: diuretics - increase excretion of

A

sodium > reduction in extracellular fluid volume > lower circulating fluid volume > reduction in preload

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4
Q

classes of diuretics

A

3 classes:
1. loop
2. thiazide
3. potassium sparing

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5
Q

diuretics side effects

A

-polyuria
-polydipsia

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6
Q

diuretics complications

A

-hypotension
-azotemia
-hypokalemia(loop), hyponatremia

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7
Q

furosemide, torsemide

A

=loop diuretics
>blockade of Na+/K+/2Cl-
>loop of Henle
(most potent 25%)

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8
Q

hydrochlorothiazide

A

-thiazide
>blockade of Na+/Cl- carrier
>distal tubule and connecting segment

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9
Q

furosemide drug that decrease preload-diuretics: first line therapy for patients with signs of

A

congestion

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10
Q

furosemide: patients can become refractory to drugs to drug with chronic treatment

A

-higher doses
-coadministration of diuretics that act at different sites in nephron
-substitute for torsemide

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11
Q

spironolactone-drugs that decrease preload: diuretics: aldosterone receptor

A

antagonist
-insufficient natriuretic potency to be used as sole diuretic
-benefits well regocnized
>cats: cutaneous adverse drug reactions

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12
Q

drugs decrease preload: ventilators: nitroglycerin: treatment of

A

acute heart failure ( with loop diuretic)
-transdermal
-adverse effects: rashes at application site, hypotension, headache

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13
Q

drugs that decrease AFTERLOAD: vasodilators: left ventricular afterload reduction:

A

systemic vasodilation
>nitroprusside
-ACEI-angiotensin converting enzyme inhibitors
>pimobendan: Ca channel blockers
-complications: hypotension

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14
Q

drugs that decrease AFTERLOAD: vasodilators: right ventricular afterload reduction:

A

pulmonary vasodilation
-indication: pulmonary hypertension
>slidenafil: phosphodiesterase V inhibitor
>pimobendan can have pulmonary vasodilatory properties

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15
Q

drugs that decrease AFTERLOAD: vasodilators: 1. nitroprusside and 2. ACEI and 3. Ca channel blockers

A
  1. balanced effect: preload reduction via ventilation and afterload reduction via arteriodilation, CRI, only in ICU setting (Intensive Care Unit), indications: acute/severe hypertension, acute heart failure, combo with dobutamine
  2. ACEI: enalapril, benazepril, inhibition of angiotensin converting enzyme : vasodilation, inhibit fluid retention, part of chronic therapy for heart failure
  3. Ca channel blockers: amlodipine: systemic hypertension, in dogs also as afterload reducer for refractory heart failure
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16
Q

drugs that enhance inotropic function: myocardial contractility is frequently

A

impaired in patients with heart failure
> increased cardiac contractility > increased cardiac output, indirectly decreased preload

17
Q

enhance inotropic function: dobutamine used in

A

acute treatment of heart failure

18
Q

enhance inotropic function: pimobendan used in

A

chronic treatment of heart failure

19
Q

enhance inotropic function: digoxin treatment for

A

atrial fibrillation

20
Q

enhance inotropic function: dobutamine indications

A

-acute signs if heart failure + hypotension / primary failure of myocardial contractility

21
Q

enhance inotropic function: dopamine

A

adrenergic /dopaminergic inotropic agent

22
Q

dopamine indications

A

in ICU setting severe hypontension/shock due poor cardiac contractility and / or vasodilation, hypotension during general anesthesia
(dobutamine preferred)

23
Q

drugs enhance inotropic function: Pimobendan

A

=INODILATOR
-phosphidiesterase inhibiton and calcium sensitization: inotropic and casodilatory properties = INODILATOR

24
Q

pimobendan indications

A

-most dogs, some cats with heart failure
-dogs with preclinical heart disease

25
Q

anti arrhythmic therapies : Vaughan williams system classes 1-4

A

-class 1: block Na channels, depress depolarization ; Class 1a-1c
-class 2: antiadrenergic drugs: mainly beta adrenergic receptor blockers: indications : atrial tachyarrhythmias AF
-class 3: prolong repolarization,indications: ventricular arrhythmias, supra ventricular arrhythmias
-class 4: Ca channel blockers, indications: atrial tachyarrhythmias

26
Q

adverse effects of antiarrthythmic therapy

A

-arrhythmias
-cardiac systolic and diastolic function
-many class 1 drugs have CNS and GI effects

27
Q

mexiletine: class 1b: similar to lidocaine but less rapid

A

hepatic metabolism and longer elimination half life
-indicaiton: chronic therapy of ventricular tachyarrhythmias in dogs
-class 1b neurotoxic to cats

28
Q

lidocaine: class 1b: first choice for treatment of

A

ventricular tachyarrhythmias
-hypokalaemia : poor response to lidocaine
-adverse effects: cats prone neurotoxicity>lower dose , GI effects

29
Q

beta adrenergic blockers: class 2: action

A

reduced heart rate and excitability
-indications : supraventricular and ventricular tachuarrhythmias
-adverse effects: lethargy, collapse, bradycardia, hypotension
most used: atenolol, metoprolol

30
Q

sotalol: class 3 (+class 2 action)- prolong

A

repolarization + beta 1 and 2 blocker
-indication: ventricular and supraventricular tachyarrhythmias: most often used in boxers with arrhythmogenic cardiomyopathy
-dogs ventricular tachycardia use lidocaine and procainamide
>adverse effects: negative inotropy

31
Q

diltiazem: class 4

A

Ca channel blockers
>actions: slow sinus rate and AV node conduction, arteriodilator
>indication: supraventricular tachyarrhythmias
>adverse effects: bradycardia (dogs), vomiting (cats)

32
Q

digoxin: digitalis glycoside DG : actions with

A

heart failure > increased myocardial contractility and cardiac output, diuresis, reduction of edema, reduction heart size, HR
>indication: dogs with atrial fibrillation + CHF
>adverse effect: arrhythmias, worsening HF

33
Q

antithrombotic drugs: prevention of

A

arterial thromboembolism

34
Q

antiplatelet drugs: inhibition of platelet aggregation

A

-aspirin NSAID
-clopidogrel

35
Q

sedative/analgetic agents

A

-butorphanol: opioid agonist/antagonist > decrease stress (acute CHF)
-mu agonist (fentanyl)-severe pain (FATE)

36
Q

drugs used in CPR

A

-reversals: opioids-naloxone
-vasopressors: maintain perfusion to vital organs

PHARMACOLOGY (14 decks)

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