Veterinary Pharma - Clinical Pharmacology Cardiovascular drugs Flashcards
Cardiovascular drugs are mainly grouped into? (5) CAPVA
Cardiac glycosides/digital glycosides
Angiotensin-converting enzyme (ACE) inhibitors
Phosphodiesterase (PDE) inhibitors
Vasoactive drugs
Antiarrhythmics
Under the group cardiac/digitalis glycosides, what are the two (2) subgroups of drugs?
Digoxins
Digitalis
Under the group angiotensin-converting enzyme/ACE inhibitors), what are the drugs? (3) CBE
Captopril
Benazepril
Enalapril
Under the group phosphodiesterase enzyme/PDE inhibitors), what are the four (4) subgroups?
PDE-3 inhibitors
PDE-4 inhibitors
PDE-5 inhibitors
Non-specific PDE inhibitors
Of the group phosphodiesterase enzyme (PDE) inhibitors, what are the drugs under PDE 3 inhibitors? (4) CDMA
Cilostazol
Dipyridamole
Milrinone
Amrinone
Of the group phosphodiesterase enzyme (PDE) inhibitors, are the drugs under PDE 4 inhibitors? (3) RPC
Roflumilast
Premilast
Crisaborole
Of the group phosphodiesterase enzyme (PDE) inhibitors, are the drugs under PDE 5 inhibitors? (4)
Sildenafil
Tadalafil
Vardenafil
Avanafil.
Of the group phosphodiesterase enzyme (PDE) inhibitors, are the drugs under non-specific PDE inhibitors? (2)
Theophylline
Ibudilast
Under the group antiarrythmic drugs, what are the four (4) classifications?
Class 1
Class 2
Class 3
Class 4
Of the four classes of antiarrythmic drugs, which class are membrane stabilizers?
Class 1
Of the four classes of antiarrythmic drugs, which class are beta-adrenergic blockers?
Class 2
Of the four classes of antiarrythmic drugs, which class inhibits norepinephrine release?
Class 3
Of the four classes of antiarrythmic drugs, which class blocks entry of calcium?
Class 4
What examples under Class 1 antiarrythmic drugs? (11) QPDLPTMELFP
Quinidine
Procainamide
Disopyramide
Lidocaine
Phenytoin
Tocainide
Mexiletin
Encanide
Lorcainide
Flecainide
Propafenone
What examples under Class 2 antiarrythmic drugs? (4) PTAP
Propanolol
Timolol
Alprenolol
Pindolol
What examples under Class 3 antiarrythmic drugs? (3) BSA
Bretylium
Sotalol
Amiodarone
What examples under Class 4 antiarrythmic drugs? (3) VND
Verapamil
Nifedipine
Diltiazem
Drugs under antiarrythmics that are of veterinary importance (5) QPPLP
Quinidine
Phenytoin
Propanolol
Lidocaine
Procainamide
What are the electrophysiologic properties of the heart which are affected by digitalis glycosides? (4) ACER
Automaticity
Conduction
Excitability
Refractoriness
What are the cardiac regions of the heart that exhibits electrophysiologic properties? SAPAAVAV
SA node
AV node
Purkinje fibers
AV juntional tissues
Atrium
Ventricle
Atrial muscle
Ventricular muscle
These drugs increases the strength of cardiac muscle contraction by increasing the quantity of intracellualr calcium available for binding with muscle proteins.
Positive inotropes
What is the MOA of postive inotropes?
-increases intracellular calcium
-alters the Sodium-Calcium exchange pump an
-increases production of cyclic adenosine monnophosphate (cAMP) because stimulation of adenylate cyclase
-decreases degradation of cAMP via inhibition of phosphodiesterases
What is the MOA of cadiac glycosides?
-inhibits membrane-bound sodium-potassium-ATPase pump
-increase calcium in the cell, increase sodium-calcium exchange
-increase release of calcium from sarcoplasmic reticulum
-increased contractility of the cardiac muscle
-increases automaticity and cardiac arrythmias
An effect by the digitals drugs where there is decreased conduction velocity in the AV node
Negative chronotropic effect
How does digitalis drugs provide a negative chronotropic effect?
-Potentiation of the vagal (cholinergic) activity of the heart
-Changes the conduction of the heart which might result in AV nodal blockade
-at toxic level, increase acetylcholine sensitivity which may directly slow sinus nodal activity
What are the general clinical uses of digitalis drugs? (2)
-Congestive heart failure (circulation restoration)
-Supraventricular tachyarrythmias (slow down ventricular rate)
What are the general clinical uses of digoxin drugs?
Same with digitalis, but not prefered with animals with renal disease
What are the drugs under beta-adrenergic agonists? (4) DDEI
Dopamine
Dobutamine
Epinephrine
Isoproterenol
What are the drugs under beta-adrenergic agonists? (4) DDEI
Dopamine
Dobutamine
Epinephrine
Isoproterenol
What is the main mode of action of Dopamine, Dobutamine, Epinephrine, and Isoproterenol?
Effects on beta-adrenergic receptors
Of the beta-adrenergic agonist, which drugs are synthetic?
Dobutamine
Isoproterenol
Of the beta-adrenergic agonist, which drug is endogenous?
Dopamine
Of the beta-adrenergic agonist, which drug can either be endogenous or synthetic?
Epinephrine
As beta-adrenergic substance, what is the main action of dopamine mode of action?
Selective beta-1 activity
What are the indications of Dopamine? (3)
Cardiogenic shock
Endotoxic shock
Oliguria
What may occur if you use Dopamine?
Cardiac arrythmias
As beta-adrenergic substance, what is the main action of Dobutamine mode of action?
Minimal beta-1 activity
What is the indications of Dobutamine?
Short-term therapy for refractory chronic heart failure
What may occur if you use Dobutamine? (3)
More effective positive inoptrope than dopamine
Less chronotropic effect
Absent dilatation of renal vascular bed
As beta-adrenergic substance, what is the main action of Epinephrine mode of action?
Greatest increase in rate of energy usage
Greatest increase in myocardial oxygen demand
Rapidly metabolized in GIT (PO no go)
What are the indications of Epinephrine? (s)
Cardiac arrest
Anaphylactic shock
As beta-adrenergic substance, what is the main action of Isoproterenol mode of action?
Non-specific beta-agonist
Affects beta-1 and/or beta-2
What are the indications of Isoproterenol?
Short-term bradyarrhythmia therapy
Short-term AV block therapy
What is the mode of action of Phosphodiesterase inhibitors?
Blocks breakdown of cAMP
Increases intracellular cAMP concentrations
Increases myocaridal contractility
What is the mode of action of angiotensin-converting enzyme inhibitors?
Inhibits formation of angiotensin 2 from angiotensin 1
Inhibits vasoconstriction
Reduces sodium and water retention
Reduces cardiac (arterioles) preload and afterload (veins)
What are the indications of ACE inhibitors?
Chronic congestive heart failure treatment
What are the drugs that are vasoactive dilators? (5) HANNP
Hydralazine
Amlodipine
Nitroglycerin
Nitroprusside
Prazosin
What are the two (2) catergories of vasoactive drugs?
Afterload reducer (Dilates arterioles )
Preload reducer (Dilates veins)
Under vasoactive drugs, what drugs are arterial dilators? (2)
Hydralazine
Amlodipine besylate
Hydrazaline and Amlodipine are vasoactive drugs that dilates the arterioles. What is their MOA?
Inhibits calcium fluxes into the cell
Increases local prostacyclin concentrations
Decreases peripheral vascular resistance
Absent decrease of myocardial contractility
Under vasoactive drugs, what drugs are arterial and venous dilators? (2)
Nitrogycerin
Nitroprusside
Prazosin
What is the indications of nitrogylcerin?
Acute congestive heart failure treatment with fulminant pulmonary edema
What is the indications of nitroprusside?
Lowers blood pressure
Severe congestive heart failure
Most potent vasodilator. May cause unwanted hypotension.
What is the MOA of prazosin?
alpha-1 adrenergic receptor blocker
Afterload reducer
Preload reducer
PO, tolerance is of concern
May undergo first-pass metabolism
Class 1 antiarrhythmics are further subdivided into? (3)
1A
1B
1C
Of the two subdivisions of class 1 antiarrhythmic drugs, what is does 1A do to conduction and repolarization?
Slow conduction
Prolong repolarization
What are drugs under antiarrhythmic Class 1A?
Quinidine
Procainamide
Disopyramide
Of the two subdivisions of class 1 antiarrhythmic drugs, what is does 1B to conduction and repolarization?
Slow conduction
Shorten repolarization
What are drugs under antiarrhythmic Class 1B?
Lidocaine
Tocainide
Mexiletine
Phenytoin
Of the two subdivisions of class 1 antiarrhythmic drugs, what is does 1C to conduction and repolarization?
Prolong conduction
Little or no effect on repolarization
What are drugs under antiarrhythmic Class 1C?
Encainide
Flecainide
Propafenone
Generally, what is the MOA of antiarrhythmic class 1 drugs?
Selectively blocks fast sodium channels
Depressing phase 0 of the action potential
Decreases conduction velocity
Causes local anesthesia
Of the two(2) drugs under class 2 antiarrhythmic drugs, which one is a selective beta-1 selective blocking agent (affects only beta-1 adrenergic receptors)?
Atenolol
Of the two(2) drugs under class 2 antiarrhythmic drugs, which one is only a beta-adrenergic receptor blocker (affects beta-1 and beta-2 adrenergic receptors)?
Propranolol
What are the indications of Atenolol? (3) SSH
Supraventricular tachyarrhythmias
Systemic hypertension
Hypertrophic cardiomyopathy
What is the MOA of class 3 antiarrhythmic drugs?
Block cardiac tissue potassium channels
Prolong cardiac action potential
Prolong refractory period
