Clin Pharm Cardio

Front 1

what are the pharmacological objectives of drug therapy for congestive heart failure

Back 1

1. decrease preload
2. decrease afterload
3. alter contractility
4. correct arrythmias
5. decrease sympathetic input

Front 2

how can you directly decrease preload

Back 2

decrease total blood volume = diuretics

increase venous capacity = vasodilators, ACE

Front 3

What diuretics are used for congestive heart failure

Back 3

Furosemide- most commonly used
spironolactone - K sparing
Thiazide diuretics - used rarely include hydrochlorthiazide and chlorthiazide

Front 4

what are adverse effects of furosemide

Back 4

dehydration and volume depletion
hypokalemia, hyponatremia
protein binding - can displace other drugs
digoxin interaction - hypokalemia potentiates digoxin toxicity
NSAID may interfere with PGN vasodilation
Dehydration of airway secretions can exaccerbate respiratory disease

Front 5

why shoould you be cautious about using ACE inhibitors with spironolactone

Back 5

increased risk of hyperkalemia

Front 6

how do vasodilators help with congestive heart failure

Back 6

they decrease preload by reducing filling pressures of left and right ventricles and myocardial oxygen demand

Front 7

how do ACE inhibitors help with congestive heart failure

Back 7

they are mixed vasodilators that affect both the arterial and venous systems

Front 8

true or false ACE inhibitors can decrease both peripheral and pulmonary resistance, increase CO and stroke volume without increases in heart rate

Back 8

TRUE

Front 9

true or false ACE inhibitors should be considerd as first line drugs for emergency treatment of congestive heart failure

Back 9

FALSE all ACE inhibitors are prodrugs that need to be metabolized and therefore are not used in emergencies

Front 10

what are the ACE inhibitors used in veterinary medicine

Back 10

Enalipril
Benazepril
Captopril

Front 11

what can be used as a venodilator in an emergency

Back 11

nitroglycerin

Front 12

how do nitrate venodilators function

Back 12

they increase cellular cGMP concentration --> inhibits contractile process in smooth muscle --> relaxes blood vessels

Front 13

what are the nitrate drugs

Back 13

nitroglycerin
isobide dinitrate
sodium nitroprusside

Front 14

what drugs directly decrease the afterload

Back 14

ACE inhibitors
hydralazine
amlodipine
Prazosin
Phenoxybenzamine

Front 15

what are the positive inotropic drugs

Back 15

pimobendin (#1)
digitalis glycosides -digoxin, digitoxin
dobutamine
dopamine

Front 16

what are contraindications for positive inotropes

Back 16

hypertrophic cardiomyopathy

aortic stenosis

Front 17

what is the clinical use for pimobendin

Back 17

cardiomyopathy and mitral valve insufficiency

useful for Doberman Pincher cardiomyopathy

Front 18

what do digitalis glycosides do

Back 18

increase contractility

decreased heart rate and conduction

Front 19

why is digoxin dosing based on lean weight

Back 19

because digoxin enters fat minimally

Front 20

what are the benificial effects of digitalis glycosides

Back 20

decreases heart rate
decreased electrical conduction throught the AV node
improved myocardial contractility without increased nyocardial O2 demand

Front 21

how does dobutamine function

Back 21

stimulate B1 receptors on the hear -> increased contractilty.
Stimulates contractility without increasing heart rate

Front 22

what is dobutamine used for

Back 22

short term management of heart failure
in clinic only due to short 1/2 life

Front 23

when is dobutamine used for heart failure

Back 23

only in clinical setting with CRI
1/2 life = 2 minutes

Front 24

what is dopamine used for

Back 24

used to correct hypotension with no response to fluid therapy

Front 25

what are the negative inotropic drugs

Back 25

beta blockers - propranolol, metoprolol

ca channel blockers - diltiazem

Front 26

what are the clasifications of anti-arythmic drugs

Back 26

1. inhibit Na influx
2. beta agonists
3. antagonize K efflux
4. Ca channel blockers

Front 27

what are the class 1 antiarrythmic drugs

Back 27

lidacaine
quinidine
procainamide
phentoin - limited use

Front 28

what does lidacaine do (broadly)

Back 28

decreases the action potential amplitude and depresses automacity

Front 29

what is the therapeutic use of lidacaine as an antiarrythmic

Back 29

for reverting ventricular arrythmias (that develop during anesthesia)

Front 30

true or false Class 1 antiarrythmics often affect only abnormal cells

Back 30

true refered to as "use dependance" they bind more readily to channels in the open or refractory state

Front 31

what is an important side effect of quinidine

Back 31

an atropine like vagolytic action -> increased heart rate so they are often given with a negative chronotopic i.e. digoxin

Front 32

what are the Class 2 antiarrythmics - beta blockers

Back 32

propanolol
atenolol
metoprolol

Front 33

what are the class3 antiarrythmics - antagonize K efflux

Back 33

sotolol
amidorone

Front 34

what ar ethe class 4 antiarrythmics - Ca channel blockers

Back 34

diltiazem
verapamil

Front 35

what are clinical uses for the class 4 antiarrythmics

Back 35

feline HCM
supraventicular tachycardia
vasodilation

Front 36

what drugs are used for short term and long term treatment of ventricular arrythmias

Back 36

short term - lidacaine

long term - quinidine, procainamide

Front 37

true or false beta blockers may prolong survival time

Back 37

true by decreasing the sympathetic input beta blockers may prolong survival time

Front 38

what are the clinical uses of beta blockers

Back 38

arrythmias associated with excess sympathetic stimulation
controlling ventricular rate in supaventricular or ventricular arrythmias
ventricular and supraventricular premature complexes
controlling tachycardia in hyperthyroid cats
controlling heart rate in feline HCM
may benifit dogs with DCM
propanolol may be combined with class 1 druggs when single drug therapy is ineffective