Navle- Cardiac Drugs

Front 1

Right congestive heart failure results in:

Back 1

1. sytemic venous hypertension
2. congestion of the liver and other abdominal viscera
3. pleural effusion

Front 2

Left ventricular congestive failure results in:

Back 2

1. pulmonary venous congestion
2. pulmonary edema

Front 3

As an aid for optimal therapy, causes of heart failure can be categorized. What are the categorizes of CHF?

Back 3

1. myocardial dysfxn
2. volume-flow overload
3. pressure overload
4. restricted diastolic filling (diastolic failure)
5. persistent arrthymias

Front 4

What re the two cardiac compensatory mechanisms?

Back 4

1. Frank-Starling mechanism
2. Myocardial hypertrophy

Front 5

What is the Frank-Starling mechanism?

Back 5

increase in heart filling cause stronger contraction to help normalize output

Front 6

What are the types of myocardial hypertrophy?

Back 6

1. concentric hypertrophy- (w/ systolic pressure loads; fiber thickening)
2. eccentric hypertrophy- (volume loads- chamber enlargement)

Front 7

What are the neurohormonal compensatory mechanisms for heart failure?

Back 7

1. increased sympathetic nervous tone
2. activation of the renin-angiotensin-aldosterone system
3. release of ADH, vasopressin

Front 8

Why are diurectics used in congestive heart failure?

Back 8

counteract the sodium and volume retention activated by the neurohormonal compensatory mechanism

Front 9

What are the three types of diuretics used in heart failure?

Back 9

1. loop diuretic (high ceiling)- FUROSEMIDE
2. Thiazide diuretics-CHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE)- decrease renal blood flow and should not be used in the presence of azotemia
3. Potassium- sparing diuretics- SPIRONOLACTONE, TRIAMTERENE, used in conjuction with Furosemide to reduce potassium wasting

Front 10

When are K+ sparing diurectics contraindicated?

Back 10

animal receiving potassium supplementation or an ACE inhibitor

Front 11

When should Thiazides not be used for CHF?

Back 11

in the presence of AZOTEMIA, b/c thiazide diuretics decrease renal blood flow

Front 12

What affect do vasodilators have when CHF?

Back 12

1. increase cardiac output
2. reduce edema and effusions

Front 13

What is the only ACE inhibitor that is licensed for veterinary use?

Back 13

Enalapril (Enacard)

Front 14

What are the four ACE inhibitors used in animals?

Back 14

Enalapril, Captopril, Lisinopril, Benazepril

Front 15

What causes the release of RENIN?

Back 15

1. decr. in renal perfusion
2. incr. in sympathetic tone
3. decr. in sodium to macula densa

Front 16

What are the fxns of angiotensin II?

Back 16

1. increases aldosterone release
2. increases vasoconstriction
3. increases thirst
4. increases vasopressin release
5. increase norepinephrine release
6. increases renal sodium retention
7. hypertrophy of vessels and heart

Front 17

What are the adverse reaction of ACE inhibitors?

Back 17

1. hyptotension
2. gastroIN upset (esp w/ captropril)
3. worsening of renal function
4. hyperkalemia

Front 18

What are the vasodilators used in cardiac medicine?

Back 18

1. ACE inhibitors
2. Hydralazine
3. Nitrates
4. Prazosin

Front 19

What is hydralazine?

Back 19

Its a vasodilator that directly relaxes arteriolar smooth mm but has little effect on the venous system

Front 20

What is considered when adminestering hydralazine with food?

Back 20

Food decreases bioavability of hydralazine by 60%

Front 21

What are the therapeutic uses for hydralazine?

Back 21

1. mitral insufficiency
2. myocardial failure
3. hypertension

Front 22

What are the adverse effects of hydralazine?

Back 22

1. hypotension
2. reflux tachycardia
3. GI upset in cats

Front 23

What are the preparations of NITRATES?

Back 23

1. sodium nitroprusside
2. nitroglycerine ointment
3. isosorbide dinitrate

Front 24

How do the NITRATES work (MOA)?

Back 24

1. sodium nitroprusside- both an arterial and veno dilator
2. nitroglycerine and isosorbide- venous dilators

Front 25

What is the therapeutic use for sodium nitroprusside?

Back 25

IV, for fulminant congestive heart failure in dogs

Front 26

How is nitroglycerine normally administered?

Back 26

most commonly- transcutaneously- groin, axillary, and ear pinna; every 4-6 hours
can also be sublingual- well absorbed

Front 27

Prolonged effects of nitroglycerine can lead to:

Back 27

1. hypotension
2. cyanide toxicity

Front 28

What drug is used commonly for supraventricular tachyarrhythmias and as a positive inotrope?

Back 28

Digoxin

Front 29

Explain the mechanism of anaphylactic shock?

Back 29

there's a massive vasodilation, which results in systemic blood pressure falling dramatically; consequently, venous return decreases, cardiac output drops precipitously, and organ perfusion is insuffient

Front 30

What is the major ion involved in myocardial contractility?

Back 30

Calcium