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breathing and circulating > cardiac drugs > Flashcards

cardiac drugs Flashcards

1
Q

which diuretics do we not use for cardio patients

A

carbonic anhydrase (dorzolamide) and osmotic diuretics (oliguric renal failure patients)

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2
Q

treatment of choice in edema of cardiopulmonary, hepatic and renal origin

A

furosemide, loop diuretic

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3
Q

things to remember when you put a patient on furosemide

A

watch for dehydration and tolerance to the drug. increase dose=increase effect

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4
Q

what is the main difference between thiazide and loops (furosemide)

A

thiazide does can cause hypercalcemia and it can decrease renal blood flow. furosemide does the opposite

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5
Q

if we have a patient that is hypercalcemic and/or azotemic, what drugs do we avoid?

A

thiazide diuretics and digoxin ( +inotrope by increasing calcium)

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6
Q

competitive antagonist with aldosterone, this antagonist rship decreases cardiac fibrosis and reduces ion reuptake.
what drug?

A

spironolactone (potassium sparing diuretic)

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7
Q

what does NSAIDS do to our cardiac treatment

A

decreases the effects of diuretics and vasodilators, decreases furosemide getting to the loop of henle.

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8
Q

what do ACEi do? who are they for

A

decrease congestion by vasodilation and decrease ion reuptake

benazepril elanapril
dogs and cats

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9
Q

what is the preferred vasodilators for our renal failure patients

A

benazapril: hepatic and renal secretion

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10
Q

Treatment of choice in cats with systemic hypertension

A

amlodipine

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11
Q

drug that causes pulmonary vasodilation and used for pulmonary hypertension in combo with other drugs

A

sildenafil (phosphodiesterase inhibitor)

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12
Q

what is an effect of ACEi

A

azotemia

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13
Q

in hospital drug we reach for when MAP >220

A

hydralazine. risk of severe hypotension. ER drug

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14
Q

dog treatment when furosemide cant be used

A

thiazide diuretic

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15
Q

when do we reach for vasodilators

A

systemic hypertension or CHF adjunctive therapy especially in DMVD

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16
Q

when do we reach for antiarrhythmics

A

when there is an arrhythmia that is incompatible with life or it could lead to life threatening arrhythmias

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17
Q

emergency treatment for VTach

A

lidocaine IV or procainamide

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17
Q

what toxicity signs are we looking for when giving lidocaine IV

A

neuro signs, seizures. cats are extra sensitive

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18
Q

what do we do if its been an hour in VTach, and no drugs are working

A

sedate dog and shock to try and reset their heart. its painful and dangerous

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18
Q

ecg shows tachy with narrow QRS and regular rhythm. what drug do we reach for

A

procainamide, decreases slope and slows action potential

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19
Q

what are our class two antiarrhythmics

A

beta blockers, inhibit sympathetic influence

20
Q

what antiarrhythmics can you never use together

A

potassium channel blockers and drugs that decrease potassium.

21
Q

what myocytes use potassium to repolarize

A

ventricular cells. so K channel blockers work in vent

22
Q

what cells use calcium to repolarize

A

atria and AV node. can only use on SVT

23
Q

what is our acute management of afib

A

usually doesnt require ER drugs. can start oral digoxin + diltiazem.

24
Q

chronic treatment for Vtach

A

mexiletine and sotalol

25
Q

how should we think about mexiletine

A

oral form of lidocaine

26
Q

acute treatment of SVT

A

vagal maneuvers- retropulsion and carotid massage. increases vagal tone to slow AV node

then diltiazem our C IV drug to slow depolarization

27
Q

chronic treatment of SVT

A

diltiazem and atenolol

28
Q

what is our goal with afib dogs? drug?

A

slow the rate of the fibs so that it is compatible with life. do not try and cure the fibs.

diltiazem and digoxin
digoxins slows av conduction by increasing PS tone

29
Q

what does digoxin do to heartrate

A

negative chronotrope by slowing av conduction by increasing PS tone

30
Q

what are the rules about digoxin use

A
  1. sample 8 days after you start the drug, 8hrs after dose was given, and serum levels need to be <0.8ng/ml
31
Q

atrial fib in a horse

A

quinidine, or internal cardioversion if you caught it early and there is not heart failure.

32
Q

what are our class II drugs

A

atenolol

33
Q

atenolol, BBlocker, can be used for

A

chronic management of VTach or afib

due to it blocking sym effects

34
Q

class III drugs and type

A

potassium channel blockers,
sotalol and amiodarone

35
Q

why can we use C III drugs for atrial and ventricular arrhythmias

A

all myocytes use K+ to repolarize

36
Q

why would I reach for dobutamine

A

+ inotrope (inc contractility)

acute heart failure with systolic dysfunction

37
Q

dog comes in with acute heart failure due to DCM what drugs do i give

A

dobutamine and pimobendan (increase contractility)

38
Q

why do we use dobutamine and not dopamine is heart failure treatment

A

dopamine is a vasoconstrictor which causes the heart to have to work harder. not ideal

39
Q

treatment of acute onset heartfailure- respiratory signs

A

furosemide. give before rads even if unsure its heartfailure.

40
Q

why do we like pimobendan for heart failure

A

it increases contractility while also vasodilating

41
Q

who do we give pimobendan to

A

MMVD, DCM, any decrease in contractility HF

42
Q

acute positive inotrope

A

dobutamine

43
Q

when do we reach for spironalactone

A

when we have ACEi on board and feel like the chymase pathway is being used

stage C MMVD
DCM?

44
Q

vasodilate and decrease blood volume

MMVD, DCM, stage C MMVD

A

ACEi . BID

45
Q

how do we give thiazides

A

EOD in conjunction with furosemide to get exponential effects compared to furosemide alone

46
Q

chronic heart failure drug combos

A

furosemide diuretic
pimobendan inc cont
ACEi: decrease BP, vasod
Spironalactone: helps ACEi
+- thiazide, +- digoxin if afib
+- antiarrhythmic

47
Q

diuretics are contraindicated in what patients

A

pericardial effusion patients, their barely moving blood as it is and we dont need to decrease blood volume.

decrease in preload

48
Q
A

breathing and circulating (21 decks)

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