cardiac drugs

Question 1

which diuretics do we not use for cardio patients

Answer 1

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

Question 2

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

Answer 2

furosemide, loop diuretic

Question 3

things to remember when you put a patient on furosemide

Answer 3

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

Question 4

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

Answer 4

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

Question 5

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

Answer 5

thiazide diuretics and digoxin ( +inotrope by increasing calcium)

Question 6

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

Answer 6

spironolactone (potassium sparing diuretic)

Question 7

what does NSAIDS do to our cardiac treatment

Answer 7

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

Question 8

what do ACEi do? who are they for

Answer 8

decrease congestion by vasodilation and decrease ion reuptake

benazepril elanapril
dogs and cats

Question 9

what is the preferred vasodilators for our renal failure patients

Answer 9

benazapril: hepatic and renal secretion

Question 10

Treatment of choice in cats with systemic hypertension

Answer 10

amlodipine

Question 11

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

Answer 11

sildenafil (phosphodiesterase inhibitor)

Question 12

what is an effect of ACEi

Answer 12

azotemia

Question 13

in hospital drug we reach for when MAP >220

Answer 13

hydralazine. risk of severe hypotension. ER drug

Question 14

dog treatment when furosemide cant be used

Answer 14

thiazide diuretic

Question 15

when do we reach for vasodilators

Answer 15

systemic hypertension or CHF adjunctive therapy especially in DMVD

Question 16

when do we reach for antiarrhythmics

Answer 16

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

Question 17

emergency treatment for VTach

Answer 17

lidocaine IV or procainamide

Question 17

what toxicity signs are we looking for when giving lidocaine IV

Answer 17

neuro signs, seizures. cats are extra sensitive

Question 18

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

Answer 18

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

Question 18

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

Answer 18

procainamide, decreases slope and slows action potential

Question 19

what are our class two antiarrhythmics

Answer 19

beta blockers, inhibit sympathetic influence

Question 20

what antiarrhythmics can you never use together

Answer 20

potassium channel blockers and drugs that decrease potassium.

Question 21

what myocytes use potassium to repolarize

Answer 21

ventricular cells. so K channel blockers work in vent

Question 22

what cells use calcium to repolarize

Answer 22

atria and AV node. can only use on SVT

Question 23

what is our acute management of afib

Answer 23

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

Question 24

chronic treatment for Vtach

Answer 24

mexiletine and sotalol

Question 25

how should we think about mexiletine

Answer 25

oral form of lidocaine

Question 26

acute treatment of SVT

Answer 26

vagal maneuvers- retropulsion and carotid massage. increases vagal tone to slow AV node then diltiazem our C IV drug to slow depolarization

Question 27

chronic treatment of SVT

Answer 27

diltiazem and atenolol

Question 28

what is our goal with afib dogs? drug?

Answer 28

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

Question 29

what does digoxin do to heartrate

Answer 29

negative chronotrope by slowing av conduction by increasing PS tone

Question 30

what are the rules about digoxin use

Answer 30

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

Question 31

atrial fib in a horse

Answer 31

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

Question 32

what are our class II drugs

Answer 32

atenolol

Question 33

atenolol, BBlocker, can be used for

Answer 33

chronic management of VTach or afib due to it blocking sym effects

Question 34

class III drugs and type

Answer 34

potassium channel blockers, sotalol and amiodarone

Question 35

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

Answer 35

all myocytes use K+ to repolarize

Question 36

why would I reach for dobutamine

Answer 36

+ inotrope (inc contractility) acute heart failure with systolic dysfunction

Question 37

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

Answer 37

dobutamine and pimobendan (increase contractility)

Question 38

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

Answer 38

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

Question 39

treatment of acute onset heartfailure- respiratory signs

Answer 39

furosemide. give before rads even if unsure its heartfailure.

Question 40

why do we like pimobendan for heart failure

Answer 40

it increases contractility while also vasodilating

Question 41

who do we give pimobendan to

Answer 41

MMVD, DCM, any decrease in contractility HF

Question 42

acute positive inotrope

Answer 42

dobutamine

Question 43

when do we reach for spironalactone

Answer 43

when we have ACEi on board and feel like the chymase pathway is being used stage C MMVD DCM?

Question 44

vasodilate and decrease blood volume MMVD, DCM, stage C MMVD

Answer 44

ACEi . BID

Question 45

how do we give thiazides

Answer 45

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

Question 46

chronic heart failure drug combos

Answer 46

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

Question 47

diuretics are contraindicated in what patients

Answer 47

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