Cardio drugs Flashcards
(47 cards)
1
Q
Atenolol
A
B-blocker
2
Q
Sotalol
A
B-blocker
3
Q
Amlodipine
A
Ca2+ channel blocker
4
Q
Diltiazem
A
Ca2+ channel blocker
5
Q
Verapamil
A
Ca2+ channel blocker
6
Q
Benazepril
A
ACE inhibitor
7
Q
Enalapril
A
ACE inhibitor
8
Q
Telmisartan
A
Angiotensin-2-receptor blocker
9
Q
Atropine
A
Anticholinergic (mAch-R blocker, parasympatholytic)
10
Q
Glycopyrrolate
A
Anticholinergic (mAch-R blocker, parasympatholytic)
11
Q
Vasopressin
A
= Anti-diuretic hormone
12
Q
Epinephrine
A
Vasopressor (α1 β1 β2 agonist)
13
Q
Norepinephrine
A
Vasopressor (α1 >> β1 β2 agonist)
14
Q
Milrinone, amrinone
A
Inhodilators - Phosphodiesterase (PDE-III) inhibitors
15
Q
Pimobendane
A
Inodilators -
Calcium sensitizer + PDE-inhibitor
16
Q
Digoxin, digitoxin
A
Cardioglycosides
17
Q
Name the two main vasopressors
A
Epinephrine (adrenaline),
Norepinephrine (noradrenaline)
18
Q
Treatment of choice for CHF
A
- Furosemide (spironolactone if hypoK)
- ACE inhibitor
- Inhodilator (pimobendane)
- Exercise restriction
- Dietary Na+ restriction
19
Q
B-blockers - general effects
A
- ↓contractility (- ionotropic)
- ↓ HR (antiarrhythmic for sinus, ventricular or supraventricular tachycardia or tachyarrythmias)
= ↓ blood pressure
20
Q
B-blockers - side effects and main C/I
A
- Bradycardia
- Hypotension
- C/I if CHF (may exacerbate)
21
Q
Ca channel blockers - general effects
A
- ↓contractility (- ionotropic)
- ↑ lusitropy (myocardial relaxation)
- ↓ HR (antiarrhythmic for a-fib and supraventricular tachycardia)
- ↓ SVR (anti-hypertensive drug)
22
Q
Ca channel blockers - side effects
A
- Hypotension
- Bradycardia
- Non cardiogenic pulmonary edema (mechanism unknown)
23
Q
Treatment for Ca channel blocker overdose
A
IV lipids
24
Q
Name 2 anticholinergic drugs
A
- Atropine
- Glycopyrrolate
25
3 indications of atropine
- Atropine response test (distinguish between increased vagal tone vs SA node Lx)
- Correction of bradycardia (except if 2ary to a2)
- Cholinergic crisis (crosses BBB)
26
Main effects of anticholinergic
Opposite of SLUD
* Lower Salivation
* Lower lacrimation
* Lower Urinartion
* Lower Defection (constipation, ileus)
* Myosis
* Tachycardia
27
4 indications for the atropine response test
- Sinus bradycardia
- Sinus arrest
- Sinoatrial exit block
- BAV
Positive if HR ↑ \> 50%
28
1 major species-Sp C/I of atropine
- HORSES (topical or systemic) -\> risk of ileus -\> colic
29
3 other C/I for atropine
* _Reflex bradycardia_ following a2-agonist administration. Only if NOT associated with hypertension.
* _Narrow-angle glaucoma_
* _Urinary obstruction_
30
Main clinical difference between atropine vs glycopyrrolate
Glyco does not cross the BBB (so cannot be used to treat central signs of OP toxicity)
31
ACE inhibitors - general effects
Blocks the RAAS (angiotensin 1 -x--\> 2)
- ↓SVR (vasodilator) - adjunct therapy for hypertension
- ↑ cardiac output
- Counteracts the mean effects of the RAAS during CHF.
32
Epinephrine - general effects, main indication
- ↑SVR (vasoconstriction, a1 → improves coronary perfusion)
- ↑contractility (B2)
- ↑HR (B1)
CARDIOPULMONARY RESUSCITATON
ANAPHYLAXIS
33
Norepinephrine (noradrenaline) - General effects and main indication
- ↑SVR (vasoconstriction, a1)
when you don't necessarily want to increase HR
SEPTIC SHOCK = NE + dobutamine
34
Name 4 categories of + ionotropes
- Cardiac glycosides (digoxin, digitoxin)
- PDE inhibitors (amrinone, milrinone)\*
- Catecholamines (dopamine, dobutamine, isoproterenol)
- Inhodilators / calcium sensitizers (pimobendane)\*
\* are both inhodilators = +inotropic AND vasodilator effects
35
Pimobendane - general actions and two indications
- ↑contractility (+ ionotropic)
- ↓ SVR (vasodilator)
INDICATIONS
- During CHF to enhance cardiac performance
- PREVENTION of CHF during either :
\*B2-stage MDCVAV in dogs
\*Occult (asympto) DCM in Dobes
36
PDE inhibitors (amrinone, milrinone) - general action
- ↑contractility (+ ionotropic)
- ↓SVR (vasodilator)
37
Cardiac glycosides - general effects
- ↑contractility (+ ionotropic)
- ↓HR (- chronotropic)
- ↓SVR (given PO)
38
Dopamine, dobutamine - general effects
- ↑ contractility and CO
+ for short-term (24-48 hours) support of myocardial contractility.
* Dopamine (DA, β1 \>\> β2, α1) has more variable dose-dependent effects (vasodilation -\> ↑ contractility -\> vasoconstriction)*
* Dobutamine (β1 \>\> β2 \>\> α1 ) has more selective effects on B1 and thus ↑ contractility.*
39
Main drug - cardiopulmonary resuscitation
Epinephrine
+/- vasopressin (ADH)
40
2 drugs for septic shock
Norepinephrine + dobutamine
41
Anaphylactic shock
Epinephrine
42
Hemorrhagic shock
vasopressors only given if hypotension persists despite fluid replacement and arrest of hemorrhages.
43
Drugs for BAV1
Anticholinergic (atropine, gylcopyrrolate). cuz usually linked to increased vagal tone.
44
Drugs for BAV2 in PA
Beta-agonists (terbutaline, isoproterenol)
45
Drugs for A-fib in PA ? horses?
PA = diltiazem, digoxin, amiodarone, β-blockers (e.g., atenolol).
Eq = quinidine
46
Drug - Ventricular arrythmias (V-tac, PVC)
Dogs : _Lidocaine_ or Amiodarone if V-tac follows recovery from cardiac arrest
Cats : _B-blocker_ \> lidocaine (higher risk of toxicity)
47
Situation where lidocaine should NEVER be used (type of ectopic rythm)
_Escape ventricular rhythm_ : **NON** (is heart's survival mode)
PVC / V-tac : OUI
Always careful in **cats**
