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Pharamcology > Cardiovascular drugs > Flashcards

Cardiovascular drugs Flashcards

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1
Q

What is this?

A

The Cardiac Cycle

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2
Q

What is the RAA system?

A
  1. Renin-Angiotensin-Aldosterone system
  2. Raises BP + conserves Sodium + water
  3. To restore fluid balance
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3
Q

In basic steps, how does the RAA system work?

A
  1. Low BP or Sodium > Triggers kidneys to release Renin
  2. Renin converts Angiotensionogen (from Liver) > ANGIOTENSIN 1
  3. ACE (Angiotensin-Converting Enzyme) from lungs converts Angiotensin 1 > Angiotensin 2 then:
    * Causes vasoconstriction of BVs > RAISING BP
    * Stimulating ALDOSTERONE release - from adrenal glands
    * Causing Sodium + water retention in Kidneys > increasing BV + BP
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4
Q

What is this?

A
  1. The Juxtagolmerular apparatus (JGA)
  2. Specialised structure in the kidneys
  3. Plays a crucial role in regulating BP, BV + filtration rate of the Glomerulus
  4. Located in the Distal Convoluted Tubule (DCT), made up of the:
    * Macula densa
    * Juxtaglomerular cells
    * Extraglomerular mesangial cells
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5
Q

What do Cardiovascular drugs generally do?

A

Act on the:
1. Heart
2. BVs
3. Kidneys

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6
Q

What are the 5 categories of Cardiovascular drugs?

A
  1. Positive Inotropes + Chronotropes
  2. Negative Inotropes + Chronotropes
  3. Vasodilators
  4. Anti-dysrhymthmic drugs
  5. Diuretics
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7
Q

What do Positive Inotropes + Chronotropes do?

A
  • Enhance/Increase:
    1. Myocardial CONTRACTILITY
    2. HR
  • Example = Adrenaline
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8
Q

What do Positive Inotropes do?

A

Increases the FORCE of heart muscle Contraction

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9
Q

What do Positive Chronotropes do?

A

Increases HR

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10
Q

What is Inotropy?

A

Stronger contractions

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11
Q

What is Chronotropy?

A

Faster heart rates

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12
Q

What is Dromotropy?

A

Faster conduction of AV node

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13
Q

What is Lusitropy?

A

Faster relaxation

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14
Q

What do Negative Inotropes + Chronotropes do?

A

Reduce:
1. Contractility
2. HR
* Example = Verapamil + Diltiazem

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15
Q

Name 1 Positive Inotropes + Chronotropes

A

Adrenaline

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16
Q

Give 2 examples of Negative Inotrope + Chronotrope

A
  1. Verapamil
  2. Diltiazem
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17
Q

How do Vasodilators work?

A
  1. Reduces the PRESSURE in the arteries
  2. Leading to reduction in Cardiac AFTER-load + PRE-load
    * Examples = Benazapril + Enalapril*
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18
Q

What are Verapamil & Diltiazem?

A

Negative Inotropes + Chronotropes

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19
Q

What are Benzapril & Enalapril?

A

Vasodilators

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20
Q

What are Anti-dysrhymthmic drugs?

A
  • They normalise heart rhythm
  • Examples = Propanalol + Digoxin*
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21
Q

Name 2 Anti-dysrhymthmic drugs

A
  1. Propanalol
  2. Digoxin
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22
Q

What are Diuretics?

A
  1. Act upon the Urinary system
  2. To Increase production of urine
    * Example = Frusemide
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23
Q

Name a Diuretic

A

Frusemide

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24
Q

Some cardiovascular drugs have more than 1 effect.

Name the cardiovascular drug that is a Positive Inotrope, but also has Vasodilator properties?

A

Pimobendan

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25
Name 2 **centrally** acting Cardiovascular drugs
1. **Cloni**dine 2. Methyl**dopa**
26
Name a B**1**/B**2** **blocker**
**Pro**pranolol
27
Name 2 B**1**-**Selective** blockers
1. **Aten**olol 2. **Metopr**olol
28
Thiazide drugs ***decrease*** **Sodium** + blood **volume**. Name **2** **Thiazide** diuretics.
1. Bendro**flumethide** 2. **Indap**amide
29
What do **B**(Beta)-**Blockers** do?
***Reduces*** Cardiac **Output**
30
Name the **5** different types of **Vasodilators**
1. **Converting** ***Enzyme*** **Inhibitors** 2. **Angiotensin** **Ant**agonists 3. **Calcium** Antagonists 4. **A1**-blockers 5. Na+-**channel** ***activators***
31
Name **2** **Converting** ***Enzyme*** **Inhibitors**
1. **Capto**pril 2. **Enala**pril
32
Name a **Angiotensin** **Ant**agonist
**Los**artan
33
Name **2 Calcium** (Na+) **Ant**agonists
1. **Nife**dipine 2. **Amlo**dipine
34
Name **2 A1**-blockers
1. **Pra**zosin 2. **Doxa**zosin
35
Name a **K+**-***Channel*** **Activiator**
**Min**oxidil
36
In the **ANS**, what ***parasympathetic*** component **decreases** the **HR**?
The **Vagus** **nerve**
37
In the **CNS**, what ***Sympathetic*** component **increases** the ***force*** of HR **contraction**?
The **Sympathetic** Cardiac **Nerves**
38
Name 2 CNS hormones that affect the Cardiovascular System
1. Acetylcholine 2. Noradrenaline
39
What is Adrenaline?
1. A **naturally** occuring neurotransmitter, **Catecholamine** 2. **Produced by** the ***Adrenal glands*** 3. In **response to** the **Sympathetic** stimulation *(Fight, flight etc)*
40
# 3 .. What is the MOA for **Adrenaline**?
1. Its a **positive** ***Iontrope*** + ***Chronotrope*** 2. **Increases** the ***FORCE*** of **contraction** + **HR** 3. By **stimulating** ***B-1 adrenergic*** **receptors** **in** the **heart**
41
What side effect can ***peripheral*** **vasoconstriction** lead to?
**Inc**reased **BP**
42
Name the **3** **CVS** effects of Adrenaline
Increased: 1. **HR** *(Positive **chrono**tropic effect)* 2. **Myocardial** ***contractility*** *(Positive **ino**tropic effect)* 3. ***Conduction*** **velocity** *(Postitive **dromo**tropic effect)*
43
Name the **3** **BVs** + **BP** effects of Adrenaline
**Constriction** of: 1. **BV**s of **Skin** + **MM**s 2. ***Renal***, ***Mesenteric***, ***pulmonary*** + ***splanchnic*** **vessels** 3. Vaso**dilation** of ***Skeletal muscle*** BVs + **Coronary** vessels
44
What is Adrenaline?
A ***powerful*** **cardiac** ***stimulant***
45
What is **Atropine**?
1. An ***originally derived*** **plant** chemical 2. **Deadly nightshade**!!
46
What is the MOA for **Atropine**?
1. It **reduces** the ***Parasympathetic nervous*** **input** 2. By **preventing** ***Acetylcholine*** from **binding** to ***M2*** *(muscarinic receptor)* 2. Leading to an **inc**reased **HR**
47
Name the **4** indications for **Atropine**
1. Life-threatening ***Brady***-**dysrhythmias** 2. ***Hemodynamically*** unstable **brady**cardia 3. **Tachy**cardia 4. Hyper**sensitivity**
48
# 4 .. What is **Propanolol**?
1. It's a **Negative** **chrono**trope + **Ino**trope, **β-blocker** + **Anti**-***arrhythmic*** 2. That **reduces** the **effects** of ***Catecholamines*** on the **heart** 3. **Dec**reasing ***HR*** + ***force*** **contraction** 4. Which ***lowers*** **BP**
49
What does **Propanolol** do?
Manages: 1. **High** ***BP*** 2. **Tachy**cardia 3. **Atrial** ***fibrillation*** 4. Hyper**thyroidism** *(In Cats)*
50
True or False. **Propanalol** undergoes extensive 1st pass metabolism and is poorly absorbed by the oral route in comparison to intravenous administration.
True
51
# 4 .. What is **Propranolol**'s MOA?
1. **Selectively** ***blocks*** the **β1**-**receptor** ***in*** the ***kidneys*** 2. **Dec**reasing **Renin** ***secretion*** 3. Decreasing the **effects** of **RAA** System 4. Decreasing **BP**
52
What is **Lidocaine** used for?
1. ***Ventricular tachydysrhythmia*** 2. By **slowing** down the ***electrical conduction*** in the heart
53
# 4 .. What is the MOA of **Lidocaine**?
1. Local anaesthetic agent that ***blocks*** the **activity** 2. Of **sodium** ***channels*** 3. **In** the **nerve endings** 4. **Preventing** ***conduction*** of **nervous impulses**
54
What is **Lidocaine**/Lignocaine?
An **Local anesthetic** agent
55
Name the **4** **Anti**-***arrhythmic*** drugs
1. Adrenaline 1. Atropine 1. **Propanolol** 1. ***Lidocaine***
56
Name **2** ***Calcium*** channel **blockers**
1. **Dilt**iazem 1. Amlo**dipine**
57
# 4 .. What is **Diltiazem**?
1. A **Calcium** ***channel*** **blocker** 2. Vaso**dilator** 3. **Negative** ***Chron***otrope + ***Ino***trope 4. **Dec**reasing **myocardial** ***O2*** **demand**
58
What is the MOA for **Diltiazem**?
1. **Block** the ***movement*** of **Calcium** 2. **INTO** ***smooth*** **muscle** cells 3. Found **in** the **BV**s 4. Leading to **dilation** of ***peripheral*** ***arteries***, **arterioles** + **coronary** vessels
59
What is **Diltiazem**?
A **Calcium** ***channel*** **blocker**
60
What **2** diseases are **Diltiazem** ***licensed*** for?
1. **Feline** HCM 2. **Obstructive** cardiomyopathies, like ***Aortic Stenosis***
61
Why should you **not** give *(or give very reduced amounts)* **Diltiazem** to patients with ***Hepatic*** disease?
Because it has a **very** reduced ability to **metabolise** the drug
62
What is **Amlodipine**?
1. A **voltage**-***dependent*** 2. **Calcium** channel ***blocker*** 3. Member of the ***Dihydropyridine*** group
63
What is **Amlodipine**'s MOA?
1. **Binds** ***selectively*** to the **L**-**type** of **channels** 2. Found **in**: * ***Smooth*** muscle * **Cardiac** muscle * Cardiac ***nodal tissues*** 1. Greatly **lowering** **BP**, due to its ***dilatory action*** of **Arteries** + **Arterioles** 1. ***Decreasing*** **vascular resistance**
64
What type of drugs are used for **Hypertension**?
**ACE** **in**hibtors!
65
Name the **3** **ACE** inhibitors
1. **Benaz**april 2. **Enala**pril 3. **Rami**pril
66
What does **ACE** stand for in ACE inhibitors?
* A = **Angiotensin** * C = ***Converting*** * E = **Enzyme** * Inhibitors
67
# 9 .. What is the MOA for **ACE** ***inhibitors***?
1. **Prevent** ***conversion*** of **Angiotensin** **1** > **2** 2. ***Reducing*** BP 3. Reducing **Sodium + Water** ***retention*** (***Blood volume***) 4. **Lowering** the **GFR** 2. They cause vaso**dilation** + **arterio**dilation 3. Causing the **body** to ***lose*** **salt + water** 4. To **stop** ***Aldosterone*** **secretion** 5. ***Lowering*** **BP** + ***reducing*** **vascular bed** ***resistance*** *(CARDIAC **AFTERLOAD**)* 6. Making it **easier** **for** the heart to **pump** blood
68
What **2** conditions do **ACE** inhibitors treat?
**Management** of: 1. ***CHF*** 2. Protein**uria**
69
What is **Digoxin**?
1. A cardiac **glycosides** 2. **Extracted** from ***Floxglove*** (Digitalis spp)
70
# 3 .. What is the MOA for **Digoxin**?
1. The **positive** ***Ino**trope* **increases** heart **contractility** 2. **W/o** ***increasing*** **Myocardial oxygen** demand 3. With its **negative** **chrono**trope effects + ***anti-arrhythmic*** effect
71
What are the **2** cardiovascular diseases **Digoxin** is used to treat?
1. **DCM** 2. ***Atrial fibrillation***
72
True or False. **Digoxin** has a narrow therapuetic index, increasing toxicity + risk of arrhythmias.
True
73
What is **Pimobendan**?
1. An injectable or oral tablet/capsule 2. Drug used to treat **heart failure** 2. Otherwise called ***Vetmedin***/***Cardisure*** 3. A ***positive*** **ino**trope that **increases** the ***sensitivity*** of the **myocardial** ***myofilaments*** to **Calcium** 4. **Inc**reasing the **force** of cardiac ***contractions*** 5. It also causing vaso**dilation** 6. Due to its **inhibition** of the **enzyme** 7. ***Phosphodiesterase 3*** 8. Which acts on **vascular** ***smooth*** muscle
74
What is **Pimobendan** used to treat?
Congestive Heart Failure (**CHF**) Caused by: 1. ***MVD*** 1. ***DCM***
75
Why should Pimobendan be given ***1hr before*** feeding?
Because the **bioavaliability** of the drug is ***significantly affected*** by **food**
76
True or False. Pimobendan is licensed for **Cats**.
False Pimobendan isn't licensed for Cats.
77
Whats the **difference** between Pimobendan + Digoxin?
**Pimobendan** 1. ***Positive*** **Ino**trope 2. Sodium, Potassium + ATPase **antagonist** 3. **Inc**reased **risk** of ***arrhythmias*** **Digoxin** 1. **No inc**rease in ***intracellular*** **Calcium** 2. No increased **risk** in ***arrhythmia***

Pharamcology (18 decks)

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