Chapter 7 - Drugs mentioned during lecture Flashcards Preview

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Flashcards in Chapter 7 - Drugs mentioned during lecture Deck (24):
1

Atropine

- Anti-cholinergic
- raises HR by blocking parasympathetic nervous system's tendency to lower HR
- be careful when giving this, you lost the HR as a monitoring tool during anesthesia

2

Glycopyrolate

- Anti-cholinergic
- raises HR by blocking parasympathetic nervous system's tendency to lower HR
- be careful when giving this, you lost the HR as a monitoring tool during anesthesia
- Stays around longer than Atropine

3

Acepromazine

Opens up arterioles (vasodilator)

4

Compensatory mechanisms of the CV system

1. Increasing HR
2. Increasing SV
3. Increasing the efficiency of the heart muscle
4. Cardiac remodeling

5

Chronotropic drugs

Increase or decrease HR to make CO more efficient

6

Inotropic drugs

Increase or decrease the mycardial wall tension and SV to normalize CO and cardiac O2 consumption

7

Dromotropic drugs

Stabilize the electrical conduction system of the heart

8

Define hypertrophic and dilated cardiomyopathy

Hypertrophic:
enlarged muscle, ineffective pump (seen lots in cats)
Dilated:
heart is a great big paperbag; not efficient; low SV; blood slushes around in heart (taurine can help w/dilated cardiomyopathy)

9

Define mitral insufficiency

Blood being ejected from the left ventricle back into the atrium.
Sodium and water retention, increased SV, increased heart muscle follow.

10

Mixed inotrope/chronotrope/dromotrope

Cardiac Glycosides (Digoxin and digitoxin)
- derived from the dried leaves of the plant Digitalis purpurea
- Useful for atrial fibrillation, supraventricular tachycardia (current choice Ca channel blockers)
- also used for CHF (current choice ACE inhibitors and diuretics)
- Narrow therapeutic index, therefore no longer drug of choice
- Must monitor blood drug levels and perform ECG

11

Name three inotropes

1. Epinephrine
- raises BP, HR, and SV
- rescue drug; ER crisis of asystole
- mixed alpha & beta activity
- if it has an adrenergic receptor, it hits it
2. Dopamine
- given by drip to increase BP, HR, and SV
- Alpha 1 and beta 1 receptors
- constricts vasculature w/o affecting heart too much
3. Dobutamine
- not used often
- increases SV & CO without vasodilation
- works on heart (beta 1 receptors)

12

Name the current drug of choice for canine CHF

Pimobendin (Vetmedin)
- Inodilator (inotropic, mixed dilator); dual action of +inotrope and mixed vasodilation
- better SV; less peripheral vasculature resistance; better tissue perfussion; increased venous return
- does not increase mycardial oxygen consumption
- good therapeutic index
- may be used for MI
- side effects are minimal (or tolerable)
- expensive

13

Name the ACE inhibitors

The "prils":
Benazepril (LoTensin)
Enalapril (Enacard)
Lisenopril (given SID - little more friendly)
- These are considered antihypertensives
- They inhibit angiotensin I from being converted to angiotensin II

14

What does ACE stand for?
And what does it do?

= Angiotensin converting enzyme
It converts angiotension I into angiotensin II, releasing aldosterone thereby increasing intervascular volume (as water follows salt and aldosterone is known as the salt keeper)

15

Name a calcium channel blocker

Cardizem LA (long-acting)
- Antihypertensive
- interferes w/transport of calcium
- increases coronary circulation w/peripheral artery dilation

16

What drug can control blood/vascular volume?

- A diuretic like furosamide (Lasix - sodium losing loop diuretic), or Spironolactone (diuretic sparing K)
However, restriction of sodium intake through dietary changes can control blood volume as well. Many petfoods & treats are over 1% NaCl. Client education is key!

17

Before trying Pimobendin, what else could you try to reduce BV in CHF?

Salt restriction in conjunction w/ACE inhibitors

18

Define afterload

Resistance of tissue to forward flow of blood (after ventricular contraction)

19

Name afterload reducers

*Pimobendin (Vetmedin)
*Prazosin (Minipress), comes as cream or capsules; potent venodilator
*Sildenafil (Viagra) for pulmonary hypertension

20

How to manage acute ventricular arrhythmia?

*Procaineamide - lasts longer than lidocaine
*Lidocaine w/o epinephrine - will put electric instability in heart to rest

21

Lidocaine comes in several doses. Name a few!

*Lidocaine w/epinephrine = lasts longer, but not for crash card
*Lidocaine w/o epinephrine = IV use for crash cart
*Lidocaine w/o epinephrine and preservatives = good for epidurals

22

SA node stabilizers

Sotalol (Betapace)
Quinidine

23

Ventricular antipacing to reduce HR

*Propanalol (Inderal) - beta adrenergic blocker
*Digoxin (Lanoxin) - Glycosides
*Diltiazem (Cardizem) - Calcium channel blocker

24

Anti-coagulation drugs

*Aspirin - platelet stickiness inhibitor
*Clopidogrel (Plavix) - platelet aggregation inhibitor
*Coumarin - inhibits Vit K for longer term anticoagulation effects