CV Drugs 3

Question 1

name two ace inhibitors

Answer 1

enalapril and benazepril

Question 2

where are local RAS systems located?

Answer 2

heart, kidney, brain, adrenal glands, etc.

Question 3

what organ converts enalapril and benazepril?

Answer 3

liver

Question 4

T/F: benazepril has more hepatic clearance than renal clearance compared to enalapril

Answer 4

TRUE, enalapril is only renal clearance

Question 5

which ace inhibitor would be more appropriate for a patient with impaired renal function?

Answer 5

benazepril

Question 6

between benazepril and enalapril which drug is longer acting?

Answer 6

benazepril

Question 7

what are ace inhibitors used to treat?

Answer 7

• CHF
• hypertension
• protein losing renal disease (reduce intraglomerular hypertension)

Question 8

T/F: benazepril has more GI signs than enalapril

Answer 8

FALSE, opposite

Question 9

what group of drugs pose a risk of worsening azotemia due to decreasing GFR?

Answer 9

ace inhibitors, watch out w/ patients w/ systemic hypertension & pre-exisiting renal disease

Question 10

T/F: sildenafil is a phosphodiesterase inhibitor

Answer 10

TRUE, PDE V inhibitor > increased cGMP > NO mediated vasodilation

Question 11

what muscle does sildenifil work on?

Answer 11

smooth muscle of pulmonary vasculature

Question 12

what is sildenifil primarily used to treat for?

Answer 12

pulmonary hypertension

Question 13

what drug is used to treat eisenmenger’s syndrome?

Answer 13

sildenafil

Question 14

T/F: below are all categories of pulmonary hypertension

• pulmonary thromboembolism
• chronic respiratory disease
• cardiac disease
• heartworm disease
• neoplasia or obstructive disease

Answer 14

TRUE, all might indicate the use of sildenafil

Question 15

what do you want to avoid using concurrently w/ sildenafil?

Answer 15

nitrates

Question 16

name three direct-acting vasodilators

Answer 16

nitroprusside, nitroglycerine, hydralazine

Question 17

what potent endogenous vasodilator do nitrates increase the formation of?

Answer 17

nitric oxide (NO) > activates guanylyl cyclase

Question 18

what is the result of the MOA of nitrates?

Answer 18

direct arteriolar and venous vasodilation

Question 19

what is the MOA of hydralazine?

Answer 19

increases local PGI2 concentration altering cellular calcium metabolism in smooth muscle

Question 20

T/F: like nitrates, hydralazine results in direct arteriolar and venous vasodilation

Answer 20

FALSE, arteriolar only

Question 21

you have a patient in a hypertensive crisis! what group of drugs do you grab?

Answer 21

direct-acting vasodilators (nitrates, hydralizine)

Question 22

what direct-acting vasodilator is contraindicated with renal disease?

Answer 22

hydralazine, pre-treat w/ ACE-I & spironolactone to reduce risk

Question 23

T/F: amolodipine as a ca channel blocker has clinically significant antiarrhythmic effects

Answer 23

FALSE

Question 24

what is the MOA of amlodipine?

Answer 24

inhibits the influx of extracellular calcium across myocardial and smooth m. cell membranes > DILATION of coronary and systemic arteries

Question 25

what are the clinical effects of amlodipine?

Answer 25

- negative inotropic effects - negative chronotropic effects - increase oxygen delivery to myocardial tissue - decrease afterload - coronary vasodilation - decrease peripheral resistance - decrease systemic BP

Question 26

what is the drug of choice in first line treatment of hypertension in cats?

Answer 26

amlodipine

Question 27

sassy the cat comes in with hypertension due to hyperthyroidism. what drug might you use?

Answer 27

beta-blocker is preferred (propanolol)

Question 28

what are two things you should look out for when deciding whether to treat a patient with amlodipine?

Answer 28

AV block and elevated liver enzymes