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Flashcards in Drugs for Heart Failure Deck (79):
1

List 5 drug options to decrease preload.

1. Furosemide
2. Spironolactone
3. Hydrochlorothiazide
4. Nitroprusside
5. Nitroglycerine

2

List 3 drug options to increase ionotope.

1. Pimobendan
2. Dobutamine
3. Digoxin

3

List 5 drug options to decrease afterload.

1. Nitroprusside
2. Enalopril
3. Amlodipine
4. Hydralazine
5. Sildenafil

4

What are the 5 drug options to optimize heart rate?

1. Digoxin
2. Diltiazem
3. Atenolol
4. Atropine
5. Theophylline

5

What are the 3 drug options to block RAAS/SNS?

1. Enalopril
2. Atenolol
3. Spironolactone

6

Where do thiazide diuretics work?

Distal convoluted tubule

7

Where do loop diuretics work?

Ascending loop of henle

8

Which transporter do loop diuretics effect?

Na+/K+/2Cl- transporter

9

What transporter do thiazide diuretics effect?

Na+/Cl- transporter

10

Where do K+ sparing diuretics work?

Late DCT and collecting duct

11

What is the 1st line of defense for CHF?

Furosemide

12

What class of diuretic is Furosemide?

Loop diuretic

13

Where is the nephron does Furosemide work?

Ascending loop of henle

14

On which transporter does Furosemide work?

Na+/K+/2Cl- cotransporter

15

With Furosemide, what electrolyte values would be abnormal within the urine?

1. Increased sodium
2. Increased chloride
3. Increased potassium
4. Increased calcium
5. Increased magnesium

16

What are the 5 adverse side effects associated with Furosemide?

1. Azotemia
2. Metabolic alkalosis
3. Hypochloridemia
4. Hypomagnesemia
5. Hypokalemia

17

What is the 2nd line of defense for CHF?

Spironolactone

18

What type of diuretic is Spironolactone?

K+ sparing diuretic

19

Where in the nephron does Spironolactone work?

Late DCT and collecting duct

20

On which specific receptor/transporter does Spironolactone bind?

Aldosterone/Na-H antiporter

21

What are the 3 adverse side effects associated with Spironolactone?

1. Azotemia
2. Hyperkalemia
3. Facial dermatitis (cats)

22

What is the 3rd line of defense for CHF?

Hydrochlorothiazide

23

What type of diuretic is Hydrochlorothiazide?

Thiazide

24

Where is the nephron does Hydrochlorothiazide work?

DCT

25

On which transporter does Hydrochlorothiazide bind?

Na+/Cl- cotransporter

26

What are the 3 adverse side effects associated with Hydrochlorothiazide?

1. Azotemia
2. Hypercalcemia
3. Hypokalemia

27

What drug class does Enalopril fit in?

ACE inhibitor

28

What are 2 indications for using Enalopril?

1. Chronic CHF
2. Proteinuria

29

What are the 2 side effects associated with Enalopril?

1. Azotemia
2. Hypotension

30

What 3 factors determine stroke volume?

1. Preload
2. Afterload
3. Inotrope

31

What 1 reason would cause left sided heart failure due to too much afterload?

Systemic hypertension

32

What 1 reason would cause left sided heart failure due to too much preload?

Valvular disease (mitral, aortic)

33

What 2 reasons would cause left sided heart failure due to not enough contractility?

1. DCM
2. Myocarditis

34

What 1 reason would cause left sided heart failure due to not enough relaxation/filling?

HCM

35

What 1 reason would cause right sided heart failure due to too much afterload?

Pulmonary hypertension

36

What 1 reason would cause right sided heart failure due to too much preload?

Valvular disease (tricuspid)

37

What 2 reasons would cause right sided heart failure due to not enough contractility?

1. DCM
2. Myocarditis

38

What 1 reason would cause right sided heart failure due to not enough relaxation/filling?

Neoplasia

39

What are the clinical signs of low output heart failure?

1. Syncope
2. Prerenal azotemia
3. Cyanosis
4. Pallor
5. Hypokinetic pulses

40

What are the clinical signs of congestive heart failure?

1. Pulmonary edema
2. Pleural effusion
3. Pericardial effusion
4. Ascites
5. Hepatomegaly
6. Splenomegaly

41

With low output heart failure, what structure in the kidney recognizes the decreased renal perfusion?

Juxtaglomerular apparatus

42

What are the long-term effects of the neurohormonal compensatory system in response to heart failure?

1. Myocardial remodeling
2. Myocardial fibrosis
3. Renal sclerosis
4. Aortic sclerosis

43

With low output heart failure, what within the SNS recognizes the low blood pressure?

Baroreceptors

44

Of the drugs discussed, which 6 are vasodilators?

1. Enalopril
2. Amlodipine
3. Hydrazaline
4. Sildenafil
5. Nitroprusside
6. Nitroglycerine

45

Name one indication to use Hydralazine (vasodilator).

Acute severe CHF

46

Name one indication to use Nitroprusside (vasodilator).

Acute severe CHF

47

Name one indication to use Nitroglycerine (vasodilator).

Acute severe CHF

48

Name two indications to use Amlodipine (vasodilator).

1. Systemic hypertension
2. Severe chronic CHF

49

Name one indication to use Sildenafil (vasodilator).

Pulmonary hypertension

50

What is Pimobendan's effect on the heart rate?

NO effect

51

What is Dobutamine's effect on the heart rate?

Increase

52

What is Digoxin's effect on the heart rate?

Decrease

53

What is the ONE specific indication for Pimobendan?

1st line CHF

54

What is the ONE specific indication for Dobutamine?

Cardiogenic shock

55

What is the ONE specific indication for Digoxin?

Atrial fibrillation

56

What is the ONLY positive inotrope that slows heart rate?

Digoxin

57

Does Diltiazem increase or decrease contractility?

Decrease

58

Does Digoxin increase or decrease contractility?

Increase

59

Does Atenolol increase or decrease contractility?

Decrease

60

What are the 3 NEGATIVE CHRONOTROPES discussed?

1. Diltiazem
2. Digoxin
3. Atenolol

61

What is a consistent adverse effect of all the negative chronotropes?

Bradycardia

62

What are the 3 adverse effects of the negative chronotrope Diltiazem?

1. Bradycardia
2. GI upset
3. Hypotension

63

What are the 3 adverse effects of the negative chronotrope Digoxin?

1. Bradycardia
2. V/D
3. Ventricular arrhythmias

64

What are the 3 adverse effects of the negative chronotrope Atenolol?

1. Bradycardia
2. Bronchospasm
3. Hypotension

65

What are the acute (in hospital) pharmacological treatments of CHF in dogs?

"FOPS"

1. Furosemide
2. Oxygen
3. Pimobendan
4. Sedation

66

What are the chronic (at hone) pharmacological treatments of CHF in dogs?

"DOG'S ARE FOR SPECIAL PEOPLE"

1. Dietary Na+ restriction
2. ACE inhibitor
3. Furosemide
4. Spironolactone
5. Pimobendan

67

What are the acute (in hospital) pharmacologic treatments for CHF in the cat?

" FOPS +/- T"

1. Furosemide
2. Oxygen
3. Pimobendan
4. Spironolactone
5. Thoracocentesis

68

What are the chronic (in home) pharmacologic treatments for CHF in cats?

"DON'T FORGET ABOUT CATS, PLEASE"

1. Dietary Na+ restriction
2. ACE inhibitor
3. Furosemide
4. ACE inhibitor
5. Clopidogrel
6. Pimobendan

69

What is the mechanism of action of class I antiarrhythmic drugs?

Block Na+ channels

70

What is the mechanism of action of class II antiarrhythmic drugs?

Beta-adrenergic blockers

71

What is the mechanism of action of class III antiarrhythmic drugs?

Block repolarizing K+ channels, prolonging action potentials

72

What is the mechanism of action of class IV antiarrhythmic drugs?

Block Ca2+ channels

73

What is the "go-to" acute treatment for ventricular tachyarrhythmias?

IV lidocaine

74

In controlling ventricular tacharrhythmias, what are your 3 longer-term oral options?

1. Sotalol
2. Mexiletine
3. Amiodarone

75

What is the "go-to" acute treatment for supraventricular tachyarrhythmias?

IV diltiazem

76

What are your 3 oral options for controlling supreventricular tachyarrhythmias long-term?

1. Diltiazem
2. Beta blocker
3. +/- Digoxin

77

What is the "go-to" acute treatment for bradyarrhythmias?

IV atropine

78

What is a normal VHS in most dog breeds?

8.5 - 10.5

79

What is a normal VHS in cats?

7.5 (