Heart Failure

Question 1

When does heart failure occur?

Answer 1

When CO is insufficient to meet metabolic needs

Question 2

What will prolonged hypertension lead to?

Answer 2

Increased afterload due to difficulty of pumping blood out

Question 3

Explain, consequences and compensations in heart failure renal

Answer 3

Heart failure -> decrease BP -> decrease RBF -> Increase renin, converts angiotensinogen to angiotensin I, ACE converts this to Angiotensin II, which affects Adrenal causing form increased aldosterone thus increase salt and therefore water retention increase venous return increasing preload

Question 4

Affect of venous dilators on preload?

Answer 4

Reduce preload

Question 5

Nitroglycerin

1. MOA
2. Uses

Answer 5

Nitrate
1. Vasodilator
increases NO causing for increase cGMP which decreases contraction of smooth muscles

2. Topical - high 1st pass effect from hepatic metabolism

Question 6

Sodium Nitroprusside

1. MOA
2. Uses

Answer 6

Nitrate
1. Vasodilator
increase cGMP, decreases smooth muscle contraction

2. IV - emergency situations

Question 7

Hydralazine

1. MOA

Answer 7

1. Reduce Afterload - mechanism not really known.

Question 8

Amplopidine

1. MOA
2. Uses

Answer 8

1. Ca channel blocker causing arterial vasodilation

2. Cats with hypertension

Question 9

Enalapril

1. MOA
2. Uses

Answer 9

1. ACEi

2. HF in dogs caused by mitral regurgitation

Question 10

Benazapril

1. MOA
2. Uses

Answer 10

1. ACEi

2. HF in dogs caused by mitral regurgitation and proteinuric cats

Question 11

Imidapril

1. MOA
2. Uses

Answer 11

1. ACEi

2. HF in dogs caused by mitral regurgitation

Question 12

Telmisartan

1. MOA
2. Uses

Answer 12

Angiotension-receptor blocker

1. Binds to AT1 receptor Reduction of proteinuria
2. Chronic kidney failure in cats

Question 13

Digoxin

1. MOA
2. Uses

Answer 13

Positive ionotrope and Negative chronotrope
1. Increase myocardial contractility without increasing myocardial oxygen demand.
Also causes for decreased HR
2. CHF - h/e small therapeutic window - must do drug monitoring

Question 14

Pimobendan

1. MOA
2. Uses

Answer 14

Positive ionotrope and vasodilator
1. Sensitizes troponin to Ca causing increased contractility - ionotrope
Inhibits phosphodiesterase III and V

Question 15

Dopamine

1. MOA
2. Uses

Answer 15

Inotrope

1. Activates alpha and beta and dopamine receptors
2. Emergencies

Question 16

Dobutamine

1. MOA
2. Uses

Answer 16

1. Beta1 agonist
   Positive inotrope at low doses
   Chronotrope at higher doses
2. Critical care

Question 17

Bipyridine

1. MOA
2. Uses

Answer 17

1. Increase intracellular Ca, also causes arterial and venous vasodilation
2. IV, not common in animals