Kumar Final Review - Cardio - AH Flashcards Preview

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Flashcards in Kumar Final Review - Cardio - AH Deck (49):
1

What are the major classes of Inotropic Drugs?

Cardiac Glycosides, Phosphodiesterase inhibitors, beta-1 agonist, Aminophylline

2

Cardiac glycosides consist of what drugs?

Digoxin + Digitoxin +Oubian → Digitalis glycosides

3

Digitalis MOA?

Inhibits Na/K ATPase → exchange of Na for Ca → increased Ca in contractile proteins → positive inotropic action

4

Effects of Digitalis?

Increase vagal tone → decrease in SA node activity → decrease in heart rate. Decreased Av node conduction. Diuretic response → decreased edema

5

Digitalization accomplishes what?

loading and maintenance dose → get effect with small amount of drug.

6

What do you base the dose of digitalis on?

Lean body weight (not well absorbed by fat)

7

Vd for digitalis?

Wide

8

Digitalis Metabolism?

Enerhepatic

9

Digitalis Toxicity

dependent on K and Ca serum electrolytes low serum potassium increases digitalis toxicity

10

Tx for Digitalis Toxicity?

Mild – give oral potassium supplement. Quinidine → displaces digoxin from binding site and inhibits PgP

11

What can improve the inotropic action as well as vasodilation?

Inodilators

12

What are the 3 Phosphodiesterase inhibitors?

Milrinone, Amrinone, and Pimobendan

13

MOA of Dobutamine?

Selective beta-1 agonist

14

MOA of aminophylline?

Phosphodiesterase inhibitor

15

SE of Aminophylline?

Bronchodilation

16

What is Aminophylline used to Tx?

Causes Diuresis which relieves pulmonary edema brought on by CHF

17

What diuretics can be utilized as anti-edema drugs?

Thiazides (K excretion increased) and K sparing diuretics (Spioronolactone, triametrene and amiloride)

18

List the main vasodilators

Sodium Nitroprusside, Prazosin, Nitroglycerin, isoxsuprine, Amlodipine, Hydralazine/Minoxidil

19

MOA of Prazosin

alpha1 antagonist (→ renin release)

20

Nitroglycerin MOA?

Increased NO release → improves cGMP release

21

Isoxuprine indication?

Navicular Dz

22

Amlodipine MOA?

Calcium channel blocker

23

What do you use Amlodipine for?

Tx for hypertension in cats

24

What class of drugs is good to use in ischemic heart Dz?

Ace Inhibitors: they produce vasodilation without inducing the sympathetic activation = safer for ischemic heart disease.

25

What are the main indications for Ace inhibitors?

Heart failure and hypertension

26

What is the significance of Ace inhibitors?

Produce vasodilation without inducing sympathetic activation

27

PDE3 Ace inhibitor drugs?

Captopril. Prodrugs: Enalapril, Benazepril

28

PDE5 Ace Inhibitors?

Sildenafil – used for hypertension in dogs

29

Why combine Ace inhibitors with Thiazides?

Thiazides → loss of K. Ace inhibitors → K sparing

30

Interaction of NSAIDs with Ace inhibitors?

NSAIDs decrease hypotensive effect of Ace by blocking bradykinin induced vasodilation (PGI2 mediated)

31

What should you never use with epinephrine?

Left ventricular failure drugs: Morphine sulfphate

32

What does morphine sulphate block?

Medullary respiratory center

33

Never combine what two anti-arrhythmia drugs?

Calcium channel blocker and beta-blockers

34

Class I MOA

Causes blockade of voltage gated Na+ channels. Reduces max rate of depolarization in cardiac fibers (phase 0 ) without affecting resting membrane potential. Local anesthetics for nerves and myocardial cell membrane.

35

Effects of class I drugs

Increase the threshold of excitability. Decrease the conduction velocity. Prolongs the effective refractory period. → controls arrhythmia via inhibition of spotaneous depolarization. Also local anesthetics for nerves and myocardial cell membrane.

36

Class I A specific effects

depress phase 0 of AP: prolong the duration of action potential and refractory period in normal and injured cardiac cells

37

Class I A drugs?

Quinidine, Procainamide, (disopryramide)

38

Why do you have to increase digitalis when giving it with quinidine?

Quinidine displaces digitalis from binding site

39

Class I B specific effects

Decrease phase 0 depolarization and conduction velocity in injured cardiac cells. Min effect on AP/refractoy period

40

Class I B Drugs

Phenytoin – tx arrhythmia,
Lidocane,
Tocaine,
Apridine – broad spectrum

41

SE of Apridine?

Refractory arrhythmia

42

Class II MOA

beta adrenoceptor antagonist: beta blockers

43

Class II effect

Shortens AP and refractory periods

44

Class II drugs

Propranolol, Metoprolol

45

Propranolol is indicated for what kind of arrhythmia?

Catecholamine induced/ halogenated hydrocarbon arrhythmias

46

Class III MOA

K+ channel blockade in cardiac muscle → Significantly prolongs AP duration and refractory period

47

Class III drugs

Bretylium and Amiodarone

48

Bretylium is a what?

Adrenergic neuronal blocking agent

49

Class IV drugs

Verapamil and Diltiazem