Vasodilators

Question 1

Which vasodilator is used for hypertensive emergencies

Answer 1

Sodium nitropusside

venous and arterial dilation

Question 2

Sodium nitropusside can cause marked hypotension. What should you give with it

Answer 2

Give with Dobutamine

Question 3

Which drugs are indicated in CHF secondary to mitral or aortic valve insufficiency

Answer 3

Hydralazine

Minoxidil

Question 4

Which species is hyralazine commnly used in? Discuss admin/metabolism and excretion

Answer 4

Dogs

Admin: oral - rapid absorption

Metabolism: liver

Excretion: kidneys

Question 5

Is hydralazine safe to use in uremic patients

Answer 5

No - high concentrations

Question 6

Side effect hydralazine

Answer 6

Tachycardia

Question 7

Sodium nitropusside causes the release of what, resulting in vasodilation

Answer 7

Nitrous oxide

Question 8

What do phosphodiesterase V inhibitors do? Example?

Answer 8

Inhibit cGMP degradation

Sildenafil

Question 9

Which a1 agonist provides vasodilation with minimal reflex tachycardia

Answer 9

Prazosin

Question 10

Which vasodilator has a good combo with Digoxin

Answer 10

Prazosin - pos. inotrope effect (Digoxin) and peripheral vasodilaton

Question 11

Which vasodilator gives marked relaxation of large veins

Answer 11

Nitroglycerine

Question 12

Which vasodilator is given sublingual for angina *

Answer 12

Nitroglycerine

Question 13

Describe topical use of nitroglycerine in dogs and horses

Answer 13

Topical ointment 2%

Dogs:

• for cardiogenic pulmonary edema

Horses

• for acute laminitis

Question 14

Which vasodilator acts on skeletal muscle vessels

Answer 14

Isoxsuprine (b2 agonist)

Question 15

Which vasodilator is indicated in laminitis and navicular disease (horses)

Answer 15

Isoxsuprine

Question 16

Administration Isoxsuprine

Answer 16

Powder to feed/oral paste

Question 17

Calcium channel blockers for vasodilation

Answer 17

Diltiazam

Amlodipine

Question 18

Indications of Diltiazam

Answer 18

Hypertrophic cardiomyopathy in dogs and cats

Question 19

Indications of amlodipine

Answer 19

Hypertension in cats

Question 20

Which calcium channel blocker is commonly used in vet med and has few significant cardiac effects

Answer 20

Amlodipine

Question 21

What;s important about ACE inhibitor dosing

Answer 21

Theres a threshold limit which you cant exceed even with increased dose

Question 22

What effect do NSAIDs have on ACE inhibitors

Answer 22

Decrease their hypotensive effect

Question 23

MOA Ace Inhibitors

Answer 23

1. Vasodilation (decreased Ang-2 and decrease Ang-2 receptors)
2. Reduce sympathetic outflow of brain
3. Potassium sparing effect

Question 24

Excretion ACE inhibitors

Answer 24

Kidney

*Caution with renal disease*

Question 25

Are ACE inhibitors safe for patients with renal disease

Answer 25

No - take caution

Question 26

ACE inhibitors (4)

Answer 26

'Elan Likes Ben's Cat' ## Footnote **1. Catopril** **2. Lisinopril** *_Prodrugs_* **3. Enalpril** **4. Benazepril**

Question 27

Which ACE inhibitor comes from pit viper venom

Answer 27

**Catopril**

Question 28

T/F - its preferred to give Catopril with food

Answer 28

False - *bioavailability decreases with food*

Question 29

Which is most potent ACE inhibitor

Answer 29

**Lisinopril**

Question 30

Which ACE inhibitor's bioavailability is not affected by food \*

Answer 30

**Benazepril**

Question 31

Which ACE inhibitor is an alternative to Digoxin in mild CHF? What should you administer before

Answer 31

Enalpril ## Footnote *Give diuretics before*

Question 32

T/F ACE inhibitors are safer in patients with ischemic heart disease

Answer 32

True

Question 33

Indications of ACE Inhibitors (2)

Answer 33

1. Heart failure 2. Hypertension

Question 34

T/F - ACE Inhibitors have potassium sparing effect. Explain

Answer 34

True - due to: * Decrease Na/K exchange in CD * Decrease secretion of aldosterone

Question 35

Angiotensin receptor blockers

Answer 35

**Losartan** **Irbesartan**

Question 36

Indications for Losartan and Irbesartan

Answer 36

(Angiotensin receptor blockers) ## Footnote 1. Hypertension 2. Heart failure * Doesnt alter Bradykinin activity*

Question 37

MOA of Losartan and Iberartan

Answer 37

Block angiotensin receptor --\> no vasoconstriction

Question 38

3 Objectives of treating Left Ventricular Failure

Answer 38

1. Improve gas exchange ---\> *give O2* 2. Enhance myocardial contractility --\> *give Dobutamine* 3. Reduce workload of LV --\> *give Furosemide*

Question 39

What do you give patients to relieve dyspnea and anxiety with heart failure? How does it work

Answer 39

**Morphine Sulphate** * Hypotensive effect* * Decreases response of medullary resp center to increase pCO2*

Question 40

You have a dog with pulmonary edema from LV failure. What do you give as _maintenance therapy_ after treating acute condition

Answer 40

**Digoxin**

Question 41

T/F - **Epinephrine** is beneficial in LV failure

Answer 41

FALSE -- _CONTRAINDICATED_!

Question 42

Your patient is in left ventricular failure with pulmonary congestion. What can you give immediately to help? How does it work

Answer 42

**Furosemide** *Loop diuretic ---\> increases venous capitance --\> decreased pulmonary congestion*

Question 43

Which phosphodiesterase inhibitors are preffered for myocardial failures? Which for pulmonary hypertension?

Answer 43

**Class III**: myocaridal failures (aminophylline, inamrinome, pimobendan) **Class V**: pulmonary hypertensuion (sildenafil)