flash cards

Pharm 6-1 Cardiac Pharm–Congestive Heart Failure

Question Answer
What physiologic change causes the release of natriuretic peptides? increased plasma volume
How are natriuretic peptides helpful in heart failure? decrease in preload and afterload by inhibiting RAAS, ADH, endothelin, and thirst
What is the most important natriuretic peptide for diagnosing congestive heart failure? BNP
What are the 3 main treatments of acute congestive heart failure? furosemide, oxygen, and NO
What are your 2 main therapeutic goals for treating acute congestive heart failure? decrease preload and increase oxygenation
Where is the site of action of furosemide? thick ascending limb of loop of henle
What are 4 important side effects of furosemide? panelectrolyte wasting, dehydration, hypotension, acid/base abnormalities
What is the purpose of nitroglycerin ointment in the treatment of acute CHF? decrease preload
What is the main effect of nitroglycerine ointment? venodilation
What is the main effect of hydralazine? arterial vasodilation
What is the purpose of hydralazine in the treatment of acute CHF? decrease afterload
What is the purpose of morphine and acepromazine in the treatment of acute CHF? anxiolytic
What is the purpose of dobutamine and dopamine in the treatment of acute CHF? positive ionotrope
What is the purpose of nitroprusside in treatment of acute CHF? decrease preload AND afterload
What 2 drugs are the 1st line of treatment of chronic CHF? furosemide and enalapril (loop diuretic + ace inibitor)
Why are ace inhibitors not used in acute CHF? slow acting
What is the purpose of using ace inhibitors to manage chronic CHF? decrease preload and afterload and decrease sympathetic tone
What side effect of ace inhibitors can be a problem without concurrent furosemide administration? hyperkalemia
What are the 2 main properties of pimobendan and their mechanisms of action? calcium sensitizer>positive ionotrope and phosphodiesterase inhibitor>increases cAMP>vasodilation>decrease in afterload
What effect does pimpbendan have on blood pressure? not much—increases contractility while decreasing resistance, leaving BP fairly constant
What patients should NOT receive pimobendan therapy? cats, patients with hypertrophic cardiomyopathy
What are the 3 indications for digoxin and how many of the indications must be present to justify use? supraventricula tachycardia, systolic dysfunction, and CHF (2 out of the 3!)
What are the 3 main effects of digoxin? positive ionotrope, resets baroreceptors, and slows conduction velocity
What is the mechanism behind the ionotropic effect of digoxin? inhibits the Na+/K+ ATPase pump in cardiac myocytes by competing for the K+ binding site, which shuts off the Na+/Ca++ exchanger, which forces more Ca++ to be stored in the SR, increasing the amount released during contraction
What is the dosage of digoxin for dogs less than 15 kg? 0.01 mg/kg q12hr
What is the doage of digoxin for dogs greater than 15 kg? 0.22 mg/m^2 q12hr
What is the half life of digoxin in the dog and how many days does it take to reach steady state? ~30hrs…7 days to steady state
What is the target steady state concentration of digoxin in dogs? 1.5 ng/mL
Name 5 side effects of digoxin intoxicaton. arrhythmias, lethargy, anorexia, vomiting, orange diarrhea

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