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L1 - CV Pharm 1
Clin Pharm Ex 1
| Question | Answer |
|---|---|
| Chronotropy | electrical conduction of heart rate & rhythm |
| Dromotropy | speed of conductivity of electrophysiological signals |
| Bathmotropy | how easily an aberrent signal can be triggered (arrhythmia) |
| Inotropy | strength of contractility |
| Lusitropy | how well the cardiac muscle relaxes; determines how well the heart can fill |
| Positive Inotropic drugs | ↑ contractility = ↑ CO, but also ↑ energy & O2 use bc ↑ work load |
| Negative Inotropic drugs | ↓ contractility = ↓ CO, work, & O2 & energy use |
| Pimobendan | most common Phosphodiesterase Inhibitor (PDE-3) |
| Phosphodiesterase Inhibitors | inhibits PDE activity = ↓cAMP degredation = ↑cAMP acitivity = vasodilation = ↓ afterload = ↑ CO |
| Positive Inotropic drug ex: | PDE-3 inhibitors, Adrenergics, & Cardiac Glycosides |
| All positive inotropic drugs act… | by increasing intracellular Ca++ |
| Pimobendan T1/2… | short-lived (~0.5-2hrs) = need repeated doses |
| Amrinone & Milrinone | PDE3 inhibitors (older); Short T1/2 = give via CRI (emergency) |
| Inoconstrictor drugs | NE, Epi, & DA |
| Inodilator drugs | Dobutamine, Dopexamine, & Isoproterenol |
| Most clinically relevant adrenergic drugs | Dobutamine, Dopexamine, & Isoproterenol |
| Adrenergic drugs are not ideal for long term therapy bc… | they're too short lived |
| Dobutamine | Synthetic adrenergic compound; Selective B1 agonist, mild B2 agonist; Host tolerance >3 days of use (↓ reg R) |
| Cardiac Glycosides | Digitoxin (too toxic, not used anymore) & Digoxin (PDE inhibs preferred now) |
| Digoxin is derived from… | foxglove (Digitalis) - think of NaK-ATPase inhibition |
| Left sided HF causes… | blood back up in lungs |
| Right sided HF causes… | blood back up in veins/body, esp liver |
| Arterial dilators… | ↓systemic vascular resistence = ↓BP = ↓afterload = ↑ CO |
| Venous dilators… | relax systemic veins ↑ venous capacitance = ↓ preload = ↑ CO |
| Blood reservoir for the hear (65-70% of blood) | veins |
| Hydralazine | Vasodilator (↓afterload) & Stim NO synth = cellular relaxation |
| Amlodipine | Vasodilator (↓afterload) = Dihydrpyridine Ca channel blocker (minimal CV affects) |
| Na Nitroprusside | Dilates arteries AND vein & generates NO |
| Sildenafil (Viagra) & Tadalafil | PDE-5 Inhibitor = relax smooth muscle in pulmonary aa via cGMP |
| Nitroglycerin | Generates NO; Admin as an ointment, so BE CAREFUL w/gloves!! |
| B-blockers (B antagonists) | Slow HR = ↓BP = ↓CO = ↓renin release = ↓NE release |
| What's the best way to identify a B-blocker drug name? | they usually end in "-lol" |
| Atenolol | selective B1 antagonist |
| Carvedilol | non-selective a1 & B antagonist |
| Propanolol | non-specific B antagonist |
| Esmolol | selective B1 antagonist |
| Labetolol | non-selective a & B antagonist |
| a1-blockers (antagonists) | commonly used in hypertension therapy |
| Phenoxybenzamine | a1 antagonist |
| Prazosin | a1 antagonist |
| Phentolamine | a1 antagonist |
Created by:
Dr_B.Phillips22
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