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Pharmacology
Chapter 7 Drugs Used in Cardiovascular System Disorders
| Question | Answer |
|---|---|
| Describe the anatomy of the heart. | Four chambered pump. Dorsal chambers= atria; ventral chambers=ventricles. Right atrium & ventricle are "right-side pump"--blood returning to heart from general circulation. "Left-side pump"--blood returning from lungs. Valves prevent backflow. |
| In the heart, why does the left ventricle have a thicker wall than the right? | It works harder than the right. |
| What are the two phases of pumping action in the heart? | Systole--period of contraction of the chambers; diastole--relaxation phase when chambers are filling with blood. |
| What is the S/A node of the heart? | Cardiac pacemaker; controls the heart rate. |
| Describe how impulses from the S/A node travel through the heart. | The atrioventricular node receives impulses from the S/A node. The impulses then travel down the bundle of His (left & right branches) and into the ventricular muscle via Purkinje fibers. |
| What is depolarization? | Rapid influx of sodium ions; slower influx of calcium ions; outflow of potassium ions. Results in contraction. |
| What do the waves of an electrocardiogram represent? | Each wave represents activity in a particular area of the heart. P=atrial depolarization; QRS= ventricular depolarization; T=ventricular repolarization. |
| What are the four compensatory mechanisms of the cardiovascular system? | Increase heart rate; increase stroke volume; increase efficiency of heart muscle; cardiac remodeling (increase size & strength). |
| What are the basic objectives in treating cardiovascular disease? | control rhythm disturbances; increase strength of contractions; decrease preload/afterload; increase oxygenation of blood; ancillary treatment |
| What is an inotropic drug? | Improves the strength of contraction of the heart. The heart supposedly has reserve capacity that can be called on to improve cardiac output. Examples--cardiac glycosides (digitalis); catecholamines (epinephrine); inotropic, mixed dilator. |
| What is a chronotropic drug? | Affects the heart rate, not the strength of contraction. Examples: antiarrhythmia drugs. |
| What are the indications, effects and side effects of cardiac glycosides (digitalis)? | Indications: CHF, atrial fibrillation, supraventricular tachycardia; effects--improved contractility, decreased heart rate, antiarrhythmic effects, decreased signs of dyspnea; side effects-anorexia, vomiting, diarrhea, arrhythmias. |
| List the categories of antiarrhythmic drugs and give examples. | Class IA--qunidine, procainamide Class IB--lidocaine, tocainide, mexiletine Class II--beta-adrenergic blockers (propranolol) Class III-bretylium, amiodarone Class IV-calcium channel blockers (verapamil, amlodipine, nifedipine, dilitiazem) |
| List potential adverse effects of antiarrhythmic drugs. | Bradycardia, vomiting, diarrhea, lethargy, depression, hypotension, ataxia, muscle tremors, laminitis (horses), weakness, pulmonary edema. |
| Describe actions and potential side effects of vasodilator drugs. | Act by dilating veins, arteries or both. Dilation of arteries decreases afterload; dilation of veins reduces preload. Side effects include rashes, hypotension, syncope, vomiting, diarrhea, azotemia, hyperkalemia. |
| Describe actions & potential side effects of ACE inhibitors. | Prevent angiotensin I from converting into angiotensin II by inhibiting the enzymes; mild preload & significant afterload reduction (vasodilators). Side effects: vomiting, diarrhea, azotemia, hyperkalemia, hypotension, and others. |
| What is an ectopic focus/foci? | A local group of cells that begins to depolarize faster than the sinoatrial node. It is a foci if more than one location is involved. |
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