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Chapter 7 Drugs Used in Cardiovascular System Disorders

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.
Created by: kidtaxi9