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Cardiac drugs
Cardiac drugs from the list.
29
Veterinary Medicine
10/16/2011

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Term
Lasix
Definition
MOA: inhibition of Na/K/2Cl symporter (loop diuretic)
Ind: CHF (organ system edema)
Drugs: aminoglycosides increase oto & nephrotoxicity, NSAIDS dec efficacy
Effects: polyuria, ototoxicity, nephrotoxicity, hypokalemia, pre-renal azotemia, sulfa-like hypersensitivity
Monitor: azotemia, BP, potassium
Term
Enalapril
Definition
MOA: ACE inhibitor, blocks conversion of ATI to ATII, dec ATII and aldosterone effects (RAAS inhibition)
Ind: CHF, SHT, PLnephropathy, anti-myocardial remodeling
Drugs: BFF w/ lasix
Effects: RAAS inhibition, azotemia, hyperkalemia, hypotension, not for pregos.
Monitor: azotemia, BP, potassium
Term
Atenolol
Definition
MOA: B1 selective block
Ind: PS, SAS, HCM, SV and ventricular arrhythmias, SHT
Drugs: don't combo w/ Ca channel blocker
Effects: negative ino/chronotrope, never 100% selective, bronchoconstriction, vasoconstriction
Term
Digoxin
Definition
MOA: Blocks Na/K ATPase pump, increases intracellular Ca by Na/Ca exchanger
Ind: DCM, systolic dysfunction, atrial fib
Drugs: inc. conc: quinidine, aspirin, macrolides, chloramphenicol. dec conc: GI drugs, phenobarb
Effects: positive inotrope, neg chronotrope, narrow TE, anorexia, wt loss, v/d, collapse, seizures, death, arrhythmias, hypokalemia
Monitoring: Check digoxin levels in 8 days, 8 hrs post pill and the goal serum level is 0.8 ng/mL
Term
Pimobendan
Definition
MOA: inc Ca/troponin-C interaction
Ind: DCM/systolic dysfunction, CHF
Drugs: none known
Effects: positive inotrope, poss. arrhythmogenic, anti-inflammatory, + lusitrope, dec platelet aggregation
Term
Diltiazem
Definition
MOA: Ca channel blocker
Ind: diastolic dysfunction, SV tachyarrythmias, pressure overload
Drugs: w/ Bblock - additive
Effects: neg ino/chronotrope, hypotension (inappetance, nausea), bradycardia, exercise intolerance, weakness, avoid with systolic dysfunction.
Term
Spironolactone
Definition
MOA: competitive antagonism of aldosterone
Ind: refractory CHF
Drugs: effect digoxin clearance
Effects: weak diuretic, hyperkalemia, anti-myocardial remodeling, facial pruritis in cats
Term
Lidocaine
Definition
MOA: Na channel blocker, Ib, shortens AP
Ind: ventricular arrythmias, local
Drugs:
Effects: Anti-arrhythmogenic, cat and goat sensitivity, local anesthetic, potentially proarrhythmic
Term
Mexiletine
Definition
MOA: Na channel blocker, Ib, shortens AP
Ind: ventricular arrhythmias
Drugs:
Effects: anti-arrhythmogenic, GI side effects, potentially proarrhythmic
Term
Sotalol
Definition
MOA: potassium channel blocker, Beta blocker
Ind: SV and ventricular arrhythmias, Boxer ARVC
Drugs: don't combo w/ Ca channel blocker
Effects: Anti-arrhymogenic, potentially proarrhythmic
Term
Amiodarone
Definition
MOA: potassium channel blocker
Ind: refractory arrhythmias
Drugs:
Effects: Anti-arrhymogenic, potentially proarrhythmic, skin discoloration, pulmonary fibrosis, hepatopathy, thyroid level effects
Term
Procainamine
Definition
MOA: Na channel blocker, Ia, prolongs AP
Ind: Ventricular arrythmias, SV arrythmias
Drugs:
Effects: Anti-arrhymogenic, potentially proarrhythmic, GI
Term
Dopamine
Definition
MOA: dose dependent stimulation of B1, B2>a, DA1
Ind: ER/ICU, decomp DCM, CHF, hypotension, bradycardia
Drugs: MAO inhibitor
Effects: weak diuretic, + inotrope, tachycardia, hypertension, arrhythmias
Term
Dobutamine
Definition
MOA: dose dependent stimulation of B1>B2>a
Ind: ER/ICU, decomp DCM, CHF, hypotension, bradycardia, greater +inotrope effects
Drugs: MAO inhibitors
Effects: + inotrope, tachycardia, hypertension, arrhythmias
Term
Terbutaline
Definition
MOA: B2 selective agonist
Ind: sinus arrest, AV block
Effects: tachycardia
Drugs:
Effects:
Term
Plavix/clopidogrel
Definition
MOA: irreversibly inhbits ADP binding, prevents activation and aggregation
Ind: PTE, saddle thrombus
Drugs: inc bleeding w/ anticoag
Effects: inhibit platelet activation and aggregation, thrombocytopenia
Term
Aspirin
Definition
MOA: Irreversible acetylation of COX-1, interferes with thromboxane synthesis
Ind: PTE, saddle thrombus
Drugs: inc bleeding w/ anticoag
Effects: Inhibit platelet activation. Anti-inflammatory, PG inhibition at higher doses
Term
Quinidine
Definition
MOA: Na channel blocker, Ia, prolongs AP
Ind: SV arrythmias, Afib, horses
Drugs: many.
Effects: Anti-arrhymogenic, potentially proarrhythmic, colic, founder, collapse
Term
Dog with DCM and atrial fibrillation
Definition
Pimobendan, enalapril, diltiazem
Monitor: echo, ECG, Azotemia, potassium, BP
Term
horse with atrial fibrillation
Definition
Quinidine
Monitor: ECG
Term
dog with early CHF
Definition
lasix, enalapril, +/- pimobendan
Monitor: radiographs, azotemia, potassium, BP
Term
cat with HCM and CHF
Definition
lasix, enalapril, oxygen, sedation if necessary. Add diltiazem or atenolol after CHF resolved.
Monitor: azotemia, BP, potassium, rads/echo
Term
cat with renal failure and CHF
Definition
lasix, enalapril, lowest doses possible, cat has to breathe first.
Term
dog with refractory heart failure
Definition
lasix + hydrochlorothiazide (sequential nephron blockade), enalapril, pimobendan
Term
dog with acute fulminant CHF
Definition
dopamine/dobutamine, lasix, enalipril, pimobendan, OXYGEN
Term
Cat with saddle thrombus
Definition
Aspirin, analgesia
Term
horse with aortic regurg and CHF
Definition
Lasix, enalipril, digoxin?
Term
dog with ventricular tachycardia during splenectomy
Definition
Lidocaine IV
Term
Boxer with recently diagnosed ARVC
Definition
Sotalol for maintenance, lidocaine for emergency
Monitor with holter monitor (ECG)