DRUGS AFFECTING THE HEART

A. Cardiac Tonic CATECHOLAMINES

- Digitalis glycosides
Dopamine Produces positive chronotropic and
- Sympathomimetic agents
inotropic effects in myocardium
B. Antiarrhythmic
Increased HR and contractility
- Membrane stabilizers
Dobutamine Stimulates Beta 1 receptors
- Beta adrenergic blockers Increased contractility and stroke
- Inhibitors of norepinephrine volume -> increased cardiac output
- Calcium entry blockers Isoprotereno Beta 1 and 2 Adrenergic receptor
l agonists
CARDIAC TONICS
Increased HR and contractility
- Agents that improve the functionality capacity of
the cardiac muscles
Isoproterenol – activates adenyl cyclase, increase
- Inhibit Na-K pump and promotes Na-Ca exchanger
cAMP stimulate protein kinase to open Ca channels
- Increase Ca release from SR

Digoxin Positive inotropes: Inhibition of

(cardiac membrane bound Na+/K+ ATPase VASODILATOR DRUGS
glycoside) pump thus increases the force of
contraction of the heart - Adjunct treatment to CHF
Eliminated via kidney
Unload the failing heart by:
Digitoxin Same with digoxin but eliminated
via liver for patients with poor - Decrease systemic arterial pressure
kidney - Lowers resistance during ventricular contraction
Ouabain Inhibition of membrane bound - Restricts venous return
Na+/K+ ATPase pump but not
selective Prazosin Adrenergic blocker, causes
Once it binds to enzyme, the vasodilation
enzyme ceases to function leading Hydralazine Relaxes arteriolar smooth muscle
to increase intracellular sodium Captopril and Losartan (ACE inhibitor)
Enalapril
Pimobendan Increases myocardial contractility by
ANTIARRHYTHMIC EFFECT increasing calcium sensitization to
- Increase parasympathetic tone at SA and AV node troponin C
Vasodilation by inhibiting
Clinical Uses Phosphodiesterase 2

- Congestive heart failure

- Shock-acute circulatory insufficiency in which the Note: ACE inhibitors inhibits the conversion of
cardiac output is not adequate to provide for the angiotensin 1 to angiotensin 2. In which if Angiotensin 1
normal perfusion of tissues and 2 binds, it produces vasoconstriction and increase
- Cardiac arrhythmias in blood pressure
- Pre-surgery

Toxicity

- Can cause ventricular fibrillation due to depletion

of K for cardiac cells
- Dose should be adjusted to individual needs
CARDIAC DEPRESSANTS DRUGS AFFECTING RESPIRATORY

- Indicated for arrhythmia

- An abnormality in impulse formation, an abnormal
pacemaker, or disorder of impulse conduction

Expectorant Promotes secretion of products

- Guaifenesin
Note: Too much lidocaine can cause heart attack - Ammonium chloride
- Eucalyptus
- K citrate
Mucolytic Breaks down the chemical structure
of mucus
- Bromhexine
- Carbocysteine
Antitussive Cough suppressants
- Codeine
- Dextromethorphan
- Menthol
- Butorphanol
Decongestant Relieve congestion
- Diphenhydramine
- Phenylephrine
- atropine
Trivia Question
Bronchodilator Relaxes and widens airways
Which of the following is best used for cardiac arrest? - theophylline
- prednisone
a. Digoxin - Sympathomimetics
b. Pimobendan
c. Isoproterenol
d. Epinephrine

Answer: Isoproterenol to make the heart pump but can

also be supported with Pimobendan to maintain the
tonicity of the heart
DRUGS AFFECTING DIGESTIVE

A. Emetics

Apomorphine Most reliable, acts on

chemoreceptor trigger zone for
emesis
Ipecac Bitter taste
3% H202
Xylazine Side effect emesis Carminative – relieves flatulence

Astringents – reduce swollen mucous membranes

B. Anti-emetics
Cathartics – promotes defecation
Anti-histamine Allergy-causing
Cyclizine
HCl/Meclizine
Diphenhydramine
Tranquilizers
Chlorphromazine For travel
Haloperidol
Droperidol
Antacids:
AIOH, AI
carobonate, AI
silicate, MgOH,
Mg silicate,
CaOH, Ca
carbonate
Antacids:
Cimitidine
Ranitidine
Famotidine
Omeprazole Blocks the hydrochloride pump
Metoclopramide D2 antagonist
Maropitant Neurokinin antagonist, more
(cerenia) effective in cats
Ondansetron 5-HT3 receptor antagonist
(Zofran)
Kaolin (hydrated Protectants
Aluminum Adsorbents
silicate)
DRUGS AFFECTING URINARY

Diuretics Indications:

Cerebral edema trauma

Hypertension To reduce body fluids

CHF Reduce fluid to help the
work-load of heart
Acute Renal failure To help expel the urine
Liver cirrhosis To help expel the urine
Osteoporosis Because some drugs like
thiazide are known to
decrease urinary calcium
excretion

Aldosterone Antagonist
(Glomerulus) Cause heart contraction
- Prevent conservation of sodium and promotes
Mannitol (sugar) thus increased blood
Theophylline pressure -> more blood conservation of potassium
Caffeine to glomerulus to be - Potassium Sparing Diuretics -> Hyperkalemia
Sympathomimetic filtered -> more water
drugs excreted in the tubules a. Spironolactone
*sugar attracts more b. Amiloride
water c. Triamterene
(Loop of Henle) Acts on the ascending
Furosemide loop of henle,
Bumetanide furosemide prevent Anti-diuretic antagonists
Ethacrynic acid sodium reabsorption
(Proximal tubule) Carbonic anhydrase - Enhance the expulsion of water
Acetazolamide inhibitor, thus sodium
Methazolamide remains in the lumen
attracts more water to Urine pH
form more urine
*Carbonic anhydrase is responsible for the - To enhance excretion of drugs
conversion of carbonic acid to hydrogen
Dog 7 to 7.5 Cat 6.3 to 6.6
bicarbonate
Urine Acidifiers – Ammonium Chloride and Methionine

Urine Alkalinizers – Potassium citrate

DRUGS ACTING ON SKIN ENDOCRINE

A. Emollients A. Adrenal Cortex

- Occlusive, oil-based
Glucocorticoids
B. Demulcents - GCC deficient is Addisons Disease
- Watery
Preparations:
EMOLLIENTS DEMULCENTS
Petrolatum Propylene glycol SHORT ACTING INTERMEDIATE LONG ACTING
Castor oil Glycerin ( < 24 hrs) 24-48 hrs >48hrs
Paraffin Lanolin Prednisone Triamcinolone Flumetasone
Whale oil Acacia Prednisolone Dexamthasone
Mineral oil Hydrocortisone Betamethasone
Cortisone

Match the following:

Glucocorticoid Therapeutic Uses:

- Physiologic replacement
- Shock therapy (abnormal blood flow thus GCC
would stabilize the endothelial linings to prevent
exit of macrophages -> less damage)
- Anti-inflammatory and anti-allergy
- Immunosuppressive therapy (in cases of surgeries,
transplant)

B. Metabolic Hormones

Insulin

- Lente - intermediate acting 12 hours duration

- Glargine – longer acting insulin for cats
Correct Matching: - PZE (Protamine zinc insulin) – long acting 8 to 24
hours
Protectives and Calamine - NPH (neutral protamine Hagedorn) intermediate
Absorbents Zinc Oxide acting
Boric Acid - Detemir – long acting
Astringents Alcohol
Counterirritants Camphor Thyroid
Alcohol
Urea Hyperthyroidism (wasting, polyphagia, weight loss)
Methyl salicylate - Thiocyanate
- Parchlorates
Caustics/Escharotics Gentian violet - Thiouracil
Silver nitrate
- Thiourea
Glacial acetic acid
- Radioactive iodine
Keratolytics Benzoyl peroxide
Keratoplastics Resorcinol
Antiseborrheics Sulfur
Tretinoin
Urea
Selenium sulfide