15, 16 Heart Failure

Question 1

What are the loop diuretics?

Answer 1

Furosemide
Bumetanide
Torsemide

Question 2

What do loop diuretics inhibit?

Answer 2

Na- K- 2Cl symporter on ascending loop

Question 3

What are loop diuretics used to treat?

Answer 3

HF - 
reduce:
vascular volume
edema
pulmonary congestion

Question 4

What is used as iv admin for decompensated HF?

Answer 4

Loop

Question 5

What do thiazide diuretics inhibit?

Answer 5

Na-Cl co transporter on distal CT

Question 6

What does spironolactone do?

Answer 6

block effects of aldosterone on heart

Question 7

What is the treatment goal for vasodilators?

Answer 7

Decrease peripheral resistance – dec pre/afterload

Question 8

What are the ACE inhibitors?

Answer 8

-pril

Question 9

What is the mechanism of ACE inhibitors?

Answer 9

Dec PR – Dec pre/after load
Inc CO

Decrease:
Aldosterone release
Na, H20 Absorption
Cardiac hypertrophy, remodeling

Question 10

What are the side effects of ACE inhibitors?

Answer 10

Cough
Increase K
Hypotension

Question 11

What are the type 1 Angiotensin 2 Receptor antagonists?

Answer 11

-sartan

Isosartan
Candisartan

Question 12

What is the mechanism of type 1 angiotensin 2 antagonists?

Answer 12

Block AT1 receptors

Question 13

What are the advantages of Isosartan, candisartan?

Answer 13

Dec side effects
Bradykinin metabolism unaffected

AT2 receptors not blocked

Question 14

What vasodilator is given by iv only?

Answer 14

Sodium nitroprusside

Question 15

What is sodium nitroprusside mechanism?

Answer 15

converted to NO

Dec pre/after load

Question 16

What are side effects of sodium nitroprusside?

Answer 16

Hypotension
Reflex Tachycardia
Ischemia

Question 17

What is Hydralazine mechanism?

Answer 17

Dec after load

Question 18

What is Isosrbide dinitrite mechanism?

Answer 18

Dec preload

Question 19

What do you give a pts who can’t take ACE inhibitors?

Answer 19

Isosorbide dinitrate + Hydralazine combo

Question 20

What is the treatment goal of positive inotropic drugs?

Answer 20

Inc ventricular performance –

Inc CO

Question 21

What are digitalis drugs?

Answer 21

Cardiac Glycosides–
Digoxin
Digitoxin

Question 22

What is the mechanism of Digitalis?

Answer 22

Inhibit Na/K ATPase

–> Inc Intracell Ca & Inc FC

Question 23

What are effects of Digitalis?

Answer 23

Inc PNS tone
Dec Automaticity
Dec AV conduction speed

Question 24

How do you treat the side effect of Digitalis?

Answer 24

Lidocaine
K+
B Blocker
Fab fragments

Question 25

What patients are Digitalis used for?

Answer 25

HF w/ atrial arrhythmias

or

symptoms persist after ACE - & B antagonists

Question 26

What is Dopamine mechanism?

Answer 26

Dilate Renal artery

Question 27

What is Dobutamine mechanism?

Answer 27

inc FC w/out inc HR

Question 28

What are side effects of Dopamine + Dobutamine?

Answer 28

Tachycardia

Tolerance

Question 29

What drugs should you never use long term?

Answer 29

Dopamine

Dobutamine

Question 30

What are Phosphodiesterase inhibitors?

Answer 30

Inamrione

Milrione

Question 31

What is the mechanism of Inamirone, Milrione?

Answer 31

Inc intracell cAMP by inhibiting its breakdown –> Inc Ca channel –> Inc Fc

Question 32

What beta blockers work for heart failure?

Answer 32

Carvedilol
Metoprolol
Bisprolol

Question 33

What is Carvedilol, Metoprolol, Bisprolol mechanism?

Answer 33

Dec SNA to heart
Dec HR + O2 consumption

Inc EF

Question 34

What is Ernesto a combination of?

Answer 34

Sacubitril

Valsartan

Question 35

What are Entresto uses?

Answer 35

Class 2-4 failure

EF <40%

Question 36

What are side effects of Entresto?

Answer 36

Hypotension
Hyerkalemia
Cough
Renal Failure