15, 16 Heart Failure Flashcards
What are the loop diuretics?
Furosemide
Bumetanide
Torsemide
What do loop diuretics inhibit?
Na- K- 2Cl symporter on ascending loop
What are loop diuretics used to treat?
HF - reduce: vascular volume edema pulmonary congestion
What is used as iv admin for decompensated HF?
Loop
What do thiazide diuretics inhibit?
Na-Cl co transporter on distal CT
What does spironolactone do?
block effects of aldosterone on heart
What is the treatment goal for vasodilators?
Decrease peripheral resistance – dec pre/afterload
What are the ACE inhibitors?
-pril
What is the mechanism of ACE inhibitors?
Dec PR – Dec pre/after load
Inc CO
Decrease:
Aldosterone release
Na, H20 Absorption
Cardiac hypertrophy, remodeling
What are the side effects of ACE inhibitors?
Cough
Increase K
Hypotension
What are the type 1 Angiotensin 2 Receptor antagonists?
-sartan
Isosartan
Candisartan
What is the mechanism of type 1 angiotensin 2 antagonists?
Block AT1 receptors
What are the advantages of Isosartan, candisartan?
Dec side effects
Bradykinin metabolism unaffected
AT2 receptors not blocked
What vasodilator is given by iv only?
Sodium nitroprusside
What is sodium nitroprusside mechanism?
converted to NO
Dec pre/after load
What are side effects of sodium nitroprusside?
Hypotension
Reflex Tachycardia
Ischemia
What is Hydralazine mechanism?
Dec after load
What is Isosrbide dinitrite mechanism?
Dec preload
What do you give a pts who can’t take ACE inhibitors?
Isosorbide dinitrate + Hydralazine combo
What is the treatment goal of positive inotropic drugs?
Inc ventricular performance –
Inc CO
What are digitalis drugs?
Cardiac Glycosides–
Digoxin
Digitoxin
What is the mechanism of Digitalis?
Inhibit Na/K ATPase
–> Inc Intracell Ca & Inc FC
What are effects of Digitalis?
Inc PNS tone
Dec Automaticity
Dec AV conduction speed
How do you treat the side effect of Digitalis?
Lidocaine
K+
B Blocker
Fab fragments
What patients are Digitalis used for?
HF w/ atrial arrhythmias
or
symptoms persist after ACE - & B antagonists
What is Dopamine mechanism?
Dilate Renal artery
What is Dobutamine mechanism?
inc FC w/out inc HR
What are side effects of Dopamine + Dobutamine?
Tachycardia
Tolerance
What drugs should you never use long term?
Dopamine
Dobutamine
What are Phosphodiesterase inhibitors?
Inamrione
Milrione
What is the mechanism of Inamirone, Milrione?
Inc intracell cAMP by inhibiting its breakdown –> Inc Ca channel –> Inc Fc
What beta blockers work for heart failure?
Carvedilol
Metoprolol
Bisprolol
What is Carvedilol, Metoprolol, Bisprolol mechanism?
Dec SNA to heart
Dec HR + O2 consumption
Inc EF
What is Ernesto a combination of?
Sacubitril
Valsartan
What are Entresto uses?
Class 2-4 failure
EF <40%
What are side effects of Entresto?
Hypotension
Hyerkalemia
Cough
Renal Failure
