15: Drugs for CHF Flashcards
what do most ACEis end in ?
-pril
what do most ARBs end in?
-sartan
what tissue makes BNP?
ventricles
whihc is more potent, BNP or ANP?
ANP
what two hormones does ANP decrease?
renin, aldosterone
locally produced ___ contributes to cardiac fibrosis after MI
aldosterone
four major reasons to give diuretics
- essential HTN
- edema in CHF
- edema in liver failure
- edema in kidney failure
a decrease in what causes digitalis toxicity?
hypokalemia
major ECG effect of hyperkalemia vs hypokalemia
- hyperK: bradycardia
2. hypoK: tall U waves
which diuretics are considered “high ceiling”; have the greatest amount of diuresis?
loop diuretics
what part of the nephron tubule do loop diuretics work in?
thick ascending limb
first drug ever intended for one racial group (African Americans)
isosorbide dinitrate
two cellular causes of digoxin cardiac toxicity
- myocytes become overloaded with Ca -> spontaneous oscillatory releases from SR -> delayed afterdepols and aftercontractions
- free radicals
normal ECG changes with digoxin vs toxic levels of digoxin
- normal: ST depression, PR prolongation
2. toxic: AV dissociation, ectopic ventricular beats
four things to treat digoxin OD
- KCl
- lidocaine
- phenytoin
- anti-digitalis Abs
which cardiac drug can sometimes need a loading dose
digoxin
cardiorenal syndrome
a spectrum of disorders involving heart + kidney where dysfunction in one organ causes dysfunction in the other
why is it important to relieve congestion in ADHF?
so ventricular fiber length can return to optimal range
three classes of drugs to avoid when treating ADHF + why
- class I anti-arrhtyhmics: some are negative inotropes
- CCBs: suppress cardiac contractility
- NSAIDs: impair Na and H2O excretion
