33: drugs for treating heart failure Flashcards
pathological state in which CO is insufficient to meet metabolic demands of the body
heart failure
heart failure is when CO is ____
insufficient
causes of HF
decreased contractility:
myocardium disease
cardiotoxic drugs
pressure and volume overload
restriction in ventricular filling:
diastolic dysfunction
compensatory mechanisms to try to maintain adequate CO are _____
counterregulatory
counterreg mech in heart failure
kidneys interpret reduced perfusion as ineffective blood volume + stimulates Na+ and H2O retention
vasoconstriction
ventricular hypertrophy and remodeling
drugs to treat HF
RAS inhibitors beta antagonists aldosterone antagonists loop diuretics digoxin organic nitrates hydralazine
carvedilol is ___ selective
beta/alpha 1
beta antagonists MOA
reduction in HR and BP- reduce sympathetic
prolong diastolic filling - reduce sympathetic
reduce detrimental remodeling of heart - CO
inhibit renin
spironolactone and eplerenone are
aldosterone receptor antagonists
the aldosterone receptor is a
mineral corticoid receptor (class 1 nuclear)
aldosterone receptor antagonists do not directly inhibit electrolyte transporter activity, but inhibit
expression of transporters
furosemide is a
loop diuretic
furosemide MOA
inhibits Na+/K+/2Cl- at loop of Henle
what is used in patients with chronic atrial fibrillation or those who remain sympatomatic with ACEI and diuretic
digoxin
cardiac glycoside, positive inotropic effect
digoxin
digoxin MOA
inhibits Na+/K+ ATPase
digoxin ___ contraction force, ___ HR, ____ ventricular filling
increases contration forcec
decreases HR
increases ventricular filling
