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
