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Pharm Block 2 > Anti-heart failure > Flashcards

Anti-heart failure Flashcards

1
Q

Anti-heart failure drugs

A

Diuretics
Vasodilators
Positive Inotropic drugs
B receptor antagonists

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2
Q

Diuretics

A

see anti-hypertensive drugs

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3
Q

Do loop and thiazide diuretics increase survival?

A

Nope

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4
Q

Does spironolactone alone and in combination with ACE inhibitors increase survival?

A

Yep

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5
Q

ACE inhibitors

A

Captopril, enalapril, lisinopril

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6
Q

ACE inhibitor - MoA

A

drug angiotensin II levels

drop peripheral resistance and preload/afterload and CO

drop aldosterone release

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7
Q

ACE inhibitor - adverse effects

A

Cough (bradykinin)
Angioedema
Hyperkalemia
Hypotension

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8
Q

Angiotensin II receptor antagonists

A

Losartan, candisartan

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9
Q

ARB - MoA

A

Blocks AT1

Similar effects to ACE

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10
Q

Sodium Nitroprusside (IV) - MoA

A

Converted to NO
Smooth muscle relaxation
Reduces preload/afterload

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11
Q

Sodium Nitroprusside - adverse effects

A

hypotension, reflex tachycardia, ischemia

Thiocyanate toxicity

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12
Q

Nitroglycerin (topical, sublingual) - MoA

A

Same as nitroprusside

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13
Q

Nitroglycerin - adverse effects

A

Hypotension, reflex tachy, ischemia, tolerance

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14
Q

Hydralazine (oral) - MoA

A

dilate arterioles

Reduces afterload

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15
Q

Isosorbide dinitrite (oral) - MoA

A

converted to NO
preload drops
increases renal blood flow

Used in combination with hydralazine for people (af americans) who are resistant to ACE

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16
Q

Cardiac Glycosides (oral)

A

Digoxin, Digitoxin

17
Q

Digoxin, Digitoxin - MoA

A

inhibits Na/K ATPas and leads to an increase in calcium in the cell

contractility increases

18
Q

Digoxin - specific effects

A

Incr. sensitivity of baroreflex
Incr. parasymp tone
Decr. automaticity, AV conduction

19
Q

Digoxin - spectrum

A

Pts in HF with atrial arrhythmia or if symptoms persist after ACE inhibitors and Beta blockers

20
Q

Positive Inotropic drugs cont’d

A

Dopamine
Dobutamine
Inamrinone and Milrinone (PDE blockers)

21
Q

Dopamine - MoA

A

D1, B1, alpha 1 agonist

Dilates renal arteries at low doses

22
Q

Dobutamine - MoA

A

Beta1 Beta2 agnoist

23
Q

Dopa/Dobuta - adverse effects

A

tachycardia, tolerance

Not intended for long term use

24
Q

Phosphodiesterase inhibitors (inamrinone/milrinone) - MoA

A

Incr. cAMP and incr. Ca. leading to incr contractility.

Incr. cGMP in smooth muscle leading to dilation

25
Q

PDE inhibitors - spectrum

A

short term severe heart failure

26
Q

Beta Receptor antagonists

A

Carvedilol (B1, B2 > a1)
Metoprolol (B1)
Bisprolol (B1- off label)

27
Q

B receptor - MoA

A

Drops demand on failing heart

28
Q

Sacubitril/Valsartan - Entresto

A

increases naturetic peptides, bradykinin, and adrenomedullin

drops vasoconstriction

Pharm Block 2 (13 decks)

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