β-blockers, aldosterone antagonists, diuretics

Question 1

β-blockers that are most useful in heart failure

Answer 1

Carvedilol.
Metoprolol
Bisprolol

Question 2

β-blockers - when are they indicated for heart failure?

Answer 2

Heart failure caused by left ventricular systolic dysfunction.

Question 3

Carvedilol - classification

Answer 3

Third-generation β1- and β2-blocker with α 1-blockade as well. Antioxidant, antiinflammatory, antiapoptotic.
Multiple-action neuroendocrine antagonist.

Question 4

Carvedilol - effects

Answer 4

Increased left ventricular ejection fraction, slowed disease progression.

Question 5

Does carvedilol improve symptoms of heart failure?

Answer 5

Yes

Question 6

Does carvedilol improve survival in heart failure?

Answer 6

Yes

Question 7

Carvedilol - indications in heart failure

Answer 7

Symptomatic heart failure in pts without significant hypotension, pulmonary congestion, AV block.

Question 8

Carvedilol - adverse effects

Answer 8

Bradycardia, worsening heart failure, dizziness.

Question 9

Aldosterone antagonists used for heart failure

Answer 9

Spironolactone and eplerenone

Question 10

Aldosterone antagonists - effects in heart failure

Answer 10

Decrease plasma volume by increasing Na excretion, decrease K excretion.

Question 11

Aldosterone antagonists - indications for heart failure

Answer 11

Severe heart failure

Question 12

Aldosterone antagonists - contraindications

Answer 12

Renal insufficiency (hyperkalemia)

Question 13

Aldosterone antagonists - adverse effects

Answer 13

Hyperkalemia, gynecomastia.

Question 14

Diuretics used for heart failure

Answer 14

Loop diuretics (more preferred for heart failure)
Thiazide diuretics