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Fall Pharmacology > Cardiovascular- Heart Failure > Flashcards

Cardiovascular- Heart Failure Flashcards

1
Q

What kinds of drugs are used in HF to decrease pathologic sympathetic stimulation?

A

Beta Blockers

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2
Q

What kinds of drugs are used in HF to decrease the load on failing hearts?

A

Diuretics

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3
Q

What kinds of drugs are used in HF to address issues involving the RAA axis?

A

ACEI

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4
Q

Systolic HF treatment involves what meds?

A

Diuretics, ACI, digoxin & nonspecific vasodilators

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5
Q

Diastolic HF treatment involves what meds?

A

Diuretics, vasodilators, inotropic drugs, BB, hydralazine/nitrates

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6
Q

ACC/AHA 2005 guidelines say that Stages A and B are

A

at risk for heart failure

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7
Q

ACC/AHA 2005 guidelines say that Stages C and D are

A

in heart failure

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8
Q

What is the frontline treatment of systolic heart failure?

A

Diuretic + ACEI

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9
Q

What is added to treat systolic heart failure after diuretic + ACEI(or ARB)?

A

Beta Blocker

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10
Q

If persistent signs and symptoms remain in a patient with systolic heart failure who is on a diuretic, ACEI, and BB what is the next line of treatment?

A

Aldosterone antagonist or ARB

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11
Q

If persistent signs and symptoms remain in a patient with systolic heart failure who is on a diuretic, ACEI, BB, and an aldosterone antagonist with a QRS

A

Digoxin

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12
Q

What stage is a patient at high risk for heart failure but without structural heart disease or symptoms of HF?

A

Stage A

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13
Q

What stage is a patient with structural heart disease but w/out symptoms?

A

Stage B

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14
Q

What Stage is a patient with structural heart disease with prior or current symptoms

A

Stage C

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15
Q

What stage is a patient with refractory heart failure?

A

Stage D

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16
Q

What classifications does the NYHA use?

A 
Class 1-4
I= is the best
2= dyspnea w/minimal activity
3= dyspnea at lower workloads
4= dyspnea at rest
17
Q

At what stage should you begin to think about heart transplants?

A

Stage D

18
Q

How would you treat a Stage A patient?

A

Treat HTN- ACEI
Treat lipids
Control metabolic syndrome
Encourage lifestyle modifications

19
Q

How would you treat a Stage B patient?

A

ACEI/ARB in appropriate pts

BB in appropriate pts

20
Q

How would you treat a Stage C patient?

A

Routine Use of:
Diuretics for fluid retention
ACEI
BB

In selected patients:
Aldosterone antag
ARB
Digoxin
Hydralazine/nitrates

Devices:
Biventricular pacing
Implantable defibrillators

21
Q

What would you prescribe to a patient with HF and fluid retention?

A

Furosemide 40 mg

One tablet twice daily

22
Q

What would be your therapy for a patient with Stage A HF and HTN?

A

Lisinopril 40mg

One tablet daily

23
Q

Dose an ARB for use in HF

A

Valsartan 80mg

One tablet twice daily

24
Q

What would you give to a HF patient who is post MI?

A

Carvedilol 25 mg

One tablet twice daily

25
Q

What drugs reverse cardiac remodeling?

A

Beta blockers

26
Q

What ejection fraction is indicative of heart failure?

A

<40%

27
Q

Dose an aldosterone antagonist you would give to your patient in who is Stage C

A

Eplerenone 50mg

One tablet daily

28
Q

What vasodilator would you give to a refractory patient in Stage D

A

BiDil

One tablet 3x a day

29
Q

How does Digoxin work?

A

Increased force of contraction and decreased rate of contraction

30
Q

When is digoxin indicated?

A

Patients with LVEF <40%

who continue to have NYHA class, II, III, and IV despite optimal therapy

31
Q

What drugs have been shown to increase dig levels?

A

Antacids
Metoclopramide (Reglan)
St. John’s wort

32
Q

What drugs decrease dig levels?

A

Amiodarone
Alprazolam (Xanax)
Verapamil
Spironolactone (Aldactone)

33
Q

Dose a cardiac glycoside

A

Digoxin 125mcg

1 tablet daily

34
Q

How do inotropes work?

A

Stimulate B1 receptors of heart, comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects

35
Q

Dose an inotrope

A

Dobutamine infusion 5 mcg/kg/minute

titrate to effect

36
Q

How do B-type Natriuretic Peptides work?

A

Increase intracellular cGMP resulting in smooth muscle relaxation and arterial & venous dilation

Fall Pharmacology (13 decks)

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