Chapter 20: Drugs for HF + other stuff Flashcards
What signs and symptoms are a primary result of in acute heart failure?
pulmonary edema due to elevated LEFT cardiac output
What is a new onset of AHFS is tachycardia due to?
Strong sympathetic response
What are 4 non-drug treatments for HF
Reduce sodium—DASH DIET
Fluid restrictions (2-3L)
Weight management (BMI)
Exercise
What drug improves contractility and pumping ability of the heart. It increases force of contraction by inhibiting sodium, potassium, adenosine triphosphate. Calcium enters the cell In exchange for sodium, which increases contractility
Digoxin
When do you not give Digoxin?
If heart rate is less than 60 do not give.
What do Inotropes (Cardiac Glycosides) indirectly stimulate?
Vagus Nerve
What is first-line drug for those those first diagnosed with HF- cardiac function
Inotropes (Cardiac Glycosides)
When are Inotropes (Cardiac Glycosides) contraindicated? (4)
patients with severe myocarditis, ventricular tachycardia, ventricular fibrillation
What is the therapeutic serum digoxin level is ***??? in Inotropes (Cardiac Glycosides)
0.8-2.0ng/mL
What is a drug that increases CO and decreases preload?
Thiazide diuretic:
With what drug do you want to weigh patient daily?
Loop diuretics
What drug decreases edema in patients with HF?
Aldosterone Antagonist- potassium sparing diuretic
What drug blocks conversion of angiotensin 1 to production of angiotensin 2?
Angiotensin Converting Enzyme (ACE)
Enalapril (Vasotec)
What drug suppress the SNS and the resulting catecholamine excess that eventually damages myocardial cells
Beta blockers
What drug causes vasodilation by exerting direct relaxant effect on vascular smooth muscle, decreasing both preload and afterload
Cardiotonic- Ionotropic Agents
Prototype: Milrinone lactate (Primacor)
What drug in low doses it is not a beta 2 adrenergic drug, but if given in increased doses, it can cause bronchoconstriction.
Beta blockers
What drug reduces myocardial beta receptors reduces cardiac output?
Beta blockers
What drug’s prototype is Losartan potassium (Cozzar)
ARBs (Angiotensin 2 Receptor Blocker)
What is one drug not compatible with other medications?
Cardiotonic- Ionotropic Agents
What is Atenolol?
Beta blocker: beta 1 selective (cardioselective), beta adrenergic blocker, cardioselectivity is diminished at higher doses, where it inhibits beta 2 in bronchial and vascular musculature
What do you give if a patient presents without signs and symptoms of heart failure but has cardiac changes that place patient at risk for heart failure—
treat with ACE or ARB!!!
implantable defibrillator if indicated, avoid alcohol and smoking
What do you do if: Patient presents without signs or symptoms but is at high risk for developing HF?
— treatment of hypertension with ACE or ARB, control blood sugar, stop smoking, avoid alcohol
What drugs should NOT be used if: Patient presents with symptoms of HF, most commonly including dyspnea, fatigue, peripheral edema-
Nonsteroidal anti-inflammatory agents and calcium channel blockers should NOT be used.
sodium restriction, alcohol avoidance and smoking cessation, treatment with ACE and beta blockers, ARBS.
