Chapter 24-Heart Failure Drugs Flashcards
______ drugs influence the rate of the heartbeat.
Chronotropic
_____ drugs influence the conduction of electrical impulses within tissues.
Dromotropic
Ejection fraction is associated with _____ contractions
Ventricular
_____ drugs influence the force of muscular contractions, particularly contraction of the heart muscle
Inotropic
Which ACE inhibitor is used for heart failure?
Lisinopril (Prinovil, Zestril)
Which ARB is used for heart failure?
Valsartan (Diovan)
Which Beta Blockers are used for heart failure?
Metoprolol (Lopressor)-most common,
Carvedilol (Coreg)-typically combined with Digoxin
Which aldosterone antagonists are used for heart failure?
Spironolactone (Aldactone),
Eplerenone (Inspra)-selective aldosterone blocker
Prevent edema that can worsen heart failure
What is the first line drug for African-Americans with heart failure?
Hydralazine/Isosorbide Dinitrate
Peak plasma levels of hydralazine/isosorbide dinitrate are achieved in one hour
Which heart failure drug is similar to naturally occurring catecholamine dopamine
Dobutamine (Dobutrex)
What is the newest class of medications for heart failure?
B-type Natriuretic Peptide- onset of action 15 minutes
Has vasodilating effects on both veins and arteries but causes fluid and sodium loss thru the urine
Potations with acutely decompensated heart failure that have dyspnea at rest
What are the phosphodiesterase inhibitors (PDIs) used for heart failure?
Milrinone (Primacor)
Injectible only
What is the mechanism of action for PDIs?
They inhibit the action of phosphodiesterase, which results in an increase in intracellular cyclic adenosine monophosphate (cAMP).
Provides more calcium for myocardial muscle contraction
What are the indications for use of PDI’s?
Intensive care unit setting for the short-term management of acute heart failure
What is the mechanism of action for cardiac glycosides?
An increase in myocardial contractility
What are the indications for cardiac glycosides?
Systolic heart failure and atrial fibrillation
Which drugs are considered cardiac glycosides?
Digoxin (Lanoxin)
Therapeutic digoxin levels are 0.5-2 ng/mL
What conditions predispose a patient to Digitalis toxicity?
Cardiac pacemaker, hypokalemia, hypercalcemia, atrioventricular block, dysrhythmias, hypothyroidism, respiratory all renal disease, advanced age, ventricular fibrillation
What is the primary nursing diagnosis for heart failure?
Ineffective peripheral tissue perfusion related to the pathophysiologic influence of heart failure
