Chapter 24: Heart Failure Drugs Flashcards
What are the drug therapies for heart failure?
- ACE inhibitors
- Angiotensin II receptor blockers
- Beta blockers
- aldosterone antagonists
- B-type natriuretic peptides
- phosphodiesterase inhibitors
- cardiac glycoside (digoxin)
Aldosterone antagonist
indicated for severe CHF
Spironolactone
potassium-sparing diuretic that has been shown to reduce CHF symptoms
What drugs are considered aldosterone antagonists?
spironolactone and eplerenone
What are the miscellaneous drugs to treat heart failure?
- hydralazine/isosorbide dinitrate
- dobutamine
hydralazine/isosorbide dinitrate
first drug approved for a specific ethnic group, namely african americans
dobutamine
- beta1-selective vasoactive adrenergic drug
- structurally similar to dopamine
B-Type Natriuretic Peptides includes
Nesiritide (Natrecor)
nesiritide (natrecor)
used in the intensive care setting as a final effort to treat severe, life-threatening heart failure, often in combination with several other cardiostimulatory medications
Mechanism of action for B-Type Natriuretic Peptides
- effects include diuresis (urinary fluid loss), natriuresis (urinary sodium loss) and vasodilation
- vasodilating effects on both arteries and veins
- indirectly increases cardiac output
- suppresses renin-angiotensin system
Phosphodiesterase Inhibitors
work by inhibiting the enzyme phosphodiesterase
Use of phosphodiesterase inhibitors results in
positive inotropic response and vasodilation
Name a phosphodiesterase inhibitor
milrinone (primacor)
What are the indications of phosphodiesterase inhibitors?
- short-term management of heart failure
- given when patient does not respond to treatment with digoxin, diuretics and/or vasodilators
- American Heart Associations and American College of Cardiology advise against long term infusions
Adverse Effects of the Phosphodiesterase inhibitor, Milrinone
- dysrhythmia
- hypotension
- angina
- hypokalemia
- tremor
- thrombocytopenia