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Pharm EXAM 2 > chapter 30- heart failure > Flashcards

chapter 30- heart failure Flashcards

1
Q

what is HF normally related to

A

CAD

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2
Q

the main goal of HF treatment

A

symptom management, normally fluid management

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3
Q

what is HF

A

the heart’s inability to pump enough blood

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4
Q

direct causes of HF

A

-impaired contraction during systole – most common
-impaired relaxation during diastole
-combination

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5
Q

other causes of HF

A

-hyperthyroidism
-fluid volume overload
-antidysrhythmic meds
-meds that cause sodium and water retention (corticosteroids, estrogens, NSAIDS)

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6
Q

signs of left-sided HF

A

SOB, crackles, dizziness, activity intolerance
-the blood backs up and stays in the lungs

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7
Q

signs of right-sided HF

A

weight gain, JVD, peripheral edema
-the blood backs up into the veins, specifically in the lower extremities

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8
Q

nonpharm management of HF

A

-restrict Na intake, eat heart healthy
-restrict fluids
-promote weight loss
-reduce physical activity – if needed
-administer o2
-prepare for heart transplant –normally not an option due to comorbidities

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9
Q

what do cardiac glycosides do

A

allows more Ca to enter the cell, decreasing the workload of the heart

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10
Q

common cardiac glycoside

A

digoxin

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11
Q

what are cardiac glycosides used for

A

mild to moderate HF – positive inotropic
management of A fib – negative chonotropic

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12
Q

side effects of cardiac glycoside

A

weakness, HA, drowsiness, vision changes (YELLOW) GI, arrhythmias, breast enlargement

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13
Q

who cannot take cardiac glycoside

A

v tach, v fib, HB, sick sinus, acute MI, renal, electrolyte abnormalities

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14
Q

what is the problem with digoxin

A

small therapeutic window 0.8-2 ng

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15
Q

antidote to digoxin

A

digoxin immune fab

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16
Q

how do phosphodiesterase inhibitors work

A

INCREASES Ca
increase the force of contraction, having a positive inotropic effect, will decrease preload and afterload

17
Q

example of a phosphodiesterase inhibitor

A

milrinone

18
Q

side effects of milrinone

A

potentially fatal ventricular arrhythmias, hypotension, CP, N/V, thrombopenia, burning at injection sign

19
Q

who should not take milrinone

A

acute MI, aortic stenosis, PREGNANCY, pulmonary artery stenosis

20
Q

what is milrinone used for

A

long term bridge therapy for HF

21
Q

What do human B-type natriuretic peptides do

A

increased sodium excretion, direct vasodilation

22
Q

example of a human B-type natriuretic peptide

A

nesiritide

23
Q

side effects of nesiritide

A

hypotension, headache, n/v, back pain, ventricular tachycardia, dizziness, anxiety, bradycardia

24
Q

who should not take nesiritide

A

BP less than 90

25
Q

is nesiritide commonly used

A

no, there are newer more efficient meds

26
Q

how do angiotensin receptor neprilysin inhibitors work

A

degrades the atrial and brain peptide BNP to lower BP along with an ARB (valsartan)

27
Q

common angiotensin receptor neprilysin inhibitor

A

sacubitril/valsartan

28
Q

side effects of sacubitril/valsartan

A

hypotension, hyperkalemia, cough, dizziness, renal impairment, angioedema

29
Q

who can not take sacubitril/valsartan

A

people taking lithium, pregnancy

30
Q

how do sinoatrial node modulators work

A

inhibition in the SA node allows for ventricular filling

31
Q

common sinoatrial node modulator

A

Ivabradine

32
Q

adverse effects of ivabradine

A

bradycardia, hypotension, a fib, phosphine (ring/spot on the eye)

33
Q

who should not use ivabradine

A

acute decompensated HF, bradycardia, hypotension, heart blocks, sick sinus, pacemaker, severe hepatic impairment

34
Q

common ACE inhibitor used for HF

A

enalapril

35
Q

common ARB used for HF

A

losartan potassium

36
Q

common beta blocker used for HF

A

propranolol

37
Q

common aldosterone antagonist for HF and why

A

spironolactone, helps keep potassium up

38
Q

diuretics commonly used in HF

A

loop diuretics – furosemide
thiazide diuretics – hydrochlorothiazide HCTZ

39
Q

latest time diuretics are given

A

4-5 pm

Pharm EXAM 2 (8 decks)

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