CHF

Question 0

Dobutamine

Answer 0

-beta1-inotropic agent
-+lusitropy (relaxation rate)
-+inotropy (contractility)
-+chronotropy (heart rate)
-+dromotropy (conduction velocity)
-vasodilate smooth muscles
MOA
-activate beta1-receptors

Question 1

Digoxin

Answer 1

-from fox gloves
-INC contractility
-antidote: digoxin immune FAB (digibind)
MOA
-inhibit na-K ATPase pump
ADE
-nausea, vomiting, bradycardia, AV block, and other arrhythmias

Question 2

Inamrinone

Milrinone

Answer 2

-PDE-3 blockers
-INC concentration of cAMP–> INC contractility and vasodilates
-compared to dobutamine, has less effect on contractility and same effect on peripheral vasodilation
MOA
-blocks PDE-3 (phosphodiesterase-3 blocker)

Question 3

Carvedil (beta-blocker)

spironolactone (aldosterone antagonist)

Answer 3

-used to DEC cardiac contractility
-blocks detrimental effects of INC sympathetics
MOA
-blocks beta receptors
ADE
-using chronic inotropic support drugs (beta1-agonist, PDE-3 blocker) results in INC mortality bc pt dies faster if you flog a failing heart.