clinical pharmacology of heart disease Flashcards
Discuss the strengths of diuretics in treatment of heart failure.
inhibits Na/K/Cl transporter in the loop of henle.
Works at low glomerular filtration rates
prevents reabsorption of 20% of filtered sodium and water
reduces tiredness and improves exercise capacity
- Discuss the strengths and weaknesses of ACE inhibitors in the treatment of heart failure.
Can cause a cough
renal impairement
hyperkalaemia
Explain the role of renal and hepatic dysfunction in adverse drug reactions and drug interactions.
Describe the hormonal and physiological responses to heart failure and the potential sites for therapeutic intervention.
i
weaknesses of diuretics
Doesn’t reduce mortality or morbidity
weaknesses of diuretics
Doesn’t reduce mortality or morbidity
Some patients can become resistant
cause dehydration, hypotension, gout, impaired glucose tolerance
name a loop diuretic
Furosemide
ivabradine
Slows heart rate through inhibition of L channel in the sinus node and therefore should only be used for patients in sinus rhythmn
Digoxin
increases availability of calcium in the myocytes.
narrow theuraptic index
reduce number of hospitalisations
cause nausea and confusion
How do you monitor benefit of these drugs
- if they relive symptoms
- reduce clinical signs such as oedema
- monitor weight regularly as loss or gain of fluid determines dosage
angiotensin. inverting enzyme inhibitors
ramipril
competitively blocks angiotensin converting enzyme
prevents conversion of angiotensin I to angiotensin II
reduces preload and afterload on the heart
ACE inhibitors
reduces morbidity and mortality
ACE inhibitors
reduces morbidity and mortality
angiotensin receptor blockers
block angiotensin II
they are effective but don’t reduce mortality in patients with HFrEF
