Congestive Heart Failure

Question 1

What is congestive heart failure?

Answer 1

failure of heart to pump right

Question 2

What sides of the heart can it be on?

Answer 2

Left = back up to pulmonary = SOB
Right = back up to abdominal & legs = EDEMA
Total Heart Failure - Left and Right

Question 3

What else can CHF be?

Answer 3

arrhythmias

Question 4

What is CAD?

Answer 4

Coronary Artery Disease (disease of vascular)

Question 5

What is hyperlipidemia?

Answer 5

high cholesterol

Question 6

What is hypertension?

Answer 6

High Blood Pressure (high peripheral resistance in arteries)

Question 7

What is arteriosclerosis?

Answer 7

hardening/narrowing of arteries due to age

Question 8

What is atherosclerosis?

Answer 8

hardening/narrowing of arteries due to fatty plaques (hyperlipidemia & hypertension)

Question 9

What can CHF, CAD, arterio/atherosclerosis cause?

Answer 9

Angina Pectoris - chest pain

MI - Myocardial Infarction (heart attack)

Question 10

What are the 3 classes of drugs for CHF?

Answer 10

1. Cardio Glyosides
2. Diuretics
3. Vasodilators

Question 11

What are Cardio Glycosides?

Answer 11

Inhibit ATPase which inhibits Na from leaving with helps MORE Ca enter which causes stronger contraction with LESS O2 consumption
WHICH THEN
decreases HR and AV conduction b/c depressant
RESTORING
improved efficiency of heart
improved blood flow
improved kidney function

Question 12

What is the 1 cardio glycoside drug?

Answer 12

Degoxsin

Question 13

What is degoxsin derived from?

Answer 13

Digitalis Pupurea (foxglove flower)

Question 14

What does a diuretic do?

Answer 14

inhibits reabsorption of Na and so water follows which reduces follow, hence pressure

Question 15

What are the 5 different classes of diuretics?

Answer 15

1. Osmotic Agents
2. Carbonic Anyhdrase Agents
3. Thiazide/Thiazide-Like Agents
4. Organic Acid/Loop Agents
5. Potassium Sparing Agents

Question 16

Name the osmotic agent and the part of the nephron they work on.

Answer 16

Mannitol

Glomerulus (filters Na+, no reabsorption)

Question 17

Name the carbonic anhydrase agent and the part of the nephron they work on.

Answer 17

Acetazolamide

PCT (inhibits reabsorption of Na+, hence water)

Question 18

Name the Thiazide & Thiazide-Like agents and the parts of the nephron they work on

Answer 18

Thiazide
1. hydrochlorothiazide/microzide
2. chlorothiazide
Thiazide-Like
1. Metolazone
2. Indampamide
3. Chlorothalidone
DCT

Question 19

Name Organic Acid/Loop agents and the parts of the nephron they work on

Answer 19

Furosemide/Lasix
Bumetamide
Tosemide
Ascending Loop of Henle

Question 20

Name the Potassium Sparing agents and the parts of the nephron they work on

Answer 20

Spironolactone
Spironolactone/HCTZ
Amiliride
Triamterene
DCT

Question 21

How do Loop diuretics work?

Answer 21

Ascending Limb of Henle

inhibit Na+ and Cl reabsorption, Water Follows

Question 22

What are loop diuretics more potent than?

Answer 22

Thiazide/Thiazide-Like

Question 23

What is the danger of loop diuretics?

Answer 23

Hypokalemia - cauze K+ will follow the Na+ and Cl

Question 24

What are the clinical indications for loop diuretics?

Answer 24

1. Renal Disease
2. Edema
3. CHF

Question 25

What are the common side effects of diuretics?

Answer 25

1. N/V/D
2. Hypotension
3. Dizziness
4. Hypokalemia
5. Orthostatic Hypotension
6. Dehydration

Question 26

What are the 3 types of Vasodilators used in CHF?

Answer 26

1. ACE Inhibitor (Lisinopril/Prinivil)
2. Alpha Blocker (Prazosin)
3. Direct Acting (hydralazine)

Question 27

In the world of vasodilators, what does preload mean?

Answer 27

Preload = blood entering ventricles BEFORE contraction

So preload vasodilator, dilates veins

Question 28

In the world of vasodilators, what do afterload mean?

Answer 28

Afterload = blood left in ventricles AFTER contraction

so afterload vasodilator, dilates arteries