CVIII Flashcards
Exam I
ischemic CHF types
atherosclerosis, HTN, post MI
treatment of these symptoms have improved the outcome of ischemic CHF
pump failure, ventricular arrhythmias
biggest impact at improving ischemic CHF
HTN tx, especially in old ppl
CHF vicious cycle (4 things)
damaged myocardium, progressive cardiomegally, decreased Q, more ischemia
acute heart failure tx plan
hospitalize (o2 and loop diuretics), stabilize (ionotropic agents), evaluate (plan outpatient)
chronic heart failure strategy I (3 things)
reduce cardiac workload, restrict sodium, give ACEI or ARB
chronic heart failure strategy II (5 things)
digoxin, beta blockers, vasodilators, diuretics, hyperlipidemia
spironolactone and eplerenone do what and are risky with what?
help prevent remodeling (blocks aldosterone), prevent hypokalemia, RISKY W/ ACEI
this drug reduces preload on the heart, reduce heart o2 demand, helpful in fluid overload, vasodilation effects
loop diuretics
hyperkalemia is danger of what drug (main one)?
spironolactone
what are results of dig toxicity?
conduction slowing (hrt block) and ventricular arrhythmias (irritability)
chronic ischemia damages what?
myocardium
What results in progressive cardiomegaly?
remodeling
An outstretched mycardium results in? And ultimately what?
decrase cardiac output; ischemia
What is used for emergency vasodilation?
sodium nitroprusside, nesiritide
What are the inotropic agents for CHF?
cardiac glycosides, beta adrenergic agonists, phosphodiesterase inhibitors
Digoxin is a ___ and has a low __ ___ and can cause ___ and ____.
cardiac glycoside. Therapeutic index. Arhythmias, anorexia… headache, estrogenic stuff
What are the risk factors with dig?
hypokalemia, hypothyroidism, renal insufficiency
What drugs interact with dig?
verapamil, corticosteroids, quinidine, amiodarone…
What anticoagulation agents are used for CHF?
low dose ASA, warfarin, factor Xa
Can severe CHF be reversed, yes/no and if so which one?
yes; in non-ischemic CHF
Class 1-4 antiarrhythmic agents…
sodium chan, beta blockers, potassium chan, calcium chan blockers
What are some examples of Class I?
quinidine, lidocaine, flecainide
What are Class IIs good at?
tachys tx, prevent ventricle arrhythmias
What are Class III good at?
treating tachys- ex Sotalol
Which anti-arhythmic is most effective at atrial arrhythmias?
Class #4
What drugs are good with vtach
lidocaine, amioderone
What drugs are good with vfib?
lidocaine, amioderone, epi
What drug do you use with SVT?
Adenosine
What drug would you use with afib?
beta blockers, amioderone, propafenone
What are 2 health risks of A fib?
tachy to point of hypotension, mural thrombi
What drugs restore sinus rhythm in afib?
beta blockers, propafenone, flecainamide
What drugs are dangerous in previous Mis and have (-) iontrophic effects?
propafenone and flecainamide
What are some side effects of amiodarone?
pulm fibrosis, liver tox, blocks T4 to T3 conversion, photodermatis, drug interactions
What is amiodarone useful for?
vtach, vfib, afib
What drug is useful in afib or aflutter
digoxin
What is the drug of choice for SVTs and vtach?
Adenosine
What drug is useful in dig toxicity and Torsades de pointes?
magnesium sulfate
