drug management for heart failure Flashcards
What is the pathophysiology of heart failure? (failing of the pump)
cardiac remodelling
peripheral vasoconstriction
salt and water retention
What occurs when there is a fall in cardiac output?
sympathetic activation
renin-angiotensin system activation
What occurs during sympathetic activation?
increase peripheral vascular resistance, cardiac sympathetic activation
What does excessive sympathetic activation lead to?
cardiac remodelling
What occurs during cardiac remodelling?
functional deterioration
What happens when renin-angiotensin system is excessively activated?
peripheral vascular resistance
salt and water retention
What does an increase in renin-angiotensin system activation result in?
oedema in lungs
oedema in dependent areas
What are potential treatments of heart failure?
digoxin
β-adrenoceptor blockers
RAS inhibitors
diuretics
nitrates
Why can digoxin be used to heart failure?
can increase cardiac contracility
Why can nitrates be used for heart failure?
can be used for emergency vasodilation
Why can β-adrenoceptor blockers be used for heart failure?
counter effects of sympathetic stimulation on arrhythmia risk and cardiac remodelling
Why can diuretics be used for heart failure?
to counter aldosterone-driven retention of salt and water
What does digoxin do?
blocks sodium/potassium ATPase
What occurs when the sodium/potassium pump is blocked?
less efficient exchange of sodium/potassium = decrease sodium gradient
What happens to calcium when digoxin blocks sodium/potassium ATPase?
decrease calcium exchange
increase intracellular calcium
increase muscle contractility
