Drugs CHF Flashcards
Digoxin, dobutamine, and dopamine are positive ionotropic drugs
Positive ionotropic activity
Positive ionotropic activity and vasodilator
PDE inhibitor
Venodilators decrease preload, which decreases
Edema
In CHF
⬇️ TPR > ⬇️ afterload > _____ SV > ____ CO > _____ tissue perfusion
Increase
Balanced venous = arterial vasodilation
Balance ⬇️ preload and afterload
Increase CO
Nitroprusside
Venodilation mainly
Organic nitrates
Low doses > mainly ⬇️ preload which decreases congestion/edema/CO
Organic Nitrates
High doses > ⬇️ preload and afterload to maintain CO
Organic Nitrates
Decreased mortality when isosorbide dinitrate is combined with
Hydralazine
Arteriodilator
Decreased afterload > Increases SV > Increase CO
Decreased mortality when combined with a nitrate
Hydralazine
Decrease remodeling and mortality
ACEi and ARB
⬇️ afterload > ___ SV > ____ CO
⬇️ LVEDP (venodilation, _____ RAA > _____ salt and water retention)
Increase
Decrease
ACEi and ARBs
Increase cAMP in heart > __ contractility
Increase cAMP in vascular smooth muscle > vasodilation
PDEi
Increase CO and cause vasodilation
PDEi
PDEi used in short term IV treatment of severe refractory CHF
Milrinone
Carvedilol, metoprolol, and bisoprolol are
Beta blockers
Decrease mortality in CHF
Inhibit remodeling
Titrate doses up with monitoring
Beta blockers
Directly effect the heart to inhibit Na/K ATPase which ___ calcium and ______ contractility
Digoxin
Increases
Has direct vagomimetic effects to ⬇️ SA node > ⬇️ HR
⬇️AV node conduction > AV block
Digoxin
Direct effects of digoxin predominate at ___ doses
High
High doses
Induction of delayed afterdepolarization > tachyarrhythmias
Arrhythmias
Digoxin
Has renal elimination
Digoxin
Hydralazine, organic nitrates, and nitroprusside are
Vasodilators
