Drugs For Cardiac Failure

Question 0

Ace inhibitors , AT Antagonists

Hydralazine - cause vasodilation if arterial side

Answer 0

Reduce after load

Question 1

Diuretics -loop diuretics

Isosorbide dinitrate- increase venous capacitance

Answer 1

These reduce preload

Question 2

Furosemide

Answer 2

Loop diuretic
Reduce preload- decrease venous return
Reduce pulmonary congestion -reduce dyspnea
-take morning because it can disturb sleep
A.e. Hypokalemia, hypovolemia

Question 3

Isosorbide mononitrate
Isosorbide dinitrate

-good for blacks

Answer 3

Reduce preload
Acts as NO donor-increase venous capacitance
A.e. Headache, flushing, hypotension
Do not give Sildenafil

Question 4

Captopril
Enalapril
Fosinopril
Lisinopril
Quinapril

Answer 4

Ace inhibitors
Reduce after load and preload little but
-reduce aldosterone,ventricular remodeling

A.e. -angioedema

Question 5

Digoxin

Answer 5

Cardiac glycoside Inhibit Na/k activated atpase
Increased myocardial contraction
-stimulate vagal activity^> so dec. automaticity of av and sa node( dec conduction}– useful for atrial fib*
-narrow TW
T1/2 =36 hours
A.e. Gynecomastia, diarrhea, n& v, confusion, hypokalemia

Question 6

Milrinone

Inamrinone

Answer 6

Inhibit phosphodiesterase II
Increase myocardial contraction
Only used in acute cardiac failure **

Question 7

Dobutamine

Answer 7

Activate B1 receptors
Increase myocardial contractability

Only used in acute cardiac failure ***

Question 8

Losartan
Irbesraran

Switch to ARB

Answer 8

Reduce after load
. Develop cough and angioedema
-contradiction in bilateral renal stenosis and pregnant

Question 9

Hydralazine

Answer 9

Reduce after load -vasodilator

A.e- SLE .tachy sns activation

Question 10

Digoxin toxicity

Answer 10

Give k

Digoxin antibodies

Question 11

Metoprolol
Carvedilol
Bisprolol

Answer 11

Beta blockers useful in cardiac failures

Question 12

Sprinololactone

Eplerenone

Answer 12

Aldosterone antagonist
No loss of K
-cardiac failure stage 3-4
A.e. Hyperkalemia
S- gynecomastia

Question 13

Ivabradine

Answer 13

Inhibits Ifunny channel

• works on sa node
• reduce hr to seventy,helps in failure

Question 14

Aggravate heart failure

Answer 14

Na retention- NSAID, liquorice, corticosteroids,

Depress myocardial contractility- beta blockers, ccbs-verapamil, Certain anti arythmics

Cancer chemotherapy agents - doxorubicin, herceptin trastuzumab,imantibib mesylate

Question 15

Nesiritide

Answer 15

Recombinant form of 32 amino acid human

- b type natriuretic peptide- made by ventricular myocardium