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Drugs for congestive Cardiac Failure Flashcards

1
Q

reduction in cardiac contractility

A

systolic dysfunction

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2
Q

inadequate filling of ventricles during diastole

A

diastolic dysfunction

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3
Q

consequences of hyperadrenergic state

A

Long term: leads to irreversible myocyte damage, cell death & fibrosis

  1. The augmentation in peripheral vasomotor tone increases LV afterload
  2. this places added stress upon the LV and an increase in myocardial O2 demand (ventricular remodeling)

The frequency and severity of cardiac arrhythmias are enhanced in the failing heart

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4
Q

arteriolar vasodilators names & consequences

A

arteriolar vasodilators decrease after load

  1. hydrallazine
  2. calcium channel blockers: amlodipine &nifedipine
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5
Q

venodilators

A

venodilators decrease preload

Ex) Nitrates: isosorbide dinitrate

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6
Q

Nitrates effect on cardiac failure

A

they’re ventilators which results in decreased preload

Ex) Nitrates: isosorbide dinitrate

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7
Q

Hydrallazine & it’s effect on heart failure

A

arteriolar vasodilators decrease after load

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8
Q

Calcium channel blockers & their effect on heart failure

A

arteriolar vasodilators decrease after load

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9
Q

Nonselective vasodilators & their action

A

NOnselective vasodilators decrease both preload & after load

  1. ACE inhibitors: capropril, Enalapril
  2. Angiotensin receptor blockers: Losartan
  3. Na nitroprusside
  4. Bidil- Hydrallazine + Isosorbide dinitrate
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10
Q

Drugs used to treat heart failure that control Na & water retention

A
  1. diuretics: loop diuretics (ie furosemide)

2. Loop diuretics + K sparing diuretics

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11
Q

Drugs used to treat HF that increase cardiac contractility (have positive ionotropic effects)

A

aka positive ionotropic drugs

  1. Digitalis glycosides: digoxin
  2. beta adrenergic agonists: dopamine, dobutamine
  3. Bypyridines (PDE inhibitors): inamrinone
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12
Q

Drugs used to treat HF that reduce cardiac and vascular remodeling to improve the survival

A
  1. ACE inhibitors
  2. Angiotensin receptor blockers
  3. beta blockers: carvedilol, bisoprolol, metoprolol
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13
Q

ACE Inhibitors

A
  1. captopril
  2. Enalapril

vasodilators

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14
Q

ACEI MOA & effects

A

MOA: inhibits ACE–>reduces formation of angiotensin II

Effects:

  1. decreases preload
  2. decreases after load
  3. decreases aldosterone secretion
  4. increases CO
  5. decreases cardiac remodeling
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15
Q

When to use ACEI

A
  1. chronic Heart failure
  2. HTN
  3. Diabetic Renal disease
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16
Q

When to use captopril & side effects?

A 
It's an ACEI; MOA: inhibits ACE-->reduces formation of angiotensin II
USE: 
1. chronic Heart failure
2. HTN
3. Diabetic Renal disease

Side Effects:

  1. dry cough (due to increase in bradykinin)
  2. hyperkalemia
17
Q

When to use enalapril & side effects?

A 
It's an ACEI; MOA: inhibits ACE-->reduces formation of angiotensin II
USE: 
1. chronic Heart failure
2. HTN
3. Diabetic Renal disease

Side Effects:

  1. dry cough (due to increase in bradykinin)
  2. hyperkalemia
18
Q

Toxicity/drug interaction with ACEI

A
  1. dry cough (due to increase in bradykinin)

2. HYPERkalemia

19
Q

Angiotensin Receptor Blockers (ARB)

examples & uses

A
  1. Losartan
  2. Candesartan
Use: 
same as ACEI, used in patients who are intolerant to ACEI
1. chronic Heart failure
2. HTN
3. Diabetic Renal disease
20
Q

Angiotensin Receptor Blockers (ARB)

a) MOA
b) Effects
c) Side effects
d) USES

A

a) MOA: antagonize all effects of angiotensin II on AT1 receptors

b) Effects: same as ACEI
1. decreases preload
2. decreases after load
3. decreases aldosterone secretion
4. increases CO
5. decreases cardiac remodeling

c) side effects
1. NO COUGH (unlike ACEI)
2. HYPERkalemia

d) Use: 
same as ACEI, used in patients who are intolerant to ACEI
1. chronic Heart failure
2. HTN
3. Diabetic Renal disease
21
Q

Losartan

a) what is it
b) MOA
c) effects
d) use
e) side effects

A

a) Angiotensin Receptor Blockers (ARB)
b) MOA: antagonize all effects of angiotensin II on AT1 receptors

c) Effects: same as ACEI
1. decreases preload
2. decreases after load
3. decreases aldosterone secretion
4. increases CO
5. decreases cardiac remodeling

d) Use: 
same as ACEI, used in patients who are intolerant to ACEI
1. chronic Heart failure
2. HTN
3. Diabetic Renal disease

e) side effects
1. NO COUGH (unlike ACEI)
2. HYPERkalemia

22
Q

Candesartan

a) what is it
b) MOA
c) effects
d) use
e) side effects

A

a) Angiotensin Receptor Blockers (ARB)
b) MOA: antagonize all effects of angiotensin II on AT1 receptors

c) Effects: same as ACEI
1. decreases preload
2. decreases after load
3. decreases aldosterone secretion
4. increases CO
5. decreases cardiac remodeling

d) Use: 
same as ACEI, used in patients who are intolerant to ACEI
1. chronic Heart failure
2. HTN
3. Diabetic Renal disease

e) side effects
1. NO COUGH (unlike ACEI)
2. HYPERkalemia

23
Q

Na Nitroprusside

A

arteriolar & venodilator

Pharm (32 decks)

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