Drugs for Heart Failure Flashcards
Heart failure
The heart muscle weakens and enlarges & loses it ability to pump blood through the heart & into systemic circulation efficiently
Heart failure can be caused by
chronic hypertension, myocardial infarction (MI),
Cardiac remodeling:
Ventricles dilate
Hypertrophy
Promotes cardiac fibrosis
Promotes myocyte death
if HR increased too much
reduced ventricular filling
Increased contractility
increase in cardiac oxygen demand
Increased venous tone
pulmonary and peripheral edema occur, if excessive
Water retention and Increased blood volume (activates the RAAS, ↑ cardiac output)
if venous pressure is too high → edema in lungs and periphery
Brain natriuretic Peptide (BNP)
High levels indicate poor cardiac health and can predict a lower chance of survival
Heart Failure Treatments
Diuretics: first-line
RAAS Inhibitors
Beta blockers
Digoxin
ACE inhibitors (preferred):
Cornerstone of HF therapy
Improve functional status and prolong life
Angiotensin II Receptor Blockers:
Improve LV EF Reduce HF symptoms Increase exercise tolerance Decrease hospitalization Enhance quality of life Reduce mortality Little impact on cardiac remodeling
Aldosterone Antagonists:
Reduce symptoms
Decrease hospitalizations
Prolong life
Direct Renin Inhibitors:
can shut down RAAS
Not approved for HF
IV inotropic agents
Dopamine (sympathomimetic)
Digoxin (cardiac glycoside)
Dobutamine (sympathomimetic)
Milrinone (phosphodiesterase inhibitor)
Drugs like steroids that promote
fluid retention can cause worsening accumulation of fluid in the lungs
