Drugs for heart failure Flashcards
What is preload?
Volume of blood received by the heart.
preload=stretch
The amount of volume being returned to the heart.
What is afterload?
Pressure or resistance the heart has to overcome to eject blood.
afterload=squeeze
The amount of resistance that the heart has to overcome in order to eject blood.
When is heart failure treated?
Once ADLs are affected.
What mechanisms are targeted to treat heart failure?
1.Slowing the heart rate.
2. Increasing contractility.
3. Reducing myocardial workload.
What is a cardiac glycoside?
digoxin (Lanoxin)
What is the MOA of digoxin?
- Increase force and velocity of contraction.
- Slow the electrical conduction.
The hammer!
What is the primary use and AE of digoxin?
Prime use: Heart failure
AE: HA, weakness, dizziness, anxiety, depression, delirium, and hallucinations.
Considerations for digoxin administration
Narrow therapeutic range- toxicity risk
ALWAYS take apical pulse 1 min; hold <60bpm- notify MD if under 60bpm.
treat bradycardia with atropine.
Monitory potassium levels- hold if under 3.5
What do you do if patient has dig toxicity?
Over 2ng/ml, administer antidote, digoxin immune fab (Digifab).
What is a phosphodiesterase inhibitor?
sildenafil (Viagra)
What is the MOA for sildenafil?
block enzyme phosphodiesterase in cardiac and smooth muscle.
1. Increase calcium for myocardial contraction.
2. Vasodilation
3. Increase contractility
4. Decrease afterload
What are the prime uses and AE for sildenafil?
Prime use: pulmonary hypertension and ED.
Do not take at the same time as nitroglycerin.
