Drugs for Heart Failure Flashcards

1
Q

classes of drugs for acute HF

A

1) diuretics
2) vasodilators (CCB, hydralazine)
3) supplemental O2
4) beta receptor agonist: dobutamine

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2
Q

what are the classes of drugs for chronic HF

A

1) diuretics
2) ACE inhibitors (prils)
3) ARBS (sartans)
4) Beta blockers
5) Aldosterone receptor antagonists
6) cardiac glycosides (positive iontrops) - Digoxin
7) vasodilators (CCB and Hydralazine)

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3
Q

what are the drugs that are proven to have a reduction in mortality with HF patients?

A

1) ACE inhibitors
2) B blockers
3) Aldosterone receptor antagonist (Spironolactone and Eplerenone)

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4
Q

MOA of ACE inhibitor

A

inhibit Angiotensin converting enzyme which decreases angiotensin receptor activation resulting in increased cardiac output

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5
Q

what is the hemodynamic effects of ACE inhibitors

A

decreased preload and decreased afterload

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6
Q

what is the MOA of betta blockers for HF

A

decrease renin release from the kidneys which decrease workload and 02 consumption

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7
Q

what are the hemodynamic effects of Beta blockers

A

decreased preload and decreased afterload

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8
Q

what are the clinical notes for beta blockers and HF

A

may be contraindicated in severely decompensated HF

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9
Q

what is the MOA of Spironolactone and Eplerenone

A

antagonist at aldosterone receptor

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10
Q

what is the hemodynamic effect of spironolactone and eplerenone

A

decreased preload

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11
Q

what are the drugs that are used to improve symptoms of HF but do not increase mortality?

A

1) diuretics
2) Digoxin
3) organic nitrates
4) Dobutamine
5) milrinone

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12
Q

what is the MOA of digoxin

A
  • inhibit Na+/K+ ATPase
  • increase intracellular Ca2+
  • increase contractility
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13
Q

what is the hemodynamic effect of digoxin

A
  • increased contractility (positive iontrop)
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14
Q

what is the MOA of dobutamine

A

stimulates B receptors and increases HR

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15
Q

what is the Hemodynamic effect of dobutamine

A
  • increased contractility (b1)
  • decreased afterload (b2)
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16
Q

what is the MOA of milrinone

A

inhibit phosphodiesterase to have a B adrenegric effect

17
Q

what are the hemodynamic effects of milrinone

A
  • increased contractility
  • decreased preload
  • decreased afterload
18
Q

what are the adverse effects of ACE inhibitors

A

1) persistent dry cough
2) renal insufficiency
3) hyperkalemia
4) postural hypotension
5) teratogenic (fetotoxic)

19
Q

what are the hemodynamic effect of ARBs

A

decrease in preload and decrease in afterload by blocking the AT1 receptor in the heart

20
Q

what are the adverse effects of ARBs

A
  • hyperkalemia
  • orthostatic hypotension
  • teratogenic (fetotoxic)
21
Q

what are the side effects of beta blaockers

A
  • bradycardia
  • hypotension
  • fatigue
  • dizziness
22
Q

what receptors to bisoprolol and metoprolol work on?

A

B1

23
Q

what receptor does carvedilol work on

A

beta and alpha

24
Q

what is the most common types of diuretics used in HF

A

loop (semide, tanide, zone)

25
Q

what are the adverse effects of vasodilators

A
  • headache
  • hypotension
  • tachycardia
26
Q

adverse effects of digoxin

A
  • narrow therapeutic index
  • anorexia, nausea, and vomiting
  • blurred vision
  • cardic arrhythmias
  • hypokalemia