Drugs for treatment of heart failure Flashcards
Two forms of congestive heart failure
systolic dysfunction: impaired ventricular contraction
diastolic dysfunction impaired ventricular relaxation
3 symptoms of chronic heart failure?
- progressive cardiac dysfunction
- breathlessness
- tiredness
- neurohormonal disturbances
- sudden death (LOL)
pathophysiology of chronic heart failure
pump becomes less effective –> more blood remains in ventricles at the end of each cycle, end-diastolic volume increases –> over time as preload increases more, heart is overstretched and contracts less forcefully
What is the moa of nitrates?
donate nitric oxide –> helps myosin relax
Isosorbide dinitrate/mononitrate method of administration
oral
which has longer half life? ISDN or ISMN
ISDN has longer half life –> lasts longer as ISDN converted to ISMN
**usually ppl use ISDN for heart failure and ISMN is for angina
is the dominant effect of ISDN veno or arteriodilation?
venodilation
source: mitchell lai lecture
name 3 beta-blockers used for treatment of heart failure, one from each category
Non-selective: carvedilol
Cardioselective(b1): bisoprolol, metoprolol
Mixed: Nebivolol
all end with ‘lol’
Name 3 loop diuretics
furosemide, bumetanide, ethacrynic acid
administration of loop diuretics
iv
Name 4 uses of loop diuretics
acute pulmonary edema and other edema
acute hyperkalemia
acute renal failure
anion overdose: toxic ingestions of bromide, fluoride and iodide
Adverse effects of loop diuretics
hypokalemic metabolic alkalosis
ototoxicity
hyperuricemia
hypomagnesemia
don’t take with NSAID
Name 2 potassium sparing diuretics, one affecting aldosterone receptor and one affecting Na+ channel
Aldosterone receptor: spironolactone, eplerenone
Na+ channel: triamterene, amiloride
3 adverse effects of potassium sparing diuretics
hyperkalemia
metabolic acidosis
gynecomastia
acute renal failure
kidney stones
hydralazine
