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2 - CPR (cardio) > Drugs to control CHF state > Flashcards

Drugs to control CHF state Flashcards

1
Q

There are 2 types of Diuretics, what are the types?

A

K+ sparing

K+ losing

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2
Q

What are the K+ sparing Diuretics?

A

Spironolactone

Eplerneone

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3
Q

What are the K+ losing Diuretic classes?

A

Loops

Thiazides

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4
Q

Where do K+ sparing Diuretics work?

A

Proximal to the late distal convoluted tubule

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5
Q

What are 4 Loops (K+ losing Diuretics)?

A

Furosemide
Torsemide
Bumetanide
Ethacrynic acid

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6
Q

What are 4 Loops (K+ losing Diuretic)?

A

Furosemide
Torsemide
Bumetanide
Ethacrynic acid

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7
Q

MOA for Loops?

A

Block Na, K, 2Cl cotransporters

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8
Q

What is the main thing that Diuretics can treat that is associated with CHF?

A

EDEMA – fluid removal!

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9
Q

What are the electrolyte changes that can occur with Loops, like Furosemide?

A

HYPO-kalemia, natremia, chloremia, calcemia

HYPER-glycemia, uricemia

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10
Q

What is a potential side effect of Furosemide?

A

Ototoxicity - vertigo, tinnitus, hearing impairment

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11
Q

Compared to other loops (K+ losing diuretics), Torsemide and Bumetanide have better?

A

Oral absorption

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12
Q

Loops are contraindicated in patients with a _____ allergy. Which loop can they take?

A

Sulfa allergy

– Can take ethacrynic acid

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13
Q

What are 3 Thiazides (K+ losing diuretics)?

A

Hydrochlorothiazide (HCTZ)
Chlorthalidone
Metolazone

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14
Q

What are 3 Thiazides (K+ losing Diuretics)?

A

Hydrochlorothiazide (HCTZ)
Chlorthalidone
Metolazone

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15
Q

MOA for Thiazides (K+ losing diuretics)?

A

Blocks NaCl cotransporter

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16
Q

Hydrochlorothiazide can treat HTN but is not effective in patients with a decreased ____

A

GFR

17
Q

What are the electrolyte changes seen with Thiazides?

A

Hypo-electrolytes

HYPER-calcemia, glycemia, uricemia

18
Q

In what patients are Thiazides and Loops contraindicated in?

A

Sulfa allergy

19
Q

Which Thiazide is a favorite to treat CHF symptoms?

A

Metolazone

20
Q

What are 4 Vasodilators to reduce cardiac work?

A

Isosorbide Dinitrate
Hydralizine
Nitroglycerin
Nitropursside

21
Q

What are 4 Vasodilators to reduce cardiac work?

A

Isosorbide Dinitrate
Hydralazine
Nitroglycerin
Nitroprusside

22
Q

Isosorbide Dinitrate vasodilates ____ to decrease ___

A

Veins to decrease preload

23
Q

Hydralazine vasodilates ____ to decrease ____

A

Arteries to decrease afterload

24
Q

What combination of Vasodilators works well on African Americans only?

A

Isosorbide Dinitrate + Hydralazine

25
Q

What are possible side effects of Hydralazine?

A

Drug-induced lupus

Angina, flushing, edema

26
Q

Nitroglyercin vasodilates ___

A

Veins

27
Q

This Vasodilator can treat Angina pectoris and acute decompensated HF?

A

Nitroglycerin

28
Q

What is 1 cardiac glycoside?

A

Digoxin

29
Q

Digoxin MOA and what it results in?

A

(-) Na/K ATPase

=> increases contractility and suppresses AV node conduction

30
Q

Digoxin MOA results in?

A

Increased contractility and suppression of AV node conduction

31
Q

What must be normal in the patient before they are given Digoxin?

A

HR

32
Q

Digoxin it taken orally and has a long half life. What does it need to be dosed with?

A

Loading dose

33
Q

Digoxin is safe for pregnant women even though?

A

It crosses the placenta

34
Q

Describe how Digoxin toxicity arises

A
  • (-) Na/K ATPase
  • DECREASED calcium movement out of cell
  • INCREASED calcium in myocte
    = spontaneous oscillatory release which contributes to twitchy arrhythmias
35
Q

Which drug tends to uncouple the atria from the ventricles and can cause alarming ECG features?

A

Digoxin

36
Q

What does Digoxin do to the AV node conduction, AV node refractory period, ventricular refractory period and purkinje automaticity?

A

AV node conduction = DECREASED
AV node refractory period = INCREASED
Ventricular refractory period = DECREASED
Purkinje automaticity = INCREASED

37
Q

What vision changes can occur with Digoxin?

A

Halos, yellowish or greenish tint to objects

38
Q

Diuretics that cause HYPOkalemia in combination with what drug can result in that drug’s toxicity?

A

Digoxin – hypokalemia increases Digoxin binding

= Digoxin toxicity

39
Q

What is the order of Diuretics that should be given?

A

Loop

  • Add K+ sparing
  • Add Thiazide

2 - CPR (cardio) (44 decks)

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