Drugs to treat heart failure Flashcards
What are the vasodilators used in CHF?
Sodium Nitroprusside, Hydralazine, Organic Nitrates, ACE Inhibitors, AT1 receptor Antagonists, Nesiritide, Phosphodiesterase inhibitors.
what vasodilator is administered IV and used in acute heart failure?
sodium nitroprusside (arteriodilation=venodilation)
what vasodilators show decreased mortality?
Hydralazine + ISDN, ACE inhibitors, Agiotensin Receptor Blockers
use of hydralazine
chronic CHF (arteriodilation)
use of Organic Nitrates
Acute and chronic CHF (venodilation>arteriodilation)
Use of ACE Inhibitors
Arteriodilation>venodilation, Chronic CHF; decrease salt and H2O retention.
use of AT Receptor Antagonists
Arteriodilation>venodilation, Chronic CHF; decrease salt and H2O retention.
MOA of Nesiritide
activates guanylyl cyclase to cause vasodilation.
use of Nesiritide
acute decompensated CHF with dyspnea. (administered IV)
what Phosphodiesterase Inhibitor is used for CHF?
Milronone
MOA of milronone
increase cardiac contractility+ vasodilation
ADR of Milronone
proarrythmic, hypotension
what B-blockers are used for CHF?
Carvedilol, Metoprolol, and Bisoprolol
What are the benefits of using B-blockers for CHF?
decreased morbidity and mortality, decrease myocardial O2 demand, Inhibit cardiac remodeling, antiarrhythmic effects.
What is the most commonly used Positive Inotropic Drug for CHF?
Digoxin
MOA of Digoxin?
increases contractility by blocking the Na-K ATPase and increasing intracellular calcium, also decreases HR (vagomimetic)
Use of Digoxin?
CHF, and to slow v rate in A flutter and fib
ADR of Digoxin
Arrhythmias, GI, Visual, CNS (lethargy, anxiety, nightmares, hallucinations, delerium.)
avoid digoxin in patients with what conditions?
Hypokalemia, Poor renal function, Hypercalcemia, Acidosis, Hypothyroidism.
Digoxin drug interactions
increased plasma levels with: K-depleting diuretics, sympathomimetics
Decreased plasma levels with: cholestyramine, colestipol
What are some other positive inotropic drugs for CHF?
Dobutamine and Dopamine
What are the uses for Dobutamine and Dopamine?
IV treatment for CHF. They increase contractility and cardiac output.
What diuretics are used for CHF?
Thiazides and Loops (control congestion)
K-sparing- spironolactone and Eplerenone (reduced cardiac remodeling). Used to prevent hypokalemia.
