Drugs to treat heart failure

Question 1

What are the vasodilators used in CHF?

Answer 1

Sodium Nitroprusside, Hydralazine, Organic Nitrates, ACE Inhibitors, AT1 receptor Antagonists, Nesiritide, Phosphodiesterase inhibitors.

Question 2

what vasodilator is administered IV and used in acute heart failure?

Answer 2

sodium nitroprusside (arteriodilation=venodilation)

Question 3

what vasodilators show decreased mortality?

Answer 3

Hydralazine + ISDN, ACE inhibitors, Agiotensin Receptor Blockers

Question 4

use of hydralazine

Answer 4

chronic CHF (arteriodilation)

Question 5

use of Organic Nitrates

Answer 5

Acute and chronic CHF (venodilation>arteriodilation)

Question 6

Use of ACE Inhibitors

Answer 6

Arteriodilation>venodilation, Chronic CHF; decrease salt and H2O retention.

Question 7

use of AT Receptor Antagonists

Answer 7

Arteriodilation>venodilation, Chronic CHF; decrease salt and H2O retention.

Question 8

MOA of Nesiritide

Answer 8

activates guanylyl cyclase to cause vasodilation.

Question 9

use of Nesiritide

Answer 9

acute decompensated CHF with dyspnea. (administered IV)

Question 10

what Phosphodiesterase Inhibitor is used for CHF?

Answer 10

Milronone

Question 11

MOA of milronone

Answer 11

increase cardiac contractility+ vasodilation

Question 12

ADR of Milronone

Answer 12

proarrythmic, hypotension

Question 13

what B-blockers are used for CHF?

Answer 13

Carvedilol, Metoprolol, and Bisoprolol

Question 14

What are the benefits of using B-blockers for CHF?

Answer 14

decreased morbidity and mortality, decrease myocardial O2 demand, Inhibit cardiac remodeling, antiarrhythmic effects.

Question 15

What is the most commonly used Positive Inotropic Drug for CHF?

Answer 15

Digoxin

Question 16

MOA of Digoxin?

Answer 16

increases contractility by blocking the Na-K ATPase and increasing intracellular calcium, also decreases HR (vagomimetic)

Question 17

Use of Digoxin?

Answer 17

CHF, and to slow v rate in A flutter and fib

Question 18

ADR of Digoxin

Answer 18

Arrhythmias, GI, Visual, CNS (lethargy, anxiety, nightmares, hallucinations, delerium.)

Question 19

avoid digoxin in patients with what conditions?

Answer 19

Hypokalemia, Poor renal function, Hypercalcemia, Acidosis, Hypothyroidism.

Question 20

Digoxin drug interactions

Answer 20

increased plasma levels with: K-depleting diuretics, sympathomimetics
Decreased plasma levels with: cholestyramine, colestipol

Question 21

What are some other positive inotropic drugs for CHF?

Answer 21

Dobutamine and Dopamine

Question 22

What are the uses for Dobutamine and Dopamine?

Answer 22

IV treatment for CHF. They increase contractility and cardiac output.

Question 23

What diuretics are used for CHF?

Answer 23

Thiazides and Loops (control congestion)

K-sparing- spironolactone and Eplerenone (reduced cardiac remodeling). Used to prevent hypokalemia.