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Pharmacology > Drugs Used in Heart Failure > Flashcards

Drugs Used in Heart Failure Flashcards

1
Q

Reduces excessive sympathetic stimulation

A

Beta blockers

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2
Q

Reduces preload and afterload

A

Vasodilators

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3
Q

Augments depressed cardiac contractility

A

Positive inotropes

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4
Q

DOC for acute heart failure

A

Loop diuretics

If very severe: positive inotropes (beta-agonists or PDE inhibitors) and vasodilators

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5
Q

DOC for chronic heart failure

A

ACEI (slows down cardiac remodeling)

Loop + spironolactone + ACEI
If tolerated, + BB

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6
Q

MOA of digoxin

A

Inhibits Na/K/ATPase–> increased intracellular sodium–> Sodium-Calcium exchanger is altered–> reduced calcium expulsion –> increased Ca stored in sarcoplasmic reticulum–> increased cardiac contractility

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7
Q

SE of digoxin

A

Arrhythmia

Visual changes

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8
Q

Drugs with narrow therapeutic index

A 
WALA na Cyang PaPa! vasTeD na!
Warfarin
Aminoglycoside
Lithium
Amphotericin B
Carbamazepine
Phenobarbital
Phenytoin
Vancomycin
Theophylline
Digoxin
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9
Q

Digitalis toxicity is increased by?

A

Hypokalemia
Hypomagnesemia
Hypercalcemia

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10
Q

DOC for digoxin-induced arrhythmia

A

Lidocaine

2nd line: phenytoin

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11
Q

Beta blockers which reduce progression of chronic heart failure; no value in acute failure

A

Carvedilol
Labetalol
Metoprolol

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12
Q

No value in acute heart failure

A

Beta blockers

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13
Q

No value in chronic heart failure

A

PDEIs (inamrinone and milrinone)

CCB

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14
Q

Effective in CHF due to increased afterload (HTN + infarct)

A

Nitroprusside

Nitroglycerine

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15
Q

Improve survival in heart failure

A

ABA! Buhay ka pa!
ACEIs
BB
Aldosterone antagonists

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16
Q

Used to remove retained salt and water

A

Diuretics

17
Q

Positive inotropic drugs used in heart failure

A 
Cardiac glycosides (digoxin)
Beta agonists (dobutamine)
PDE inhibitors (inamrinone)
18
Q

Vasodilators used in the management of heart failure

A

PDEI (Inamrinone)
Nitroprusside
Nitrates
Hydralazine

19
Q

MOA of furosemide

A

Decreases NaCl and KCl reabsorption in thick ascending loop of Henle –> reduces peripheral edema, preload, and afterload
Vasodilates pulmonary vessels –> reduces pulmonary edema

20
Q

Toxicities of furosemide

A

Ototoxicity
Hypovolemia
Hypokalemia

21
Q

MOA of hydrochlorothiazide

A

Decreases NaCl reabsorption in the DCT–> Reduces edema and preload

22
Q

Toxicites of thiazides

A 
HyperGlycemia
HyperLipidemia
HyperUricemia
HyperCalcemia
HypoKalemia
23
Q

MOA of spironolactone

A

Blocks cytoplasmic aldosterone receptors in collecting tubules of nephron –> increases salt and water excretion; reduces remodelling; reduces mortality

24
Q

Toxicities of spironolactone

A

Hyperkalemia

Gynecomastia

25
Q

Reduces afterload and salt and water retention

A

ACEIs

26
Q

Cardiac effect of ACEIs and ARBs

A

Arteriolar and venous dilation;
Reduces aldosterone secretion;
Increases cardiac output;
Reduces cardiac remodelling

27
Q

MOA of Carvedilol

A

Competitively blocks B1 receptors –> slows heart rate; reduces BP; reduces heart failure mortality; used in CHRONIC heart failure

28
Q

MOA of isosorbide dinitrate

A

Releases nitric oxide; activates guanylyl cyclase –> venodilation –> reduces preload and ventricular stretch; used for acute and chronic heart failure as well as angina

29
Q

MOA of hydralazine

A

Probably increases NO synthesis in endothelium –> reduces BP and afterload –> increases CO

30
Q

MOA of nitroprusside

A

Releases NO spontaneously; activates guanylyl cyclase –> marked vasodialtion –> reduces preload and afterload

31
Q

MOA of dobutamine

A

Beta 1-selective agonist; increases cAMP synthesis–> increases cardiac contractility and CO

32
Q

MOA of dopamine

A

Dose-dependent; Increases renal blood flow; higher doses increase cardiac force and BP

33
Q

MOA of Bypiridines (inamrinone and milrinone)

A

Phosphodiesterase type 3 inhibitors; decrease cAMP breakdown –> vasodilation –> reduces peripheral vascular resistance; Also increases cardiac contractility

34
Q

MOA of nesiritide (natriuretic peptide)

A

Activates BNP receptors; increases cGMP –> vasodilation; diuresis

35
Q

Used for acute decompensated heart failure

A 
Nitroprusside
Dobutamine
Dopamine
Inamrinone, milrinone
Nesiritide

Pharmacology (31 decks)

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