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CV II Exam 3 > Drugs Used in Heart Failure II > Flashcards

Drugs Used in Heart Failure II Flashcards

1
Q

ethacrynic acid

A

loop diuretic

-no sulfa

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2
Q

nesiritide

A

natriuretic peptide

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3
Q

isosorbide dinitrate

A

venodilator

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4
Q

hydralazine

A

arteriolar dilator

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5
Q

nitroprusside

A

arteriolar and venodilator

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6
Q

vit B deficiency

A

decreased myocardium contractility

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7
Q

drug therapies for HF

A

volume overload (congestion)

and myocardial dysfunction

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8
Q

diuretics and inotropes

A

not proven to decrease mortality

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9
Q

reduce mortality

A

ACE
ARB
beta blockers
aldosterone receptor blocker

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10
Q

systolic failure

A

reduced CO and contractility
reduced EF

respond to positive inotropes**

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11
Q

diastolic failure

A

hypertrophy and stiffened myocardium

CO reduced

EF normal

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12
Q

HF clinical

A

tachycardia, decreased exercise tolerance, SOB, edema, cardiomegaly

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13
Q

Tx for HF and atrial fib

A

digoxin

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14
Q

digoxin mechanism

A

inhibit Na/K ATPase

improve contractility
AND prolong refractory of AV node

Ca accumulates in myocardium**

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15
Q

therapeutic digoxin

A

early prolonged AP
-followed by AP shortening

increased PS, decreased S
-inhibited by atropine

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16
Q

toxic digoxin

A

shortened AP - with depolarizing afterpotentials

-premature ectopic beats

AV junctional rhythm, premature ventricular depolarization, bigeminal rhythm, second degree AV block

can deteriorate to fibrillation

also toxic GI affects

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17
Q

hyperkalemia

A

reduce toxic effects of digoxin

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18
Q

hypokalemia

A

increase toxic effects of digoxin

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19
Q

hypercalcemia and hypomagnesemia

A

increase risk of digoxin induced arrhythmia

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20
Q

inamrinone

A

bipyridine

21
Q

milrinone

A

bipyridine

22
Q

bipyridine

A

short term support of circulation of HF

23
Q

bipyridine MOA**

A

inhibit phosphodiesterase isozyme 3 (PDE3)
-increased cAMP

cardiac - stimulated contraction and fast relaxation

vasculature - balances a and v dilation

both mediated by cAMP increases

24
Q

dobutamine

A

beta1 agonist

positive inotropic

used short term**

25
Q

dopamine

A

D1 agonist

26
Q

intermediate dopamine doses

A

beta stimulation

27
Q

high dose dopamine doses

A

constriction of a and v - alpha-adrenergic

28
Q

diuretics

A

loop, thiazide, K-sparing, aldosterone antagonist

only aldosterone antagonists reduce mortality**

29
Q

SIADH

A

give vasopressin

30
Q

conivaptan

A

ADH antagonist

31
Q

tolvaptan

A

selective antagonist of V2 ADH receptors

32
Q

angioedema, cough, hyperkalemia

A

with ACE inhibitors

33
Q

ARBs

A

selectively block AT1 - resulting in beneficial effect of ANGII action at AT2

34
Q

isosorbide dinitrate

A

venodilator

-decreased preload

35
Q

hydralazine

A

arteriolar dilator

-decreased afterload

36
Q

nitroprusside

A

arteriolar and venodilator

-decreased preload and afterload

37
Q

nesiritide

A

given IV
-form of BNP

smooth m relaxation

38
Q

reduce mortality

A

bisoprolol
carvedilol
metoprolol
nebivolol

39
Q

beta blockers and CHF

A

therapy initiated at low doses

40
Q

thiazide and loop diuretics

A

secondary loss of potassium - hazardous with digoxin

-

41
Q

ACE - and ARBs

A

first choice in HF with no edema

42
Q

in african americans who cannot tolerate standard HF therapy

A

hydralazine and isosorbide dinitrate

43
Q

digoxin

A

no effect on mortality

44
Q

improve mortality

A 
ACE
ARBs
beta blockers
aldosterone antagonists
hydralazine + nitrate

for chronic HF
-along with diuretics and digoxin

45
Q

Tx for acute HF

A

diuretics, IV vasodilators, beta agonists, bipyridines

46
Q

diuretic

A

get rid of congestive symptoms

47
Q

inotropic agent

A

get rid of low output symptoms

48
Q

spironolactone and eplerenone

A

reduce mortality

CV II Exam 3 (21 decks)

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