Exam 3: Drugs Used In Heart Failure Flashcards

0
Q

50% of younger patients have this type of HF in which there is reduced mechanical pumping action and reduced ejection fraction

A

Systolic HF

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1
Q

Most common cause of HF in US?

A

Coronary Artery Disease (CAD)

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2
Q

This type of HF is characterized by stiffening and loss of adequate relaxation playing a major role in reduced filling and CO. Ejection fraction may be reduced even though SV is super reduced

A

Diastolic HF

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3
Q

2 goals in treatment of HF:

A
  1. Reducing symptoms & slow progression

2. Manage acute episodes of decompensated failure

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4
Q

In this type of HF it is believed that it is primarily due to a problem within the excitation-contraction coupling machinery of the heart

A

Systolic HF

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5
Q

In the treatment of HF, therapy directed towards non-cardiac elements are much more valuable strategies for long term management instead of the use of positive ionotropes such as digitalis. T/F?

A

True

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6
Q
Only agents in current use that actually prolong patient's life with chronic HF. There are 5. Choose the one that does not belong: 
A. Diuretics
B. ACEI
C. ARB
D. Beta blockers
E. Aldosterone receptor agonists
F. Hydralazine nitrate
A

A

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7
Q

Which classification of drug is most useful in acute systolic failure? And give example

A

Positive ionotropes, cardiac glycosides like digitalis

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8
Q

Positive ionotropes help increase survival in chronic failure. T/F

A

False. They consistently reduce survival. The only positive ionotrope that doesn’t reduce survival is digitalis. But the use of other positive ionotropes is discouraged

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9
Q
This drug is derived from the purple foxglove plant: 
A. Aspirin 
B. Warfarin
C. Digoxin
D. Dobutamine
A

C

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10
Q

Bipyridines, such as Inamrione and Milrinone inhibit what? Available only parenterally and elimination half lives of 3-6 hours.
A. Inhibits PDE-1
B. Inhibits PDE-2
C. Inhibits PDE-3

A

C

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11
Q

All are MOAs of bipyridines except:
A. Vasodilator effect
B. Inhibition of PDE-3 results in inc cGMP, thus inc in contractibility & vasodilation
C. Inc calcium influx during action potential
D. Stimulate sacroplasmic reticulum to release calcium

A

B. It inc camp, not cGMP

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12
Q
This drug is a selective beta 1 agonist wildly used in the treatment of HF: 
A. Captopril
B. Amiodarone
C. Milrinone
D. Dobutamine
A

D

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13
Q

Drugs primarily used in the treatment of chronic HF? Name them. There’s 5

A

Diuretics, ACEI, ARB, aldosterone antagonists and beta blockers

AAABD

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14
Q

Important drugs used in acute HF? Name them. There are 2

A

Diuretics and vasodilators

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15
Q

All are main goals of diuretics except:
A. Reduce venous pressure
B. Increase cardiac contractility
C. Reduce ventricular preload

A

B

16
Q

Spironolactone and eplerenone have an additional benefit of decreasing morbidity and mortality in pts with severe HF also taking ACEI and other standard therapy. What class do they belong to?

A

Aldosterone antagonist diuretics

17
Q

This class of drug, alone reduces long term remodeling of heart and vessels. Which is good because it reduces morbidity and mortality

A

ACEI like Captopril

18
Q

So your patient comes back to you after consult because the ACEI you put him in results in a really annoying cough. It’s incessant and he hates it. What drug can you give instead of the ACEI?

A

Give angiotensin (AT1) blocker

19
Q

Renin inhibitor used to tx HTN?

A

Aliskiren

20
Q

If you combine these two drugs they also result in reduced cardiac remodeling following damage to the heart

A

Long term use of hydrazaline and isosorbide dinitrate

21
Q

This drug activates BNP receptors to increase cGMP. Results in vasodilation and diuresis. Only given IV:
A. Nesiritide
B. Inamrinone
C. Dopamine

A

A

22
Q

This drug inhibits the Na/K ATP-ase pump resulting in reduced calcium expulsion and increased calcium stored in sacroplasmic reticulum
A. Dobutamine
B. Digoxin
C. Dopamine

A

B