Heart Failure Flashcards
the most common site of digitalis toxicity outside the heart
GIT
What electrolyte imbalances may reduce the digitoxin toxicity
Hyperkalemia and Hypermagnesemia
Istaroxime is another inotropic drug that has a similar effectto digitoxin; however it produces less arrhythmia due to what effect?
SR Sequesteration of Calcium ions
MOA of Inamrinone and Milrinone
inhibits Phosphodiesterase (isozyme 3), thus increased cGMP and cAMP
a drug that sensitizes the troponin system to calcium
Levosimendan
other name of Inamrinone
Amirnone
cAMP increases contractility or promotes Vasodilation?
BOTH
the most common selective B1 agonist used in Px w/ HF
Dobutamine
True/False. Dopamine may be used for AHF if there is a need to increase blood pressure
True
types of drugs that are 1st line therapies for CHF
Diuretics ACE inhibitors Ang receptor antagonist Aldosterone Antagonist B-blockers
2 major types of Heart failure
Sytolic HF and Diastolic HF
a type of heart failure where ejection fraction remains normal
Diastolic HF
the cardiac myocyte pump that maintains the free cytoplasmic calcium at a low level
SERCA
what inhibits SERCA?
unphosphorylated Phospholamban
if phosphorylated, inhibition to SERCA is removed
what is the normal ejection fraction
> 60%
the four primary factors of cardiac performance
Preload
Afterload
Contractility
Heart Rate
what are the electrical effects of digitalis?
dec AP duration
delayed after depolarization
less negative RMP
T/F. low dose admin of Digitalis promotes parasympathomimetic cardioselectivity.
TRUE
Phosphodiesterase Inhibitors
Levosimendan
Milrinone
Inamrinone
an synthetic form of BNP that is used in Acute HF
Nesiritide
orally active competitive inhibitors of endothelin
Bosentan
Tezosentan
what are the 4 stages of development of HF (describe each)
Stage A: no Sx; has risk factors
Stage B: Sx on severe exercise
Stage C: Sx during mild exercise
Stage D: Severe Sx at rest
Aldosterone Antagonist, Digitoxin, Hydralizine and Nitrites are the DOC in what developmental stage of Chronic Heart Failure?
Stage C
what drugs are used at Stage B of CHF? (4)
ACE inhibitors
Ang Receptor Blocker (ARB)
BB
Diuretics
diuretics used in CHF
furosemide and thiazides
specific ACEI and ARB used in CHF
ACEI: Enalapril
ARB: Losartan
try this nomenclature: all -ARtAns (losartan,candesartan etc.) A=Ang Rt=receptors An=Antagonists
:)
4 BB that are used in CHF
Metoprolol
Bisoprolol
Nevibolol
Carvedilol
Digitalis is usually given before ACEI and ARB. True/False
False.
True if you want to kill the Px :)
A Tx for AHF that corrects euvolemic hyponatremia and a V1a and V2 receptor antagonist
Conivaptan
selective V2 antagonist
Tolvaptan
Divisions of Vasodilators (3)
Venodilator
Arteriolar dilators
non selective vasodilators
what type of Vasodilators should be used in the the condition:
Px w/ high filling pressure and whose principal Sx is Dyspnea
Venous Dilators (Nitrates)
what type of Vasodilators should be used in the the condition:
Px w/ fatigue due to low left ventricular output
Arteriolar dilator (Hydralazine)
