Heart Failure Flashcards
Digoxin
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milrinone
VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
◦ Cardiac Glycoside
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
d. Digoxin
Vasodilator
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milrinone
a. BiDil® (hydralazine+isosorbide)
ARNI
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milrinone
b. Sacubitril + Valsartan
◦ Inodilator
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milrinone
c. Milrinone
Heart Failure
• home/stable/chronic/controlled
•Compensated or •Decompensated
•Compensated
Heart Failure (heart failure exacerbation) • acute/hospitalization/uncontrolled
•Compensated or •Decompensated
•Decompensated
? Toxicity = Hypokalema, Hypomagnesemia, Hypercalcemia
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
d. Digoxin
•What can cause toxicity? ◦ hypokalemia, a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
d. Digoxin
◦ ANTIDOTE: ◦ Digibind ®- Digoxin specific Antibody Fab fragment a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
d. Digoxin
Normal range= 0.5 -2 ng/ml
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
Digoxin
Digoxin
Normal range= ? -? ng/ml
0.5 -2 ng/ml
DRUG- DRUG INTERACTIONS- LOTS! ◦ Diuretics that lower potassium a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
d. Digoxin
DRUG- DRUG INTERACTIONS- LOTS! ◦ Drugs/Foods that can bind up Digoxin and result in lower levels ◦ Bile Acid Sequestrants- Cholestyramine ◦ Sodium Polystyrene Sulfate- Potassium Binder (Kayexalate) ◦ High Fiber foods like Bran a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
d. Digoxin
DRUG- DRUG INTERACTIONS- LOTS! •KINETICS: • Drug is renally eliminated a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
d. Digoxin
•MED MATH
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
d. Digoxin
Nurses should assess potassium levels (3.5 -5 mEq/L)
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
d. Digoxin
USED TO TREAT ◦ Intended for self identified African American patients who have Heart Failure a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
a. BiDil® (hydralazine+isosorbide)
USED TO TREAT ◦ Heart Failure a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
b. Sacubitril + Valsartan
(an Angiotensin II Receptor Blocker (ARB)
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
b. Sacubitril + Valsartan
(new drug- Neprilysn Inhibitor)
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
b. Sacubitril + Valsartan
• Drugs that work on the RAAS can cause injury and death to a developing fetus a. BiDil® (hydralazine+isosorbide) b. Sacubitril + Valsartan c. Milione d. Digoxin
b. Sacubitril + Valsartan
• Orthostatic hypotension (especially with other BP meds like diuretics
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
b. Sacubitril + Valsartan
◦ Lithium can accumulate, potential for toxicity
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
b. Sacubitril + Valsartan
◦ Avoid potassium supplements (+ Salt substitutes)
a. BiDil® (hydralazine+isosorbide)
b. Sacubitril + Valsartan
c. Milione
d. Digoxin
b. Sacubitril + Valsartan
VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
USED TO TREAT ◦ Hemodynamic Support ◦Inotropic Support for Heart Failure VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
• Dopamine
USED TO TREAT ◦ Severe, acute heart failure (cardiogenic shock) VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
• Dobutamine
(Antidote: Phentolamine) VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine -milrinone
- Dopamine
- Dobutamine
- Phenylephrine
- Isoproterenol
- Norepinephrine
- Epinephrine
USED TO TREAT ◦ PDE3- CHF ◦ PDE4- COPD- Theophylline ◦ PDE5- PENIS- Erectile Dysfunction- VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine -milrinone
-milrinone
ADVERSE EFFECTS ◦ dysrhythmias (ventricular) ◦ Hypotension CONTRA-INDICATIONS: ◦ Can’t use if MI or dysrhythmia VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine -milrinone
milrinone
USED TO TREAT Anaphylaxis Asthma Emergencies Pulseless Cardiac Arrest (ACLS) Shock VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
• Epinephrine
USED TO TREAT Shock VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
Norepinephrine
USED TO TREAT Systemic: Shock/Hypotension Local/Oral: Nasal Congestion, Dry eyes, for eye exam Local: rectal- hemorrhoids VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
Phenylephrine
USED TO TREAT Cardiogenic Shock to Bradycardia VASOPRESSORS/SHOCK • Dopamine • Dobutamine • Phenylephrine • Isoproterenol • Norepinephrine • Epinephrine
• Isoproterenol
