Heart Failure Flashcards
careful when taking this with digitoxin
antibiotics! toxicity! in some people, bacteria convert digoxin into inactive form
disturbed color vision and other general and neuro SE
digoxin toxicity
digoxin: slowing heart rate
vagal effect on SA node
digoxin: shortened QT interval
increased cytosol Ca2+ levels
digoxin: prolonged PR interval
automaticity/refractory period at AV node
digoxin: PVC, arrhythmia
increase of sympathetic tone
pts w/ severe HF might benefit from low dose…
dopamine, renal vasodilator!
Inamrinone can be mixed up with…
Amiodarone!! be careful, not same thing!
Inamrinone is…
inotropic! good (short-term)
Inamrinon SE
arrhythmia long-term, why it’s short-term tx
systolic, reduced ejection fraction
low output HF, use inotropic agent
hyperthyroidism, severe anemia, AV shunts can cause this type of HF
high output HF, doesn’t benefit from inotropic agent
Clinically significant ventricular dysfunction
limit SALT intake!
Tx preload by:
reducing volume via venodilators, salt restiction, diuretics
Tx afterload by:
reducing arteriolar tone via alpha-blockers, ACEIs
Coronary steal
Nitrovasodilators
ACUTE management HF (ICU)
nitrovasodilators
mild to moderate HF pts taking digoxin and diuretics can benefit from…
ISND + Hydralazine
Hydralazine SE
reflex sympathetic activity
Low-output HF would not benefit from
verapamil, diltiazem, nifedipine (decrease contractility/CCB’s)
CHF should not take…
NSAIDs (ibuprofen, naproxen)… will decrease GfR > fluid retention by kidney > make HF worse!
pt w/ HF and A-fib
- pre-treat w/ blood-thinner (warfarin)
- use digoxin + b-blocker (rate control)
- amiodarone +sotalol is another option (rhythm control)
DM, or reduced ejection fraction can use
SGLT2 inhibitor!
Newer tx option
Valsartan/Sacubitril and/or Ivabradine
