Heart Failure

Question 1

careful when taking this with digitoxin

Answer 1

antibiotics! toxicity! in some people, bacteria convert digoxin into inactive form

Question 2

disturbed color vision and other general and neuro SE

Answer 2

digoxin toxicity

Question 3

digoxin: slowing heart rate

Answer 3

vagal effect on SA node

Question 4

digoxin: shortened QT interval

Answer 4

increased cytosol Ca2+ levels

Question 5

digoxin: prolonged PR interval

Answer 5

automaticity/refractory period at AV node

Question 6

digoxin: PVC, arrhythmia

Answer 6

increase of sympathetic tone

Question 7

pts w/ severe HF might benefit from low dose…

Answer 7

dopamine, renal vasodilator!

Question 8

Inamrinone can be mixed up with…

Answer 8

Amiodarone!! be careful, not same thing!

Question 9

Inamrinone is…

Answer 9

inotropic! good (short-term)

Question 10

Inamrinon SE

Answer 10

arrhythmia long-term, why it’s short-term tx

Question 11

systolic, reduced ejection fraction

Answer 11

low output HF, use inotropic agent

Question 12

hyperthyroidism, severe anemia, AV shunts can cause this type of HF

Answer 12

high output HF, doesn’t benefit from inotropic agent

Question 13

Clinically significant ventricular dysfunction

Answer 13

limit SALT intake!

Question 14

Tx preload by:

Answer 14

reducing volume via venodilators, salt restiction, diuretics

Question 15

Tx afterload by:

Answer 15

reducing arteriolar tone via alpha-blockers, ACEIs

Question 16

Coronary steal

Answer 16

Nitrovasodilators

Question 17

ACUTE management HF (ICU)

Answer 17

nitrovasodilators

Question 18

mild to moderate HF pts taking digoxin and diuretics can benefit from…

Answer 18

ISND + Hydralazine

Question 19

Hydralazine SE

Answer 19

reflex sympathetic activity

Question 20

Low-output HF would not benefit from

Answer 20

verapamil, diltiazem, nifedipine (decrease contractility/CCB’s)

Question 21

CHF should not take…

Answer 21

NSAIDs (ibuprofen, naproxen)… will decrease GfR > fluid retention by kidney > make HF worse!

Question 22

pt w/ HF and A-fib

Answer 22

1. pre-treat w/ blood-thinner (warfarin)
2. use digoxin + b-blocker (rate control)
3. amiodarone +sotalol is another option (rhythm control)

Question 23

DM, or reduced ejection fraction can use

Answer 23

SGLT2 inhibitor!

Question 24

Newer tx option

Answer 24

Valsartan/Sacubitril and/or Ivabradine