Heart Failure Flashcards
cause/pathophys of HF
ischemia from decreased blood supply by coronary arteries, not meeting myocardium’s oxygen needs
drugs used for chronic heart failure
diuretics
ACE inhibitors
ARBs
beta blockers
aldosterone receptor antagonists
cardiac glycosides
vasdilators
drugs used for acuute heart failure
diuretics
vasodilators
oxygen
beta recpetor agonists/dobutamine
ACE inhibitor suffix
pril
ACE inhibitor effects
decrease afterload by decreasing vascular resistance to improve CO
indications for ACE inhibitors
pts with any stage of L ventricular failure
those with HFrEF
adverse effects of ACE inhibitors
dry cough
renal insufficiency
hyperkalemia
postural hypotension
teratogenic/fetotoxic
ARB suffix
sartan
MOA of ARBs
block At1 receptor on heart, peripheral vasculature, and kidneys
decreases preload and afterload and increase CO
adverse effects of ARBs
less cough than ACE inhibitors
hyperkalemia
postural hypotension
fetotoxic
aldosterone antagonist MOA
prevent salt retention and hypokalemia by blocking angiotensin II stimulation
beta blockers effect in HF
reduce mortality by decerasing HR, inhibit renin release from kidneys to decrease work load and oxygen consumption
list beta blockers used for heart failure
carvedilol
(beta 1 selective, below)
metoprolol
bisoprolol
adverse effects of beta blockers for HF
`bradycardia, OH, fatigue, dizziness
diuretics effect for HF
relieve pulmonary congestion and peripheral edema by reducing fluid volume and venous return (preload and afterload)
common suffix for diuretics
-ide
but not all
metolazone
vasodilators effect for Hf
dilate blood vessels to decrease preload and afterload
adverse effects of vasodilators for HF
headache hypotension, tachycardia
ionotropic drugs for heart failure effect
positive ionotropes increase cardiac contractility and CO
MOA of ionotropic drugs
increase cytoplasmic Ca concentration to strengthen muscle contraction
increase Ca concentration by inhibiting Na K pump
list ionotropic drugs
digoxin
dobutamine
milrinone
adverse effects of ionotropic drugs
narrow therapeutic window
anorexia
nausea/vomiting
blurred vision
cardiac arrhythmias
hypokalemia
digoxin MOA
increase Ca concentration by inhibiting Na K pump, ionotropic
milrinone MOA
phosphodiesterase inhibitor
increase cellular concentration of CAMP to increase Ca in the cell and cardiac contractility
MOA dobutamine
beta receptor agonist that increase CAMP to increase entry of Ca into cell and enhance muscle contraction in myocardium
PT considerations for pts with HF
monitor vital signs
consider med side effects
OH
exercise tolerance
list aldosterone antagonists
spironolactone
eplerenone
