Heart Failure

Question 1

cause/pathophys of HF

Answer 1

ischemia from decreased blood supply by coronary arteries, not meeting myocardium’s oxygen needs

Question 2

drugs used for chronic heart failure

Answer 2

diuretics
ACE inhibitors
ARBs
beta blockers
aldosterone receptor antagonists
cardiac glycosides
vasdilators

Question 3

drugs used for acuute heart failure

Answer 3

diuretics
vasodilators
oxygen
beta recpetor agonists/dobutamine

Question 4

ACE inhibitor suffix

Answer 4

pril

Question 5

ACE inhibitor effects

Answer 5

decrease afterload by decreasing vascular resistance to improve CO

Question 6

indications for ACE inhibitors

Answer 6

pts with any stage of L ventricular failure
those with HFrEF

Question 7

adverse effects of ACE inhibitors

Answer 7

dry cough
renal insufficiency
hyperkalemia
postural hypotension
teratogenic/fetotoxic

Question 8

ARB suffix

Answer 8

sartan

Question 9

MOA of ARBs

Answer 9

block At1 receptor on heart, peripheral vasculature, and kidneys
decreases preload and afterload and increase CO

Question 10

adverse effects of ARBs

Answer 10

less cough than ACE inhibitors
hyperkalemia
postural hypotension
fetotoxic

Question 11

aldosterone antagonist MOA

Answer 11

prevent salt retention and hypokalemia by blocking angiotensin II stimulation

Question 12

beta blockers effect in HF

Answer 12

reduce mortality by decerasing HR, inhibit renin release from kidneys to decrease work load and oxygen consumption

Question 13

list beta blockers used for heart failure

Answer 13

carvedilol
(beta 1 selective, below)
metoprolol
bisoprolol

Question 14

adverse effects of beta blockers for HF

Answer 14

`bradycardia, OH, fatigue, dizziness

Question 15

diuretics effect for HF

Answer 15

relieve pulmonary congestion and peripheral edema by reducing fluid volume and venous return (preload and afterload)

Question 16

common suffix for diuretics

Answer 16

-ide
but not all
metolazone

Question 17

vasodilators effect for Hf

Answer 17

dilate blood vessels to decrease preload and afterload

Question 18

adverse effects of vasodilators for HF

Answer 18

headache hypotension, tachycardia

Question 19

ionotropic drugs for heart failure effect

Answer 19

positive ionotropes increase cardiac contractility and CO

Question 20

MOA of ionotropic drugs

Answer 20

increase cytoplasmic Ca concentration to strengthen muscle contraction
increase Ca concentration by inhibiting Na K pump

Question 21

list ionotropic drugs

Answer 21

digoxin
dobutamine
milrinone

Question 22

adverse effects of ionotropic drugs

Answer 22

narrow therapeutic window
anorexia
nausea/vomiting
blurred vision
cardiac arrhythmias
hypokalemia

Question 23

digoxin MOA

Answer 23

increase Ca concentration by inhibiting Na K pump, ionotropic

Question 24

milrinone MOA

Answer 24

phosphodiesterase inhibitor
increase cellular concentration of CAMP to increase Ca in the cell and cardiac contractility

Question 25

MOA dobutamine

Answer 25

beta receptor agonist that increase CAMP to increase entry of Ca into cell and enhance muscle contraction in myocardium

Question 26

PT considerations for pts with HF

Answer 26

monitor vital signs
consider med side effects
OH
exercise tolerance

Question 27

list aldosterone antagonists

Answer 27

spironolactone
eplerenone