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T&D III exam 1 > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Vasodilators

A 
ACE-I
AT-RB
Hydralazine
organic nitrates
Nitroprusside
Nisiritide
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2
Q

Diuretics

A

Thiazides
Loop
K-sparing (Spironolactone, Eplerenone)

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3
Q

Beta-blockers

A

Carvedilol
Metoprolol
Bisoprolol

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4
Q

Positive inotropic drugs

A

Digoxin (vagomimetic)
Dobutamine
Dopamine (adrenergic agonist)

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5
Q

positive inotropic + vasodilator drugs

A

PDE inhibitors

Milrinone

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6
Q

used for acute CHF but not chronic

A

Sodium nitroprusside

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7
Q

Effect of sodium nitroprusside on SV in normal indiv

A

Decrease

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8
Q

Effect of sodium nitroprusside on SV in ptn with severe CHF

A

Increase

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9
Q

Decreased mortality

A

Hydralazine + ISDN
ACE-I
ARB

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10
Q

Chronic CHF

A

Hydralazine
ACE-I
ARB

arterio > veno

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11
Q

Acute and chronic CHF

A

Organic nitrates

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12
Q

Combination used

A

ACEI / ARBs not tolerated

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13
Q

African americans remain sx with

A

ACEI/ARB, BB, aldo antagonist

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14
Q

Nesiritide

A

Recombinant human B-type natriuretic peptide

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15
Q

Tx acute decompensated CHF with dyspnea

A

Nesiritide

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16
Q

MOA Nesiritide

A

activates GC – inc cGMP – vasodilation – dec afterload and preload

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17
Q

inc cAMP in heart vs vascular

A

heart - contractility

BV - vasodilation

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18
Q

PDE-I MOA

A

inhibit breakdown of cAMP

19
Q

Short term tx of severe acute CHF

ADR?

A

Milronone, Inamrinone

Proarrhythmic
hypotension
thrombocytopenia

20
Q

tx of compensated CHF

A

BB

21
Q

Beneficial effect of BB in CHF

A 
antiarrhythmic effects (prevent a-fib)
inh cardiac remodeling
dec myocardial oxygen demand
22
Q

what’s important to keep in mind regarding dosing of BB

A

dose gradually with careful monitoring

23
Q

Direct effect on myocardial contractility

A

Digoxin

24
Q

How does intracellular calcium increase with Digoxin

A

inhibit Na/K ATPase, no sodium gradient for the NCX to work – inc calcium inside

25
Q

Vagomimetic effects seen in

A

Digoxin

26
Q

SA node with digoxin

A

vagomimetic

dec automaticity, dec HR

27
Q

AV node with digoxin

A

direct and vagomimetic

dec AV nodal conduction and causes AV nodal block

28
Q

How does decreased AV nodal conduction help CHF patients

A

Controls ventricular rate (keeps it from going too high) when patients go into A-fib

29
Q

EKG on digoxin

A

increased PR interval

30
Q

does digoxin improve mortality?

A

no

31
Q

How is digoxin eliminated?

A

Renally

- must be monitored

32
Q

How is digoxin’s absorption affect its use?

A

Incomplete absorption with narrow therapeutic index - a small shift in dose can have negative effects

33
Q

Tx of digoxin

A

CHF

Slow ventricular rate in A flutter and fib

34
Q

ADR digoxin

A

GI
Visual
CNS - nightmares, hallucinations

35
Q

Enhance digoxin toxicity

A 
hypokalemia
dec renal function
hypercalcemia
Acidosis 
Hypothyroidism
36
Q

Drug interaction Digoxin

inc tox

A

K-depleting diuretics

Sympathomimetics

37
Q

dec tox with Digoxin

A

Chestyramine, colestipol (Resins)

  • prevents its absorption
38
Q

Tx of toxicity with Digoxin

A

Digoxin immune Fab ABs

Tx arrhythmias - lidocaine, atropine

39
Q

what drug decreases vagomimetic effects of Digoxin

A

atropine

40
Q

Increases contractility, no change in HR. Acts on Beta-1

Tx of decompensated acute CHF

A

Dobutamine

41
Q

Control congestion

A

Diuretics - thiazides and loops

42
Q

what is used as an adjunct with diuretics in control of congestion? why?

A

K-sparing diuretics - prevent hypokalemia

43
Q

Moderate to severe CHF with less than 35% LVEF

A

ARB

- spironolactone and eplerenone

T&D III exam 1 (11 decks)

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