HEART FAILURE Flashcards
What happen to the cardiac output and demand of heart failure
👇🏻cardiac output
☝🏻️demand from the body
What are the sign and symptoms in the right sided heart failure
Peripheral edema
Neck vein engorgement
Hepatomegaly
What happen in the left side HF
Pulmonary edema
What are the other sign and symptoms
Orthopenia
Dyspnea on exertion
Paroxymal nocturnal dysypnea
Third heart sound
Cardiomegaly
Heart failure is…
Pump/mechanical failure
Inability of the heart to contract
What are the NYHA functional classes
Class 1,2,3,4
What is the meaning of class 1 NYHA
Dyspnea on greater than ordinary activities
What is the meaning of class 2 NYHA
Dyspnea on ordinary activities
What is the meaning of class 3 NYHA
Dyspnea on less than ordinary activities
What is the meaning of class 4 NYHA
Dyspnea at rest
What is dyspnea
Difficult respiration
Approach to mngt of HF
☝🏻️ strength of contraction
👇🏻cardiac workload
What drugs should be use to ☝🏻️the strength of contraction
Inotropics
👉🏻cardiac glycoside
👉🏻B1 agonist
👉🏻phosphodiesterase inhibitors
What drugs should be use to 👇🏻cardiac workloads
Unloaders
👉🏻ACEi ARBS
👉🏻Diuretics
👉🏻vasodilators
👉🏻Beta blockers
👉🏻BNP analogueWhat is the meaning of orthopnea
Shortness of breath when supine
What is the MOA of cardiac glycoside
Inhibit Na/K ATPase Pump
What are the effects in Cardiac glycoside
(+) inotropism
(-) cronotropism
(-) dromotropism
What are the drugs in Inotropic agents Cardiac Glycoside
Digoxin (lanoxin)
Digitoxin
Do not give digoxin if…
👇🏻HR
Hypokalemia
Hypomagnesemia
Quinidine
HYPERcalcemia
What are the differences of digoxin in digitoxin in oral BA
Digoxin 👉🏻 70-75%
Digitoxin👉🏻 >90%
What are the differences of digoxin in digitoxin in serum t1/2
Digoxin👉🏻36-40hrs
Digitoxin 👉🏻168hrs
What are the differences of digoxin in digitoxin in protein binding
Digoxin👉🏻20-40%
Digitoxin 👉🏻>90%
What are the differences of digoxin in digitoxin in volume of distribution
Digoxin 👉🏻 6.3L/kg
Digitoxin 👉🏻 0.6L/kg
What are the differences of digoxin in digitoxin in elimination
Digoxin👉🏻 kidney
Digitoxin 👉🏻Liver
What are the signs having digoxin toxicity or narrow therapeutic index
GIT
Blurred vision
Arrythmia
What is the DOC in digoxin toxicity
Digibind
Immunefab
DOC for cardiac glycoside induce arrythmia
Lidocaine
What are the drugs in Inottopic agents B1 agonist
Dopamine
Dobutamin
What is the MOA of b1 agonist
Stimulates adenylyl cyclase
What are the drugs use in Inotropic agents Bypyridines
Milrinone
Amrinone
What is the use of B1 agonist combined with Bipyridines
Mgt of acute HF and acute exacerbation of chronic HF
Unloaders should be given with combination
Of other unloaders or inotropics
Unloaders decreases..
👇🏻preload / afterload
👇🏻 cardiac workload
ACEi and ARBs decreases and increases??
👇🏻preload and after load
👇🏻aldosterone
👆🏻 Na and H20 excretion
ACEi should be..
Use the maximum tolerable or allowable dose
Titrate the dose
What is the MOA of BNP analogue
Massive vasodilators
What is the meaning of BNP analogue
Brain natriuretic peptide analogue
Vasodilators are recommended in the ff situation
Px is africant descent
When acei arbs cannot be given
What are the drugs in vasodilators
ISDN + hydralazine
Which one 👇🏻preload in vasodilators drugs
ISDN
Which one 👇🏻afterload in vasodilators drugs
Hydralazine
