Heart failure

Question 1

Treatment of CHF;

Answer 1

1. Increasing frequency: only in life threatening cases!
   e. g. epinephrine, positive inotropic, chronotropic, increases myocardial oxygen demand
2. Increasing contractility: digitalis glycosides
3. Decreasing preload and afterload: ACE inhibitors
4. Inodilators (2+3): PDE inhibitors
5. Vasoactive substances (arterial and venous
   vasodilators) : e.g. nitroglycerine
6. Diuretics: decrease preload

Question 2

Treatment of In acute heart failure:

Answer 2

• Epinephrine
• Dobutamine
• Dopamine

Question 3

Drugs in chronic heart failure:

Answer 3

• Digitalis glycosides

- Pimobendan

Question 4

What is the pharmacokinetics of digoxin?

Answer 4

Pharmacokinetics:

• Orally
• protein binding interactions
• Accumulation in myocytes
• Measuring plasma levels after 3-5days
• Excretion via kidney

Small therapeutic index (hypokalaemia)