Heart Failure (Drugs)

Question 1

ACE Inhibitors

Answer 1

ACE Inhibitor
- Treats Hypertension

MOA:
- Inhibits ACE, preventing Ang II generation

Question 2

Angiotensin Receptor Blockers (ARBs)

Answer 2

Angiotensin Receptor Blocker (ARBs)
- Treats Hypertension

MOA:
- Inhibits AT1 Receptor on SMC

Question 3

Metoprolol

Answer 3

Beta1 Adrenoceptor Antagonist
(Beta1-Selective)
- Treats Hypertension + Heart Failure

MOA:
- Reduce cardiac output (Heart Rate + BP)
- Inhibit renin release
- Reduce detrimental remodeling of heart

Question 4

Bisoprolol

Answer 4

Beta1 Adrenoceptor Antagonist
(Beta1-Selective)
- Treats Heart Failure

MOA:
- Reduce cardiac output (Heart Rate + BP)
- Inhibit renin release
- Reduce detrimental remodeling of heart

Must be started at low doses and slowly increased

Question 5

Carvedilol

Answer 5

Beta1 Adrenoceptor Antagonist
(Beta/Alpha1-Selective)
- Treats Heart Failure

MOA:
- Reduce cardiac output (Heart Rate + BP)
- Inhibit renin release
- Reduce detrimental remodeling of heart

Must be started at low doses and slowly increased

Question 6

Spironolactone

Answer 6

Aldosterone Receptor Antagonist (Competitive Antagonist)
- Treats Heart Failure

MOA:
- Inhibits expressions of Mineral Corticoid Receptor
–> Less Aldosterone Receptors
–> Inhibits Na+ and Water retention

Question 7

Eplerenone

Answer 7

Aldosterone Receptor Antagonist (Competitive Antagonist)
- Treats Heart Failure

MOA:
- Inhibits expressions of Mineral Corticoid Receptor
–> Less Aldosterone Receptors
–> Inhibits Na+ and Water retention

Question 8

Furosemide

Answer 8

Loop Diuretic
- Treats Heart Failure

MOA:
- Inhibits Na+/K+/Cl- Transporter in Loop of Henle
–> Decreased Na+ reabsorption
–> Decreased Water reabsorption

Question 9

Digoxin

Answer 9

Positive Inotropes
- Treats Heart Failure patients with:
–> Chronic Atrial Fibrillation
–> Symptomatic after ACEI and Diuretics

MOA:
- Inhibits Na+/K+ ATPase Pump causing more Calcium in cardiac myocyte
–> Stronger Contractions
–> Slower Heart Beat
–> Increased Ventricular Filling
- Increases Cardiac Output

Question 10

Isosorbide Mononitrate

Answer 10

Organic Nitrates (Nitric Oxide Donor)
- Treats Heart Failure

MOA:
- Is metabolized and releases NO
–> Relaxes veins & reduces central venous pressure
–> Reduce preload

Question 11

Hydralazine

Answer 11

Treats Heart Failure

MOA:
- Causes a fall in BP (Reduces Afterload)
- Inhibits IP3 mediated intracellular Ca2+ release in SMC of Arteries
–> Less Ca2+ = Less Contractions