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Pharm unit 3 > Heart failure drugs > Flashcards

Heart failure drugs Flashcards

1
Q

Cause of heart failure

A
  • coronary artery disease
  • heart attack
  • cardiomyopathy
  • hig BP, thyroid, kidney, diabetes, defects
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2
Q

S/S of heart failure

A
  • dyspnea
  • fatigue
  • fluid retention
  • pulmonary edema
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3
Q

Progressive heart failure

A
  • Left or right sided (left sided more common and usually causes right sided)
  • reduced blood flow to the organs
  • chronic renal failure (puts more stress on heart)
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4
Q

ACE Inhibitors MOA

A
  • ACE = angiotensin-converting enzyme
  • block the enzyme that converts angiotensin I into II
  • inhibit aldosterone
  • decrease Na retention
  • promote diuresis
  • decrease preload
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5
Q

ACE inhibitors also used for ___

A

hypertension and post MI to prevent the remodeling that can lead to HF

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6
Q

Lisinopril and catropril drug class

A

ACE inhibitors (for HF)

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7
Q

🧠 ACE inhibitor AE

A
  • renal failure
  • angioedema near airway (rare but life-threatening)
  • fatigue, dizziness, HA, mood change, loss of taste
  • hyperkalemia
  • dry cough
  • first dose hypotensive effect
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8
Q

🧠 ACE inhibitor interactions

A
  • NSAIDS reduce BP, risk for acute kidney failure
  • other antihypertensives and diuretics
  • lithium
  • K supplements/ K sparing diuretics
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9
Q

Angiotensin receptor blockers (ARB) MOA

A
  • block angiotensin II
  • potent vasoldilating effect
  • decrease systemic vascular resistence (SVR)
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10
Q
  • Valsartan, Irbesartan, Losartan, and Candesartan classification
A

ARBs

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11
Q

ARBs also used for ___

A

chronic kidney disease and prescribed after a heart attack

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12
Q

Beta blockers MOA

A
  • cardioprotective
  • decrease HR
  • delay AV conduction
  • decrease contractility
  • decrease automaticity
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13
Q

Metoprolol and Carvedilol drug class

A

Beta-blockers (for HF)

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14
Q

Cardvedilol precautions

A

nonselective
also a calcium channel blocker

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15
Q

Hydralazine drug class

A

vasodilator

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16
Q

Hydralazine precaution

A

monitor for Lupus (SLE)

17
Q

🧠Vasodilator precautions

A
  • monitor neuro status (confusion, dizziness, syncope, hemorrhagic stroke)
  • drastic BP changes
  • elderly pt
18
Q

Milrinone (Primacor) classification and MOA

A

vasodilator
inotrope
Phosphodiesterase inhibitor (PDI, relaxes smooth muscle)
Increase Ca in the heart

19
Q

Milrinone (Primacor) contraindications

A
  • allergy
  • severe aortic/pulmonary valve disease
  • HF from diastolic dysfunction
20
Q

Milrinone (Primacor) used for

A

short term treatment of acute HF in the ICU

21
Q

Milrinone (Primacor) AE

A
  • hypokalemia
  • hypertension
  • angina
  • tremor
  • thrombocytopenia
  • ventricular dysrhythmia
22
Q

Milrinone (Primacor) interactions

A

Diuretics (hypovolemia)
Digoxin (increased inotropic effects)

23
Q

🧠Digoxin and Lanoxin classification

A

Cardiac glycosides (digitalis glycosides)

24
Q

🧠Digoxin and Lanoxin used for

A

HF and a fib

25
Q

🧠Digoxin and Lanoxin MOA

A

positive inotropic (harder contraction for more filling to allow HR to slow)
decreased conduction

26
Q

Digoxin and Lanoxin contraindications

A
  • 2nd/3rd degree heart block
  • ventricular fib
27
Q

Digoxin and Lanoxin AE

A
  • bradycardia
  • hypotension
  • HD, fatigue, confusion, convulsion
  • colored/halo vision
  • anorexia, N/V/D
28
Q

🧠Digoxin and Lanoxin toxicity

A

normal serum level is 0.5-2ng
S/S include AE and heart block, atrial tachycardia, ventricular dysrhythmias

29
Q

🧠Digoxin and Lanoxin interactions

A
  • Amiodarone
  • Quinidine
  • Verapamil
  • Dietary fiber (bran)🧠
  • Herbal supplements
  • Drugs that cause low K and Mg
30
Q

🧠Digoxin and Lanoxin toxicity antidote

A

Digoxin immune fab (Digifab) or Digoxin-specific antibody (Digibind) used for hyperkalemia and life-threatening dysrhythmias or OD

31
Q

Digoxin and Lanoxin nursing precautions

A
  • monitor electrolytes
  • digoxin levels
  • CNS effects
  • BP and apical
  • extra heart sounds
  • vision changes
32
Q

🧠Antihypertensives assessment

A
  • Full exam, history
  • Vitals
  • EKG,
  • CBC,
  • basic metabolic panel (MBP) for electrolytes
  • cholesterol
  • LFT
  • Eye/retina exam (d/t the small blood vessels of the eye)
33
Q

🧠Antihypertensives education

A
  • Don’t stop taking abruptly to avoid rebound HTN (may cause stroke)
  • Impotence
  • Usually lifelong therapy
34
Q

🧠Digoxin and Lanoxin medication administration

A

PO
IV (usually with a loading dose)

Pharm unit 3 (13 decks)

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