heart failure drugs Flashcards
what is the MOA of Digoxin
MOA: Inhibits Na+/K+ ATPase, leading to increased intracellular Na+ and Ca++, which increases the force of contraction. Decreases AV node conduction velocity.
what are the indications for digoxin
Indications: Congestive heart failure (CHF), supraventricular tachycardia (except WPW syndrome).
what are the adverse effects of digoxin
Adverse Effects: GI (anorexia, nausea, vomiting), CNS (headache, disorientation, visual halos), cardiovascular (PVCs, AV block, sinus bradycardia).
True or false: Digoxin is contraindicated in WPW syndrome
TRUE it is contraindicated in WPW
what is the MOA of dobutamine
MOA: Sympathomimetic that primarily acts on β1-adrenergic receptors, increasing heart contractility and output.
what are the indications for dobutamine
actue decompensated heart failure
what are the adverse effects of dobutamine
tachycardia, arrhythmias, hypotension
what are the contraindications of dobutamine
hypersensitivity to dobutamine
What is the MOA of milrinone
MOA: Inhibits phosphodiesterase (PDE) leading to increased cAMP, resulting in positive inotropy and vasodilation.
What are the indications for milrinone
Short-term treatment of severe heart failure
what are the adverse effects of milrinone
hypotension, thrombocytopenia (with inamrinone)
what are the contraindications of milrinone
hypersensitivity to the drug, severe obstructive aortic or pulmonary valvular disease
what’s the MOA of Enalapril/Lisinopril
MOA: Inhibits the angiotensin-converting enzyme, reducing angiotensin II levels and decreasing aldosterone secretion, leading to vasodilation and reduced blood pressure.
what are the indications for Enalapril and lisinopril
heart failure an HTN
what are the adverse effects of enalapril/lisinopril
cough, hyperkalemia, hypotension, renal impairment
what are the contraindications for enalapril and lisinopril
pregnancy and bilateral renal artery stenosis
MOA of Valsartan/Candesartan
MOA: Blocks angiotensin II receptors, preventing vasoconstriction and aldosterone-secreting effects
what are the indications for Valsartan and candesartan
heart failure and HTN
what are the adverse effects of valsartan and candesartan
Hyperkalemia, renal impairment, and hypotension
what are the contraindications for valsartan and candesartan
pregnancy, bilateral renal artery stenosis
MOA of Spironolactone/Eplerenone
MOA: Aldosterone antagonist that inhibits sodium reabsorption in the distal tubules, reducing water retention and lowering blood pressure.
what are the indications for spironolactone/Eplerenone
Heart failure, HTN, hyperaldosteronism
what are the adverse effects of spironolactone/eplerenone
Hyperkalemia, gynecomastia (spironolactone), renal impairment
what are the contraindications for Spironolactone/Eplerenone
Hyperkalemia, Addison’s disease
MOA of Furosemide/Bumetanide/Torsemide
MOA: Inhibits the Na+/K+/2Cl- co-transporter in the thick ascending limb of the loop of Henle, leading to diuresis.
list the indications, adverse effects, and contraindications for Furosemide, bumetanide, torsemide
Indications: Edema due to heart failure, hypertension.
Adverse Effects: Hypokalemia, dehydration, ototoxicity.
Contraindications: Anuria, severe electrolyte depletion.
MOA of carvedilol, metoprolol, bisoprolol
MOA: Blocks beta-adrenergic receptors, reducing heart rate, myocardial contractility, and blood pressure.
list the indications, adverse effects and contraindications for carvedilol, metoprolol, and bisprolol
Indications: Heart failure, hypertension, post-MI.
Adverse Effects: Bradycardia, hypotension, fatigue, bronchospasm.
Contraindications: Severe bradycardia, AV block, asthma (non-selective beta-blockers).
MOA of Ivabradine
MOA: Inhibits the funny current (If) in the SA node, reducing heart rate without affecting contractility.
list the indications, adverse effects and contraindications for Ivabradine
Indications: Heart failure with reduced ejection fraction (EF < 35%).
Adverse Effects: Bradycardia, visual disturbances (phosphenes).
Contraindications: Acute decompensated heart failure, bradycardia.
MOA of sacubitril/Valsartan
MOA: Sacubitril inhibits neprilysin, increasing levels of natriuretic peptides; Valsartan blocks angiotensin II receptors.
Adverse effects of Sacubitril/Valsartan
Hypotension, hyperkalemia, renal impairment
contraindications of sacubitril/valsartan
Contraindications: Pregnancy, history of angioedema related to ACE inhibitors or ARBs.
MOA of nitrogllycerin
MOA: Converts to nitric oxide, leading to vasodilation and reduced preload.
list the indications, adverse effects, and contraindications for Nitroglycerin
Indications: Acute decompensated heart failure, angina.
Adverse Effects: Hypotension, headache, reflex tachycardia.
Contraindications: Hypotension, concurrent use with PDE5 inhibitors.
MOA of bosentan/ambrisentan
MOA: Bosentan blocks ETa/ETb receptors; Ambrisentan blocks ETa receptors, leading to vasodilation.
What are the indications of bosentan/ambrisentan
Pulmonary arterial HTN
List the adverse effects and contraindications for Bosentan/Ambrisentan
Adverse Effects: Hepatotoxicity, anemia, hypotension.
Contraindications: Pregnancy, moderate to severe liver impairment.
MOA of sildenafil
MOA: Inhibits PDE5, increasing cGMP levels leading to vasodilation.
list the indications for Sildenafil/tadalafil
Indications: Pulmonary hypertension, erectile dysfunction.
list the adverse effects and contraindications for sildenafil/tadalafil
Adverse Effects: Headache, flushing, hypotension.
Contraindications: Concurrent use with nitrates.
what drugs can cause digitalis toxicity
loop diuretics, thiazide diuretics, quinidine, verapamil, NSAIDS, amiodarone, and erythromycin
The antidote to digitalis toxicity
DigiFab (digibind); supportive therapy
