Heart Failure Drugs

Question 1

ACE inhibitors - end with? SE?

Answer 1

-pril

SE: persistent dry cough, renal insufficiency, hyperkalemia, postural hypoTN, teratogenic (fetotoxic)

Question 2

ACE inhibitors - MOA

Answer 2

decrease afterload and preload -> increased CO

Question 3

Angiotensin receptor blockers (ARBs) - end with? SE?

Answer 3

-sartan

SE: hyperkalemia, postural hypoTN, teratogenic (fetotoxic)

Question 4

ARB - MOA

Answer 4

block AT1 receptor on heart, peripheral vasculature, and kidney

decreases preload and afterload

Question 5

Who are ARBs for?

Answer 5

pts who can’t tolerate ACE inhibitors b/c of cough

Question 6

Beta blockers - SE

Answer 6

bradycardia, hypoTN, fatigue, dizziness

Question 7

Beta blockers - beneficial effect

Answer 7

decrease HR, inhibit renin release from kidneys

Question 8

Diuretics - MOA

Answer 8

relieve pulmonary congestion and peripheral edema

decrease pre and afterload

Question 9

4 diuretics

Answer 9

bumetanide, furosemide, metolazone, torsemide

Question 10

3 ionotropic drugs

Answer 10

digoxin
dobutamine
milrinone

Question 11

Digoxin MOA

Answer 11

inhibits Na/K ATPase, increases intracellular Ca and contractility

Question 12

Digoxin SE

Answer 12

narrow TI, anorexia, nausea, vomiting, blurred vision, cardiac arrhythmias, hypokalemia

Question 13

Dobutamine MOA

Answer 13

stimulates beta-adrenergic receptors; hemodynamic effect → increased contractility, decreased afterload

Question 14

Dobutamine SE

Answer 14

narrow TI, anorexia, nausea, vomiting, blurred vision, cardiac arrhythmias, hypokalemia

Question 15

Milrinone MOA

Answer 15

inhibit phosphodiesterase, increase beta-adrenergic effect; increases Ca and cardiac contractility

Question 16

Milrinone SE

Answer 16

narrow TI, anorexia, nausea, vomiting, blurred vision, cardiac arrhythmias, hypokalemia?

Question 17

Spironolactone MOA

Answer 17

antagonist at aldosterone receptor; hemodynamic effect → decreased preload

Question 18

Spironolactone SE

Answer 18

hyperkalemia?

Question 19

Hydralazine MOA

Answer 19

arterial dilator, reduces systemic arteriolar resistance and decrease afterload

Question 20

Hydralazine SE

Answer 20

headache, hypoTN, tachycardia

Question 21

Isosorbide dinitrate MOA

Answer 21

combo w/ hydralazine improves symptoms and survival in black pts w/ HF

Question 22

Isosorbide dinitrate SE

Answer 22

headache, hypoTN, tachycardia

Question 23

What are 3 main symps that can affect exercise tolerance and balance

Answer 23

dizziness, fatigue, mus weakness

Question 24

How would a PT manage pt’s ex tolerance?

Answer 24

start with low intensity exercises