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pharmacology cardiovascular > Heart failure drugs > Flashcards

Heart failure drugs Flashcards

1
Q

What is the mechanism of action of digitoxin

A

Na/K+ pump inhibitor

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2
Q

What are the consequential actions of Digitoxin

A

Increased force of contraction
Increased excitability
Increased A-V conduction
Decreased heart rate

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3
Q

What is the effective range (dose) of Digitoxin

A

1.0-2.5ng/ml

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4
Q

What is the toxic dose of Digitoxin

A

> 1.5ng/ml

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5
Q

What are the side effects of Digitoxin

A 
GI:
-anorexia 
-abdominal pain 
-vominting and diarrhoea 
Arrythmias:
-Premature ventricular contractions 
-Atrial tachycardias 
-Atrioventircualr dissociation
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6
Q

Where is Digitoxin extracted from

A

foxglove plant (Digitalis)

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7
Q

What is the use of Digitalis (Digitoxin)

A

Clearly indicated in failure when atrial flutter/ fibrillation is present

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8
Q

Describe the half life and administration of Digitoxin

A

The long half life means that careful titration of patient dose is needed

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9
Q

Give examples of receptor sympathomimetics used to treat heart failure

A

Dobutamine

Dopamine

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10
Q

what is the mechanism of action of Dobutamine and Dopamine

A

stimulate beta-1 receptors

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11
Q

Give an example of a nitrate used to treat angina

A

GTN (glycerol trinitrate)

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12
Q

what is the mechanism of action of GTN (glycerol trinitrate)

A

Increase the amount of NO
Mo causes relaxation of vascular smooth muscle in arteries and veins
This decreases preload and afterload

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13
Q

What are the side effects of GTN (glycerol trinitrate)

A

heachache

dizziness

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14
Q

Give an example of a loop agent diuretic used to treat heart failure

A

Furosemide

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15
Q

What is the mechanism of action of furosemide

A

inhibits reabsorption of 30% of the filtered Na+ in the kidney

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16
Q

What is furosemide used for

A

Pulmonary and refractory oedema

Kidney failure

17
Q

What are the side effecs of furosemide

A

Ototoxicity
Hypovolemia
Hypokalemia
Hypomagnesia

18
Q

Give an example of a thiazide diuretic

A

Hydrochlorothiazide

19
Q

What is the mechanism of action of Hydrochlorothiazide

A

Mild diuretic effect
Inhibits reabsorption of <10% of filtered Na+
It mainly acts on the distal convoluted tubule
Direct vasodilator action on smooth muscle

20
Q

When is Hydrochlorothiazide used clinically

A

Hypertensives

21
Q

What are the side effects of Hydrochlorothiazide

A

Potassium loss

Hypotension

22
Q

Give an example of a K+ sparing diuretic

A

Amiloride

Spirononlactone

23
Q

What is the mechanism of action of Amiloride and

Spirononlactone

A

Weak diuretic effect

inhibits reabsorption of <5% of filtered Na+

24
Q

What are Amiloride and Spirononlactone useful for

A

controlling K+ loss

25
Q

What are the side effects of Amiloride and

Spirononlactone

A

Hyperkalemia

Spirononlactone has oestrogen like effects

26
Q

Give examples of ACE inhibitors used to treat heart failure

A

Captopril

Analpril

27
Q

What is the mechanism of action of the ACE inhibitors

A

Inhibit production of angiotensin II and thus:

  • inhibit aldosterone production
  • Cause vasodilation as inhibit bradykinin breakdown
28
Q

What are ACE inhibitors useful for

A

controlling K+ loss

Hypertension

29
Q

What are the side effects of ACE inhibitors

A

Cough
Hypotension
Hyperkalemia

30
Q

Give an example of an angiotensin II receptor blocker used to treat heart failure

A

Losartan

31
Q

What is the mechanism of action of losartan

A

angiotensin II receptor blocker
it reduces BP
Does not effect bradykinin so no cough

32
Q

What are the side effects of losartan

A

Less vasodilation than ACE inhibitors

Birth defects

pharmacology cardiovascular (9 decks)

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