Heart Failure Drugs

Question 1

What does furosemide do?

Answer 1

It’s a loop diuretic

Question 2

Name four ACE inhibitors.

Answer 2

1. Captopril
2. Enalapril
3. Ramipril
4. Lisinopril

Question 3

Name four physiologic effects that angiotensin II has.

Answer 3

1. Increases sympathetic outflow
2. Increases reabsorption of Na+ and Cl- in the kidney tubule -> H2O retention (increased BP)
3. Vasoconstriction
4. Stimulates ADH secretion by the posterior pituitary –> H2O reabsorption in the collecting duct

Question 4

Name four angiotensin receptor antagonists.

Answer 4

1. Losartan
2. Olmesartan
3. Telmesartan
4. Valsartan

Question 5

Name two aldosterone receptor antagonists.

Answer 5

1. Spironolactone

2. Eplerenone

Question 6

What is bisoprolol?

Answer 6

Beta blocker

Question 7

Name three inotropes and the specific MOA of each.

Answer 7

1. Dobutamine (B1 agonist)
2. Milrinone (phosphodiesterase inhibitor)
3. Digoxin (inhibits Na+/K+ ATPase on cardiomyocyte PMs –> reduced activity of Ca2+/Na+ exchanger –> increased intracellular Ca2+)

Question 8

Name a nitrovasodilator.

Answer 8

Isosorbide dinitrate

Question 9

Name two non-nitro vasodilators.

Answer 9

1. Sacubitril

2. Hydralazine

Question 10

What is the mechanism of action of sacubitril?

Answer 10

It inhibits neprilysin, an enzyme that degrades ANP. More ANP –> more vasodilation and salt/water excretion –> decreased afterload

Question 11

What is the mechanism of action of hydralazine?

Answer 11

It opens K+ channels on the plasma membrane of smooth muscle, leading to a decreased resting membrane potential –> harder to open voltage-gated Ca2+ channels –> less Ca2+ means less smooth muscle contraction