Heart Failure Drugs Flashcards
Symptoms of Left side HF
Decreased CO and increased pulmonary pressure
Symptoms of right side HF
fluid retention, pitting edema, hepatic congestion
To treat passive congestion due to backward HF
Give a diuretic to decrease fluid retention
To treat forward symptoms of HF
Give sympathomimetics and digoxin to increase contractility
Also need beta blockers, ACE inhibitors and ARBs to decrease workload on the heart
Drugs to decrease preload in HF patients
Diuretics, ACEI, ARB
Drugs to decrease afterload in HF patients
ACEI and ARB
Drugs to increase contractility in HF
Digoxin and beta agonists
Initial treatment for HF patients
Diuretic and ACEI and early addition of beta blocker
ACEI + ARB + spiranolactone
Causes hyperkalemia
Contraindicated
Thiazolidinediones in HF
Can worsen HF
Contraindicated
Ca channel blockers in HF
decreases CO more
Contraindicated
NSAIDs and COX-2 inhibitors in HF
Worsens renal function
Contraindicated
Digoxin
Inhibition of Na/K ATPase, increases intracellular Ca and increases contractile force
What monitoring is needed with digoxin
Digoxin levels and potassium levels as hypokalemia can increase digoxin toxicity
Early symptoms of digoxin toxicity
Nausea/Vomiting, diarrhea, anorexia
Late symptoms of digoxin toxicity
Disorientation and visual disturbances
How to manage digoxin toxicity
Fab antibodies
What electrolyte imbalances can increase digoxin toxicity
Hyperkalemia, hypomagnesia and hypercalcemia
What diuretics to use in HF
loop diuretics
First line treatment for pulmonary hypertension
Oral calcium channel blockers and treatment of underlying disorder
Milrinone
Can be used to treat acute HF
Causes arterial dilation and increased CMP, which increases contractility
Nesiritide
Acts like BNP–arterial and venous dilation and increased natriuresis
