Heart Failure Drugs Flashcards
spironolactone effects
K+ sparing diuretic - blunts ability of aldosterone to promote Na+/k+ exchange
spironolactone MOA
competitive antagonist of aldosterone receptors
spironolactone clinical app
- counteracts K+ loss induced by other diuretics - tx of primary aldosteronism
toxicities of spironolactone
- hyperkalemia - amenorrhea, hirsutism, gynecomastia, impotence
furosemide MOA
blocks NaKCCl2 transporter in thick ascending loop
furosemide effects
increased excretion of water, sodium, potassium, chloride, magnesium, Ca2+
furosemide clinical app
- edema - decreases preload - rapid dyspnea relief - HTN - ACUTE DECOMPENSATED HEART FAILURE
toxicities of furosemide
- hypokalemia - hyponatremia - hypocalcemia - hypomagnesemia - hyperglycemia - hyperuricemia
hydrochlorothiazide MOA
blocks Na/Cl cotransporter in distal convoluted tubule
hydrochlorothiazide effects
increases urinary excretion of sodium and water, potassium, and magnesium
hydrochlorothiazide clinical app
- HTN - edema
toxicities of hydrochlorothiazide
- orthostatic hypotension - hypokalemia - hypomagnesemia - hyponatremia - hypochloric metabolic alkalosis
digoxin MOA
inhibits Na/K ATPase in myocardial cells
digoxin effects
- suppression of AV conduction - increased contractility - positive inotropic event but decreased ventricular rate
digoxin clinical app
control of ventricular respones rate in chronic atrial fib - heart failure
toxicities of digoxin
- hyperkalemia - accelerated junctional rhythm - asystole - atrial tach - heart block - dizziness, mental disturbances, HA, confusion - rash - N/V/D - blurred or yellow vision
aliskiren
blocks renin
ARBs
aldosterone receptor blockers
ACE inhibitors cause what sx by maintaining bradykinin in the body
- vasodilation - decrease in GFR - cough - inflammation
ACE inhibitors lead to less angiotensin II, the effect of these inhibitors is:
- less vasoconstriction (decreased afterload) - less aldosterone secretion so less water retention (decreased preload) - decreased cell proliferation and remodeling
Losartan
angiotensin II receptor antagonist
Captopril
ACE inhibitor
effects of captopril
- lowers angiotensin II levels –> increased renin activity and decreased aldosterone secretion - lowers BP
toxicities of captopril
- cough - hypotension - HA - angioedema
effects of Losartan
- inhibition of RAAS - blocks vasoconstriction and aldosterone secretion effects of angiotensin II
toxicities of Losartan
- effects common in pts with diabetic neuropathy - hypotension - fatigue, dizziness, fever - cough
valsartan/sacubitril
inhibits neutral endopeptidase –> prolongs natriuretic peptides –> increased vasodilation
toxicities of valsartan/sacubitril
- hypotension - hyperkalemia - increased serum creatinine
carvedilol
beta blocker - nonselective beta and alpha adrenergic blocker with no intrinsic sympathomimetic activity
toxicities of carvedilol
- hypotension - bradycardia - syncope - AV block - cough
carvedilol should only be administered to _____ pts
clinically stable pts
pts with left ventricular systolic dysfunction caused by MI should be give ____ with carvedilol
ACE inhibitors
ivabradine MOA
inhibition of HCN channels and funny channels in SA node
ivabradine clinical app
tx of resting tachycardia
toxicities of ivabradine
- bradycardia - hypertension - increased risk a fib - heart block
