Heart Failure Drugs

Question 1

Digoxin

Answer 1

Use: HF and AFib
MOA: inhibits Na/K ATPase, secondarily increases intracellular Ca via Na/Ca exchanger
Effect: positive inotropic, negative chronotropic and dromotropic

Question 2

Dobutamine

Answer 2

Use: Acute treatment of severe HF
MOA: B1-agonist
Effect: positive inotropic

Question 3

Pimobenden

Answer 3

Use: HF (DCM & mitral valve insufficiency)
MOA: PDE3 & PDE5 inhibitor in heart and blood vessels
Effect: positive inotropic, vasodilator

Question 4

Metoprolol

Answer 4

Use: HCM
MOA: slows HR, relaxes ventricular wall so that diastolic filling improves
Effect: beta blocker; decreased HR, but improved CO

Question 5

Enalapril & Benazepril & Imidipril

Answer 5

Use: HF and Hypertension
MOA: inhibits angiotensin converting enzyme (ACE)
Effect: reduced Angiotensin II levels = vasodilation (mostly arteriolar) and reducing aldosterone release

Question 6

Valsartan & Telmisartan

Answer 6

Use: AT1 receptor antagonist
MOA: inhibits actions of angiotensin II
Effects: vasodilation (mostly arteriolar) and reduces aldosterone release

Question 7

Nitroglycerin & nitroprusside

Answer 7

Use: HF
MOA: exogenous sources of nitric oxide
Effect: venodilation and reduced preload

Question 8

Prazosin

Answer 8

Use: HF and Hypertension
MOA: A1 adrenergic receptor antagonist
Effect: arteriolar dilation and reduced afterload

Question 9

Hydralazine

Answer 9

Use: HF and Hypertension
MOA: unclear, may involve decrease vascular smooth muscle calcium
Effects: arteriolar and venous dilation (reduced preload and afterload)

Question 10

Sildenafil

Answer 10

Use: Pulmonary and hypertension
MOA: PDE5 inhibitor, preventing cGMP breakdown
Effect: vasodilation in lung and penile circulation, reduced pressure