Heart Failure drugs Flashcards
what sympathomimetic would you give during heart failure and why
Dobutamine because the beta 1 activity increases contractility
what could you use to increase the force of ventricular contraction?
how
Digoxin
since it blocks the sodium-potassium ATPase, the intracellular sodium increases and more calcium comes into the cell for contraction
what other effects does digoxin have, other than its effect on the ATPase?
via beta 1 stimulation:
it increases SA rate
decreases AV node refractory period
increases conduction velocity in the ventricles and Purkinje cels
Digoxin side effects
AV Block
Arryhthmias
PVCs
Sinus bradycardia
N/V/D
HA
Visual halos
hallucinations
decreased QT interval with wave inversions
hypokalemia
WPW
contraindications of Digoxin
diuretics
quinidine
Verapamil
NSAIDS
Amiodarone
Erythromycin
all cause digoxin toxicity
how do beta blockers and CCB help treat heart failure
they decrease the venous pressure/ blood pressure
what should you use if your patient has heart failure with an EF <35% and NSR >70bpm?
Ivabradine
it blocks funny sodium channels to decrease the phase 4 f the SA node t decrease heart rate
what can be used to decrease RAAS
Valsartan
ACE inhibitors
ARBs
what can be used to decrease sodium and water retention in heart failure patients
Diuretics
Nesiritide (for dyspnea at rest in CHF)
Sacubitril ( blocks neutral endopeptides to increase naturesis)
how do inotropic drugs work
The “-rinone’s”
inhibit PDE to decrease ACh return to the presynapse and increase cGMP.
Leads t vasodilation/ decreased afterload and less cholinergic activity, tus increased contractility
name the inotropic drugs and their side effects
Inamrinone: hypotension and thrombocytopenia
Milrinone: as decreased survival in heart failure
