Heart Failure Drugs (Flashcards)

Question 1

What happens in left sided heart failure?

Answer 1

Left sided (Left = Lung)
Pulmonary edema
Coughing
Shortness of breath
Dyspnea

Question 2

what happens in right sided HF?

Answer 2

Right sided
Systemic venous congestion
Pedal edema
Jugular venous distension
Ascites
Hepatic congestion

Question 3

Differences between Class I, II, II, IV HF?

Answer 3

Class I
No physical activity limitations
Class II
Ordinary physical activity results in fatigue, dyspnea, or other symptoms.
Class III
Marked limitation in physical activity
Class IV
Symptoms at rest or with no physical activity at all

Question 4

Positive inotropic drugs do what?

Answer 4

Increase myocardial contraction

Question 5

Positive chronotropic drugs do what?

Answer 5

Increase HR

Question 6

Positive dromotropic drugs do what?

Answer 6

accelerate cardiac conduction

Question 7

whats the ACE inhibitor used?

Answer 7

Lisinopril

Question 8

Whats the ARBS used?

Answer 8

Valsartan

Question 9

whats the b-blocker used?

Answer 9

Metoprolol

Question 10

Dobutamine, what does it do?

Answer 10

Has a positive inotropic effect (increased myocardial contractility).

Question 11

what does lisinopril do?

Answer 11

Prevent sodium and water resorption by inhibiting aldosterone secretion
Diuresis results, which decreases preload, or the left ventricular end volume, and the work of the heart

Question 12

Uses of lisinopril?

Answer 12

Uses: hypertension, heart failure, and acute myocardial infarction
Hyperkalemia
Dry cough
Decreased renal function

Question 13

what does Valsartan do?

Answer 13

Potent vasodilators; decrease systemic vascular resistance (afterload)
Used alone or in combination with other drugs such as diuretics in the treatment of hypertension or heart failure

Question 14

Valsartan adverse effects?

Answer 14

same as lisinopril except cough, and hyperkalemia.

Question 15

What does metoprolol do?

Answer 15

Cardioprotective quality of ß-blockers: prevent catecholamine-mediated actions on the heart by reducing or blocking sympathetic nervous system stimulation to the heart and the heart’s conduction system

Question 16

What does spironolactone do?

Answer 16

potassium-sparing diuretic and aldosterone antagonist shown to reduce the symptoms of heart failure

Question 17

What does dobutamine do?

Answer 17

β1-selective vasoactive adrenergic drug
Structurally similar to dopamine

Question 18

what does Phosphodiesterase Inhibitors do, and whats the only drug of this available in Canada?

Answer 18

inhibits phosphodiesterase which results in?
Result in
Intracellular increase in cyclic adenosine monophosphate
Positive inotropic response
Vasodilation
Increase in calcium for myocardial muscle contraction.
Inodilators (inotropics and dilators)
(the only drug available is milrinone)

Question 19

What are cardiac glycoside drug effects?

Answer 19

Positive inotropic effect
- Increased force and velocity of myocardial contraction (without an increase in oxygen consumption)
Negative chronotropic effect
- Reduced heart rate
Negative dromotropic effect
- Decreased automaticity at sinoatrial node, decreased atrioventricular nodal conduction, and other effects

Question 20

Cardiac Glycosides, adverse Effects

Answer 20

Cardiovascular: dysrhythmias, including bradycardia or tachycardia
Central nervous system: headaches, fatigue, malaise, confusion, convulsions
Eyes: coloured vision (seeing green, yellow, purple), halo vision
Gastrointestinal: anorexia, nausea, vomiting, diarrhea

MOST ADVERSE EFFECTS SIGNS AND SYMPTOMS OF TOXICITY

Question 21

what to do in digoxin toxicity?

Answer 21

digoxin immune Fab therapy
Hyperkalemia (serum potassium greater than 5 mmol/L) in a digitalis-toxic patient
Life-threatening cardiac dysrhythmias
Life-threatening digoxin overdose

Question 22

large amounts of what negatively effcets absorption of oral digoxin?

Answer 22

bran

Question 23

NHP that increase digoxin levels?

Answer 23

ginseng, hawthorn, licorice; St John’s Wort

Question 24

Conditions That Predispose to Digoxin Toxicity?

Answer 24

Hypokalemia
Use of cardiac pacemaker
Atrioventricular block
Hypercalcemia
Dysrhythmias
Hypothyroid, respiratory, or renal disease
Advanced age
Ventricular fibrillation

Question 25

Hold dose and notify prescriber if the patient experiences signs or symptoms of toxicity such as?

Answer 25

Anorexia, nausea, vomiting, diarrhea
Visual disturbances (blurred vision, seeing green or yellow halos around objects)

Question 26

How much weight should a patient report

Answer 26

Patients should immediately report a weight gain of 1 kg or more in 24 hours or 2 kg or more in 1 week.

Question 27

Avoid giving what med with high-fibre foods

Answer 27

Avoid giving digoxin with high-fibre foods (fibre binds with digitalis).

Question 28

How to administer milrinone?

Answer 28

use an infusion pump.