Heart Failure Drugs -Short versions- (Exam II)

Question 1

Furosemide

Answer 1

Diuretic. Inhibits Na+ K+ 2Cl- (NKCC2) cotransporter in thick ascending loop of Henle
Tx: edema, hypertension, hypercalcemia
Toxicity: hypokalemia, ototoxicity, dehydration
Note: rapid onset of action

Question 2

Lisinopril (captopril)

Answer 2

ACE inhibitor (RAAS drug)
Tx: CHF, hypertension, diabetic renal disease
Toxicity: bradykinin cough reflex; hyperkalemia; teratogenic
Note: oral med; persistent dry cough due to inhibition of bradykinin metabolism

Question 3

Valsartan (losartan)

Answer 3

AT-I receptor antagonist (RAAS drug)
Tx: CHF, hypertension
Toxicity: hyperkalemia; teratogenic
Note: oral med; no bradykinin cough reflex

Question 4

Spironolactone

Answer 4

Aldosterone receptor antagonist (RAAS drug)
Tx: hyperaldosteronism, CHF, hypertension
Toxicity: hyperkalemia, endocrine effects (i.e. gynecomastia)
Note: used in combination w/ loop/thiazides to prevent hypokalemia; eplerenone lacks anti-androgen effects

Question 5

Carvedilol

Answer 5

Alpha-1 Beta adrenergic receptor antagonist
Tx: CHF, hypertension, angina
Toxicity: bradycardia, AV block, CNS sedation, bronchoconstriction
Note: 4 stereoisomers; shown to reduce mortality in HF patients

Question 6

Metoprolol

Answer 6

Selective beta-1 receptor antagonist
Tx: CHF, hypertension, angina
Toxicity: bradycardia, AV block, CNS sedation
Note: fewer bronchial effects; reduces mortality in HF patients

Question 7

Dobutamine

Answer 7

Inotrope; Beta-1 receptor agonist
Tx: acute decompensated HF
Toxicity: arrhythmia
Note: IV med, short duration of action

Question 8

Milrinone

Answer 8

Inotrope; Phosphodiesterase-3 inhibitor
Tx: acute decompensated HF
Toxicity: arrhythmia
Note: IV med, short duration of action

Question 9

Digoxin (digitalis)

Answer 9

Inotrope; Na+/K+ ATPase inhibitor
Tx: CHF, certain arrhythmias
Toxicity: arrhythmias, nausea, vision problems
Note: only approved cardiotonic agent for CHF; no decrease on CHF mortality; low therapeutic index

Question 10

Isosorbide Dinitrate

Answer 10

Vasodilator; nitric oxide donor
Tx: acute decompensated HF
Toxicity: tachycardia, hypotension, headache
Note: combined w/ hydralazine for HF

Question 11

Sacubitril

Answer 11

Vasodilator; Neprilysin inhibitor
Tx: CHF
Toxicity: hyperkalemia, cough, hypotension
Note: combined w/ valsartan for CHF; sublingual = short duration; oral = long duration

Question 12

Hydralazine

Answer 12

Vasodilator; Vascular K+ channel opener
Tx: CHF, angina
Toxicity: tachycardia, excessive hypotension, headache
Note: oral, long duration of action; combined w/ isosorbide dinitrate for HF