Heart Failure Medications Flashcards
Digoxin MOA
Inhibits Na/K+ ATPase. Prevents outward current of Na+. Na+/Ca+ exchanger works instead resulting in an influx of Ca+ and increased cardiac contractility
Digoxin “accessory” MOA
Direct vagal stimulation. Acts as an anti-arrhythmic agent
Does Digoxin cause hyper or hypokalemia?
Hyperkalemia
Digoxin adverse effects
Arrhythmia's Concave ST segments Bradycardia (via vegas) Heart block (AV node) GI issues Visual disturbances
Digoxin toxicity antidote?
Fab
What does digoxin treat?
Chronic systolic heart failure
What does Milrinone and Nesiritide treat?
Acute heart failure
Milrinone MOA
Inhibition of phosphodiesterase, increased cAMP, and increased cardiac contractility. `
Milrinone effect on the heart?
Arteriolar dilation and decreased afterload
Nesiritide MOA
Synthetic BNP that increases cGMP.
Nesiritide effect on the heart?
Arteriolar and venous dilation resulting in reduced afterload and preload.
Explain renin
Renin is synthesized, stored, and released by the JGA. It converts angiotensinogen to angiotensin 1.
Explain ACE
ACE is located in vascular endothelium of the lungs. ACE converts angiotensinogen I to angiotensinogen II
Effects of Angiotensinogen II
Vasoconstriction
Increased GFR by constricting the efferent arteriole.
Increased sodium/bicarbonate reabsorption at the PCT.
Causes release of aldosterone.
Effects of Aldosterone
Increased Na+ and H2O retention.
Increased K+ excretion
ACE-Inhibitors names?
All end in -pril
ACE-Inhibitors MOA
Prevents the conversion of Ang-I to Ang-II.
Overall decreased pressor effects of Ang-II
Do ACE-Inhibitors increase or decrease Creatinine?
Increase
ACE-I adverse effects?
Hypotension
Hyperkalemia
Dry cough
Teratogenic
ACE-I are used to treat?
Heart failure Decreased cardiac remodeling MI Hypertension Slow progression of diabetic neuropathy
ACE-I contraindication
Hereditary angioedema
NSAID use
Bilateral renal stenosis
ARB MOA
ARBs block the angiotensin receptors
Aliskiren MOA
Direct renin inhibitor
