heart failure medications

Question 1

Beta Blocker med

Answer 1

Metoprolol (Lopressor)
MOA: blocks beta 1 in heart, kidneys, peripheral vessels -> decr HR, contractility, reduced renin secretion & vasodilation
A/E: dizzy, fatigue, bradycardia, BRONCHOSPASM, WHEEZING
HOLD IF HR <50
- inotropic effect
MUST taper off
indications: angina, HF, HTN

Question 2

Dual Acting Beta Blocker Med

Answer 2

Carvedilol (Coreg)
MOA: blocks alpha 1 & beta 1/2
A/E: dizzy, fatigue, bradycardia, ED, bronchospasm, WHEEZING, ORTHOSTATIC HPN, HF
MASKS S/S of hypo-/hyperglycemia

Question 3

ACE inhibitor meds

Answer 3

-prils (Enalapril, Captopril, Lisinopril)
MOA: blocks conversion of angiotensin 1 to 2 -> prevents aldosterone secretion, reduces afterload/preload
A/E: dizzy, hpn, DRY COUGH, HYPERKALEMIA, fatigue, insomnia
Has cardioprotective effects. Use post-MI pts
Enalapril available as oral & IV

Question 4

ARBs meds

Answer 4

-sartan (Losartan, Valsartan)
MOA: blocks binding of angiotensin 2 to vascular SM & adrenal cortex -> prevents aldosterone secretion. reduces afterload/preload
A/E: dizziness, hpn, hyperkalemia, chest pain, fatigue, HYPOGLYCEMIA, anemia, weakness
side effects less severe than ACE inhibitors, but more $$

Question 5

Diuretics- Aldosterone Antagonist Med

Answer 5

Spironolactone (Aldactone)

look at previous quiz

Question 6

Hydralazine/ Isosorbide Dinitrate (Bidil)

Answer 6

“Bidil” = 2 dilators
First drug approved for a specific ethnic group (African Americans)
A/E: nausea, dizzy, h/a, HEPATOTOXICITY
dosed TID

Question 7

Dobutamine (Dobutrex)

Answer 7

Incr CO by incr contractility -> incr stroke volume

Question 8

Phosphodiesterase Inhibitor Med

Answer 8

Milrinone (Primacore)
MOA: inhibits phosphodiesterase which normally causes breakdown of cAMP -> incr cAMP in circulation -> + inotropic effect & vasodilation
A/E: h/a, hpn, SVT, torsades de pointe, HYPOkalemia, thrombocytopenia, bronchospasm

Question 9

Cardiac Glycoside med

Answer 9

Digoxin (Lanoxin)
MOA: stimulates PSNS -> decr HR -> incr diastolic filling
+ inotrope, - chronotrope, -dromotrope
**Check apical pulse for 1 min prior
TOXICITY: bradyarrhythmia, YELLOW HALO, PVC, dysrhythmia, h/a, malaise, confusion, delirium
ANTIDOTE= digibind

Question 10

Chronotropic means the drug effects ____

Answer 10

HR

Question 11

Dromotropic means the drug effects ____

Answer 11

conduction

Question 12

Inotropic means the drug effects ____

Answer 12

force of contraction