Heart Failure Meds Flashcards
What are the standard of care medications for heart failure?
ACE/ARB, diuretics, b blockers, +- spironolactone, digoxin
Medicines that end in -pril
ACEis
Medicines that end in -sartan
ARB
Entresto?
ARNI
3 Beta blockers for HF?
Metoprolol
Bisoprolol
Carvedilol
Name Loop diuretics
Furosemide
Bumetanide
Torsemide
Name 2 K sparing diuretics
Spironolactone
Eplerenone
What are the desired outcomes of ACEis?
“balanced vasodilators”
Increase vasodilation of both arterioles and venules
Decreases afterload
Decreases preload
INCREASES CARDIAC OUTPUT
What are ADR’s of ACEi?
Hypotension
Hyperkalemia
Angioedema
Dry Cough
Renal problems
Pregnancy tetatogen
What medication is contraindicated for ACEis when monitoring a patient’s kidney function?
NSAIDS- they cause vasoconstriction of the afferent arteriole.
Should ACEis be prescribed to people with renal problems?
No, because blocking angio II causes vasodilation of the efferent arteriole. Lowering the pressure within the glomerulus, lowers GFR.
What medications for HF are contraindicated for pregnancy?
ACEi and ARBs
What is a antidote for angioedema caused by ACEis?
Epi
What are ADRs of ARBs?
Hypotension
hyperkalemia
What is something to keep in mind when prescribing B-blockers for HF?
Takes 3 months to see improvement. But it can decrease disease progression, decreases risk of death
When are B-blockers contraindicative for HF?
Hypotension
Bradycardia
Which diuretic is most commonly prescribed for HF?
Loop diuretic
What membrane protein is inhibited in a loop diuretic?
NA, 2CL, K symporter
What membrane protein is inhibited in a thiazide diuretic?
Na Cl symporter
What membrane protein is inhibited in a K sparing diuretic?
Aldosterone-Na pump
What are ADRs associated with loop diuretics?
Hypokalemia
Hypocalcemia
Also has potential for ototoxicity
What are ADRs associated with thiazide diuretics?
Hypokalemia
HYPERcalcemia
What are ADRs associated with K sparing diuretics?
HYPERkalemia
Hypocalcemia
Do diuretics have a direct affect on cardiac output?
NO DIRECT EFFECT ON CO
They lower preload
Which patients could potentially complain of leg cramps due to their heart failure medication?
Loop/thiazide diuretics
What are the reasons digoxin is used for HF?
Increases calcium, increases contractility, increases cardiac output, and lowers HR.
When do you use digoxin for HF?
Mostly used for Afib + HF
Only use if a patient is symptomatic after all the other therapies are maxed out.
What are the ADRS of digoxin?
Hypokalemia
Hypomagnesemia
HYPERcalcemia
Hypothyroidism
What is the ONLY CCB used for heart failure?
Amlodipine
Which phosphodiesterase inhibitor is used for HF due to increased contractility?
Milrinone and its a PDE3
What medication is contraindicated for ACEis when monitoring a patient’s kidney function?
NSAIDS- they cause vasoconstriction of the afferent arteriole.
