Heart Failure Meds

Question 1

What are the standard of care medications for heart failure?

Answer 1

ACE/ARB, diuretics, b blockers, +- spironolactone, digoxin

Question 2

Medicines that end in -pril

Answer 2

ACEis

Question 3

Medicines that end in -sartan

Answer 3

ARB

Question 4

Entresto?

Answer 4

ARNI

Question 5

3 Beta blockers for HF?

Answer 5

Metoprolol
Bisoprolol
Carvedilol

Question 6

Name Loop diuretics

Answer 6

Furosemide
Bumetanide
Torsemide

Question 7

Name 2 K sparing diuretics

Answer 7

Spironolactone
Eplerenone

Question 8

What are the desired outcomes of ACEis?

Answer 8

“balanced vasodilators”
Increase vasodilation of both arterioles and venules
Decreases afterload
Decreases preload
INCREASES CARDIAC OUTPUT

Question 9

What are ADR’s of ACEi?

Answer 9

Hypotension
Hyperkalemia
Angioedema
Dry Cough
Renal problems
Pregnancy tetatogen

Question 10

What medication is contraindicated for ACEis when monitoring a patient’s kidney function?

Answer 10

NSAIDS- they cause vasoconstriction of the afferent arteriole.

Question 11

Should ACEis be prescribed to people with renal problems?

Answer 11

No, because blocking angio II causes vasodilation of the efferent arteriole. Lowering the pressure within the glomerulus, lowers GFR.

Question 12

What medications for HF are contraindicated for pregnancy?

Answer 12

ACEi and ARBs

Question 13

What is a antidote for angioedema caused by ACEis?

Answer 13

Epi

Question 14

What are ADRs of ARBs?

Answer 14

Hypotension
hyperkalemia

Question 15

What is something to keep in mind when prescribing B-blockers for HF?

Answer 15

Takes 3 months to see improvement. But it can decrease disease progression, decreases risk of death

Question 16

When are B-blockers contraindicative for HF?

Answer 16

Hypotension
Bradycardia

Question 17

Which diuretic is most commonly prescribed for HF?

Answer 17

Loop diuretic

Question 18

What membrane protein is inhibited in a loop diuretic?

Answer 18

NA, 2CL, K symporter

Question 19

What membrane protein is inhibited in a thiazide diuretic?

Answer 19

Na Cl symporter

Question 20

What membrane protein is inhibited in a K sparing diuretic?

Answer 20

Aldosterone-Na pump

Question 21

What are ADRs associated with loop diuretics?

Answer 21

Hypokalemia
Hypocalcemia

Also has potential for ototoxicity

Question 22

What are ADRs associated with thiazide diuretics?

Answer 22

Hypokalemia
HYPERcalcemia

Question 23

What are ADRs associated with K sparing diuretics?

Answer 23

HYPERkalemia
Hypocalcemia

Question 24

Do diuretics have a direct affect on cardiac output?

Answer 24

NO DIRECT EFFECT ON CO
They lower preload

Question 25

Which patients could potentially complain of leg cramps due to their heart failure medication?

Answer 25

Loop/thiazide diuretics

Question 26

What are the reasons digoxin is used for HF?

Answer 26

Increases calcium, increases contractility, increases cardiac output, and lowers HR.

Question 27

When do you use digoxin for HF?

Answer 27

Mostly used for Afib + HF
Only use if a patient is symptomatic after all the other therapies are maxed out.

Question 28

What are the ADRS of digoxin?

Answer 28

Hypokalemia
Hypomagnesemia
HYPERcalcemia
Hypothyroidism

Question 29

What is the ONLY CCB used for heart failure?

Answer 29

Amlodipine

Question 30

Which phosphodiesterase inhibitor is used for HF due to increased contractility?

Answer 30

Milrinone and its a PDE3

Question 31

What medication is contraindicated for ACEis when monitoring a patient’s kidney function?

Answer 31

NSAIDS- they cause vasoconstriction of the afferent arteriole.