Heart Failure – Part 3:Treatment Flashcards
Specific HF Goals of Rx
Correction of the underlying cause of HF
Elimination of precipitating factors
Reduction of congestion
Improve blood flow
Reverses fluid retention (Na loss)
The most common HF therapy
Can be used chronically and acutely
Side effects: dehydration, hypokalemia, sulfa, tinnitis
Diuretics
Diuretics:Treatment of Volume Overload
inc Salt (+Water) Excretion
dec intravasc fluids
dec venous congestion
*dec dyspnea volume
…prils (lisinopril, enalapril, benazepril) are all?
ACE Inhibitors
ACE Inhibitors fx
Direct vasodilation
Decreased aldosterone activation
ACE Inhibitors side effects
Hypotension
Worsening renal function (afferent vasocontraction)
Hyperkalemia
Cough
Angioedema: <1%, can occur after months of use
…sartans (e.g. valsartan, candesartan, losartan)
ARBs
ARBs fx
Block the receptor of angiotensin II
ARBs do not produce kinin potentiation (________)
Otherwise side effects are similar to ACEI
no cough
Mineralocorticoid Receptor Antagonists (MRA) fx
Spironolactone and eplerenone
Effect: Block mineralocorticoid receptor
Mineralocorticoid Receptor Antagonists (MRA) side effects
Hyperkalemia (requires close monitoring)
Gynecomastia (spiro only)
…olols (metoprolol, carvedilol, bisoprolol)
Beta-Blockers
Beta-Blockers fx
Antagonize effect of sypathetic system (epinephrine/norepinephrine)
Beta-Blockers side effects
Negative inotrope: short-term loss for long-term gain
Fluid retention
Hypotension
Decreased cardiac output, even cardiogenic shock
Bronchoconstriction
Vasodilation
Salt / Water Excretion
ACE INHIBITORS / ANGIOTENSIN RECEPTOR BLOCKERS