Heart Failure Pharm Flashcards
Name the 5 drugs used in chronic HF?
- Digoxin
- ACE-I and ARB’s
- Loop diuretics
- BB
- Neprilysin inhibitor and ARB
Name the 3 drugs used in acute HF?
- Vasodilators (Nitroprusside)
- Beta agonist (Dobutamine, Dopamine)
- Loop diuretics (Furosemide)
Which 5 drugs reduce preload and after load?
- Vasodilators Nitroprusside
- ACE-I and ARB’s
- HCTZ
- Loop diuretics
- Hydralazine(after load) isosorbide dinitrate (preload)
T/F Furosemide causes orthostatic hypotension
TRUE
Which 4 drugs reduce mortality?
- HCTZ
- BB
- ACE-I and ARB’S
- Spirinolactone
What is MOA of Neprilysin blocker?
Sacubtril-Valsartan (Entresto)
- Sacubtril is an enzyme that blocks neprilysin
- this mechanism keeps BNP in the blood
- BNP: vasodilator, diuretic, decreases sympathetic tone
- Valsartan is ARB
What should you discontinue if you are going to give entresto?
ACE-I 36 hours before
What is the MOA of isosorbide dinitrate?
- release of NO to induce vasodilation
- reduced preload and stretch
What is a drug interaction with isosorbide dinitrate?
-synergistic effect with Viagra
What are the clinical uses of isosorbide dinitrate?
- angina
- acute or chronic HF
T/F Hydralazine decrease after load
TRUE
What are ADE with Hydralazine isosorbide dinitrate?
tachycardia
- postural hypotension
- lupus like syndrome
What is MOA of nitroprusside? What ROA?
powerful vasodilator that reduced preload and after load
-IV only and last a few minutes
What is the clinical use of nitroprusside?
Acute decompensated HF
What are ADE of nitroprusside?
cyanide toxicity
What is MOA of Digoxin/Cardiac glycoside?
- blocks Na/K ATPase
- this causes Na/Ca exchanger to be activated
- Na goes and Ca come into cell
- increases contractility
What are the clinical uses of digoxin (2)?
- Chronic HF
- a-fib with RVR
What are ADE with digoxin?
- N/V/D
- arrhythmia
What are the 2 beta agonists?
- Dobutamine Beta 1 selective
- Dopamine Beta and alpha
What are the MOA of beta agonists?
-increase BP CO and contractility
What are the clinical uses of beta agonists?
- acute decompensated failure
- dopamine-ADHF and shock
What is route of administration for beta agonists?
IV-last a few minutes
What is MOA of bypyridines?
PDE-3 inhibitor
vasodilates, increases CO
Name 2 bypyridines?
Milrinone
-Iamnirone
