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pharmacology > HF > Flashcards

HF Flashcards

1
Q

drug of choice to inhibit RAAS

A

ACEI

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2
Q

what ace drugs can be used for hf

A

any

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3
Q

what 2 drugs dec cardiac workload in ARBS for HF

A

Candesartan

Valsartan

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4
Q

what 3 drugs Dec cardiac workload: Beta blockers hf

A

Bisoprolol
Metoprolol
Carvedilol (alpha and beta blocker)

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5
Q

Once contraindicated in pts with HF bc they slow the HR with their negative inotropic effects

A

Dec cardiac workload: Beta blockers

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6
Q

Hydralazine

A

Dec cardiac workload

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7
Q

isosorbide dinitrate

A

Dec cardiac workload

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8
Q

Good to use in aftrican american pts with ACE and beta blockers

A

Hydralazine and isosorbide dinitrate

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9
Q

Sacubitril/Valsartan

A

Dec cardiac workload: Entresto

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10
Q

Bumetanide

A

loop

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11
Q

Furosemide

A

loop

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12
Q

Torsemide

A

loop

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13
Q

Usually for ppl with type 2 DM

A

Controlling excessive fluids: Farxiga

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14
Q

ONLY used in systolic HF

A

digoxin

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15
Q

digoxin enhances

A

contractility

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16
Q

Sodium nitroprusside

A

ADHF: Vasodilators

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17
Q

Nitroglycerin (NTG)

A

ADHF: Vasodilators

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18
Q

Dopamine

A

ADHF: other + inotropic drugs

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19
Q

Dobutamine

A

ADHF: other + inotropic drugs

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20
Q

Milrinone

A

ADHF: other + inotropic drugs

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21
Q

Good to use in aftrican american pts with ACE and beta blockers

A

Dec cardiac workload: Hydralazine and isosorbide dinitrate

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22
Q

moa hydralazine

A

direct vasodilator of arteries by causing Ca to be released from the sarcoplasmic reticulum

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23
Q

moa Isosorbide dinitrate

A
  • converted to NO which causes vasodilation in veins
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24
Q

Dec cardiac workload: Hydralazine and isosorbide dinitrate

se

A

SE: “classic” HA and hypotension/orthostatic hypotension

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25
Q

Dec cardiac workload: Hydralazine and isosorbide dinitrate

contra

A

Contra: don’t use with PDE 5 inhibitors (Viagra, Cialis, and Levitra) bc they can cause severe hypotension

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26
Q

moa sacubitril

A

Neprilysin inhibitor that degrades ANP and BNP; they reduce blood volume

27
Q

Dec cardiac workload: Entresto

se

A

SE: hyperkalemia and angioedema

28
Q

Dec cardiac workload: Entresto

contra

A

Contra: dont use with Aliskiren

29
Q

Dec cardiac workload: Entresto

caution

A

Cautionary: can cause fetal harm

30
Q

Dec cardiac workload: Entresto

bbw

A

BBW: dc when pregnant

31
Q

Dec cardiac workload: Entresto

pregnancy

A

Pregnancy: not listed as a letter but avoid using it

32
Q

Dec cardiac workload: Corlanor

moa

A

MOA: If ion current expressed in the SA node; regulates pacemaking activities in the SA node by selectively inhibiting If current which slows the HR and give blood more time to get to the myocardium; reduces HR w/o loss of contractility

33
Q

Dec cardiac workload: Corlanor

se

A

SE: Luminous phenomena- sudden changes in brightness of light

34
Q

Dec cardiac workload: Corlanor

contra

A

Contra: resting HR less than 70 bpm

35
Q

Cautionary: most pts on _____ will also be on beta blocker so there is a risk of bradycardia since they both slow the HR

36
Q

Dec cardiac workload: Corlanor

pregnancy

A

Pregnancy: may harm fetus; animal studies show birth defects

37
Q

Pts should weigh themselves daily if on this

38
Q

Usually used for heart failure not HTN

39
Q

Usually for ppl with type 2 DM

40
Q

Farxiga moa

A

MOA: inhibits sodium glucose co transporter 2 (SGCT-2) in the proximal renal convoluted tubule. It reduces intravascular volume through osmotic diuresis and natriuresis which reduces preload and afterload improving LV function.

41
Q

Farxiga se

A

SE: UTI, yeast infections, Nec fasc of perineum AKA fournier’s gangrene

42
Q

Farxiga contra

A

Contra: renal impairment eGRF<30

43
Q

ONLY used in systolic HF

44
Q

digoxin is a ____ inotropic drug

45
Q

digoxin has a ____ therapeutic index

46
Q

Half life of 36-40 hrs

47
Q

digoxin moa

A

MOA: normally Na K pump does 3Na out and 2K in. Digoxin inhibits this so Na builds up in the myocardium. The Na Ca pump normally does 3Na in and 1 Ca out.The build up of Na reverses the Na Ca pump. This leads to inc contractility of the heart

48
Q

digoxin se

A

SE: cardiac arrhythmias, visual disturbances (yellow or blurred vision… think Van Gogh), anorexia

49
Q

digoxin contra

A

Contra: VF

50
Q

digoxin preg

A

Pregnancy: drug enters breast milk so use with caution

51
Q

digoxin caution

A

Cautionary: more effective with hypokalemia so hypokalemia inc risk of toxicity. Don’t give to someone with renal disease

52
Q

Acute decompensated HF (ADHF) used to be known as

53
Q

ADHF caused by

A

Volume overload
Hypoperfusion
Both

54
Q

when pts are in hypotension and low CO

A

Cardiogenic shock-

55
Q

Sodium nitroprusside

moa

A

MOA: breaks down NO which relaxes smooth muscle and dilates arteries

56
Q

Sodium nitroprusside

se and BBW

A

SE and BBW: hypotension

57
Q

Nitroglycerin (NTG)

moa

A

MOA: converted to NO which causes relaxation and vasodilation in veins

58
Q

Nitroglycerin (NTG)

se

A

SE: hypotension and HA (MAJOR)

59
Q

Nitroglycerin (NTG)

contra

A

Contra: recent use PDE 5 bc they can cause dangerously low hypotension

60
Q

moa dopamine

A

MOA: direct alpha and beta adrenergic effect; at low doses (1-5 mcg/kg/min) stimulates dopamine receptors in the kidneys to inc blood flow and inc urine output

61
Q

dobutamine MOA

A

MOA: beta 1 agonist inc CO

62
Q

milrinone moa

A

MOA: inhibition of PDE 3 causing vasodilation

63
Q

Drugs that DONT dec mortality:

A

Diuretics
+ inotropes
nitrates/vasodilators

64
Q

Drugs that DO dec mortality:

A

ACE/ARBs
Beta blockers
Entresto

pharmacology (16 decks)

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