HTN II (HF) Flashcards
No symptoms but risk factors present
ACC/AHA stage A
NYHA prefailure
Symptoms w/ severe exercise
ACC/AHA stage B
NYHA I
Symptoms with marked or mild exercise
ACC/AHA stage C
NYHA II/III
Severe symptoms at rest
ACC/AHA stage D
NYHA IV
How do you treat ACC/AHA stage A/ NYHA prefailure?
treat obesity, HTN, DM, HLD
How do you treat ACC/AHA stage B/NYHA stage 1?
ACEI/ARB, beta blocker, diuretic
How do you treat ACC/AHA stage C/NYHA stage 2/3?
add aldosterone antagonist, digoxin, CRT, ARNI, hydralizine/nitrate
How do you treat ACC/AHA stage D, NYHA stage 4?
maximum therapy, transplant, LVAD
what medication reduces preload + afterload along with pulmonary + peripheral edema, for acute and chronic HF
diuretics = lasix
Watch K+, avoid fast diuresis, and sulfa allergies with
diuretics - lasix
Spironolactone is an
aldosterone antagonist
- blocks aldosterone receptors
- increased excretion
For CHF, reducing mortality
watch for hyperkalemia
Angiotensin antagonists for HF like
ACE-I = captopril, can reduce mortality
ARBs = losartan, used in patients intolerant to ACEI
Beta blockers for HF like
carvedilol
- slows HR, reduces BP
for CHF to slow progression, reduce mortality in mod-severe HF
** watch for brochospasm, brady, AV block
What is an
-Na/K inhibitor, reducing expulsion of CA
- increases contractility, PNS activity
for chronic symptomatic HF, reducing hospitilization?
digoxin (cardiac glycoside)
watch for cardiac arrhythmias
What are vasodilators for HF?
imdur (isosorbide), hydralazine, nitroprusside
What releases NO, reduces preload + ventricular stretch, for acute and chronic HF, and needs to be monitored for postural HOTN, headache, synergistic PDE5 inhibitors?
imdur (isosorbide)
What possibly increases NO synthesis n endothelium (arteriolar dilator) and reduces BP and afterload, increasing CO, and can be used + nitrates in AA to reduce mortality and must be watched for lupus symptoms?
hydralazine
What releases NO spontaneously, reduces preload and afterload, for acute cardiac decompensation, but needs to be monitored for excessive HOTN and cyanide toxicity?
nitroprusside
What is a beta agonist and increases contractility, CO, for acute decompensated HF, and has an additive effect w/ other sympathomimetisc?
dobutamine
What is a dopamine receptor agonist that has higher doses activating beta + alpha receptors with high doses increasing cardiac force + BP and can be used for acute decompensated HF?
dopamine
What’s more useful in african americans, cost effective, and helpful in elderly due to reabsorption of calcium?
beta blockers
With what drug should you expect a small bump in serum creatinine?
ACEI
Reduced renal clearance allpurinol, Digoxin, lithium, methotrexate
ACEI
When should you give loop diuretics?
morning or 3 hours prior to bedtime
