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U4 Drug table > Inotropic > Flashcards

Inotropic Flashcards

1
Q

What is the class for Diuretics

A

Diuretics

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2
Q

What is the mechanism for Diuretics

A

Decrease volume and preload

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3
Q

What are the therapeutics for Diuretics

A

Improve arterial distensibility; reduce preload

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4
Q

What are the important side effects for Diuretics

A

Causes neurohormonal activation

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5
Q

What are the miscellaneous for Diuretics

A

Contraindication in hypovolemic patients

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6
Q

What is the class for Bisoprolol, carvedilol, sustained release metoprolol

A

?-blockers

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7
Q

What is the mechanism for Bisoprolol, carvedilol, sustained release metoprolol

A

Blocks high circulating levels of catecholamines

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8
Q

What are the therapeutics for Bisoprolol, carvedilol, sustained release metoprolol

A

Dramatically decreases mortality in CHF patients

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9
Q

What are the miscellaneous for Bisoprolol, carvedilol, sustained release metoprolol

A

Should be started at very low dose and slowly ratchet up; do not stop suddenly

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10
Q

What is the class for Digoxin (Lanoxin)

A

Cardiac glycoside

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11
Q

What is the mechanism for Digoxin (Lanoxin)

A

Inhibits Na/K/ATPase (increases contractility d/t more Ca); increases vagal activity to heart (reduces SA firing rate, conduction through AV node)

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12
Q

What are the therapeutics for Digoxin (Lanoxin)

A

Improves LV function, decreases neurohormonal activation, increases vagal tone, normalizes arterial baroreceptors; decreases hospitalizations in CHF (no mortality benefit)

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13
Q

What are the important side effects for Digoxin (Lanoxin)

A

Very narrow therapeutic-toxic window (mostly arrhythmias)

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14
Q

What are the miscellaneous for Digoxin (Lanoxin)

A

Eliminated in kidneys, so dose according to renal function

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15
Q

What is the class for Dobutamine (Dobutrex)

A

?1 receptor agonist

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16
Q

What is the mechanism for Dobutamine (Dobutrex)

A

Positive inotrope and chronotrope

17
Q

What are the therapeutics for Dobutamine (Dobutrex)

A

Acutely decompensated patients (about half will die after 6 months)

18
Q

What are the important side effects for Dobutamine (Dobutrex)

A

Quick acting, but can develop tachyphylaxis after 48 hours

19
Q

What are the miscellaneous for Dobutamine (Dobutrex)

A

No NE release; given IV

20
Q

What is the class for Milrinone (Primacor)

A

Phosphodiesterase IIIa inhibitor

21
Q

What is the mechanism for Milrinone (Primacor)

A

Inhibits cAMP breakdown

22
Q

What are the therapeutics for Milrinone (Primacor)

A

Inotropy, chronotropy, lusitropy, vasodilation

23
Q

What are the important side effects for Milrinone (Primacor)

A

Increased hypotensive and atrial arrhythmia events acutely. 2 month mortality nearly 50% higher than placebo

24
Q

What are the miscellaneous for Milrinone (Primacor)

A

Given IV, depends on renal clearance, no tolerance after 72 hours

25
Q

What is the class for Nesiritide (Natrecor)

A

Synthetic BNP

26
Q

What are the therapeutics for Nesiritide (Natrecor)

A

Doesn’t really do much

27
Q

What are the miscellaneous for Nesiritide (Natrecor)

A

Given IV

U4 Drug table (7 decks)

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