Misc. Cardiac Meds

Question 1

digoxin use and MOA

Answer 1

• used to tx symptomatic HFrEF
• inhibits Na+/K+ ATPase pump in myocardial cells
• ↑ intracellular sodium
• ↑ Ca2+ from Na+/Ca2+ exchange pump
• ↑ contractility

Question 2

what drug class does sacubitril/valsartan (Entresto) belong to?

Answer 2

• ARNI (angiotensin receptor-neprilysin inhibitor)

- used to tx symptomatic HFrEF

Question 3

Valsartan MOA

Answer 3

• ↓ vasoconstriction, aldosterone release

- also ↓ catecholamine release

Question 4

Sacubitril MOA

Answer 4

• inhibits neprilysin enzyme (which typically breaks down peptides)
• ↑natriuretic peptides
• ↑ vasodilation, diuresis, natriuresis, GFR

Question 5

ARNI AEs

Answer 5

same as ARBs but higher risk of angioedema

Question 6

what is good about the ARNI drug class?

Answer 6

Reduces mortality (even more than ACEi)

Question 7

what is amiodarone used for?

Answer 7

• ventricular arrhythmias

- can also be used for rhythm control in chronic atrial fibrillation

Question 8

amiodarone MOA

Answer 8

Prolong the duration of the action potential by blocking K+, Na+, and Ca2+ channels; also some beta-blocker activity

Question 9

amiodarone AEs

Answer 9

LFTs (liver), TFTs (TSH), PFTs (pulmonary), bluish discoloration

Question 10

therapeutic concerns about digoxin

Answer 10

• NTI
• toxicity (GI, CNS, cardiac)
• kidney function