mixed deck Flashcards
Losartan
a prodrug
a special ARB because extra action
Competitive antagonist of the thromboxane A2 receptor, attenuates platelet aggregation
*It increases uric acid urinary excration (uricosuric)
Name a couple Nitrates
Tridil & Nitroprusside
What is Milrinone?
A PDE inhibitor
short term IV use
long term use increases mortality in CHF!
What is Nesiritide?
a B type natriuretic peptide (nature’s diuretic)
What is Hydralazine?
an arterial vasodilator that effectively reduces afterload in CHF
side effects like promoting edema, drug induced lupus, and coronoary steal/reflex tach!!!! bad
limited to patients with renal insufficiency and angioedema who can’t use ACEI
What are spirinoloctone? Eplerenone?
The only diuretics which improve mortality rates at all
Potassium sparing diuretics
more importantly also ALDOSTERONE ANTAGONISTS
Loop diuretics?
Furosemide
Bumetanide
*diuretics decrease preload, do not affect outcome of CHF disease
Beta blockers in CHF
-> increase CO long term, decrease LV EDpressure long term
Beta blockers in CHF
- do improve outcome
-> increase CO long term, decrease LV EDpressure long term
contraindicated with: heart block, volume overload, bradycardia, decompensated CHF in which dobutamine is employed (opposite)
Which 3 Beta blockers are approved for CHF?
My big cat
- Metoprolol
- Bisoprolol
- Carvedilol
Atrial Natriuretic peptide and Brain type natriuretic peptide
reduces preload, inhibits RAAS release, inhibits Na reabs in prox tub, selectively afferent arteriolar vasodilation
- released by atria and ventricles in response to volume overload
- naturally elevated in CHF
- promotes vasodilation of arteries and venodilation and natriuresis!!
What is Nesiritide?
- recombinant human BNP
- reserved for class IV decompensated CHF in those who can’t use nitroglycerin IV
- reduces both preload and afterload
- increases GFR, decreases sodium reabs (natriuresis)
- supresses RAAS & sympathetic NS
