Module 5 CHF/HTN

Question 1

untreated htn can =

Answer 1

angina, CHF, MI, CKD, stroke

Question 2

blocking cardiac B1 receptors prevents sympathetic stimulation= decreased ___ and __

Answer 2

HR, Contracility

Question 3

blocking A1 receptors on blood vessels= vaso___= __peripheral resistance &___ return to heart

Answer 3

vasodilation = decreased peripheral resistance/ return to heart (preload)

Question 4

A1 block effect on renal tubules

Answer 4

^salt/water excretion= vBlood volume

Question 5

blocking B1 receptors on juxtaglomelular cells suppresses ___ release=v____= 3 effects

Answer 5

renin release=vAngiotensin2=
peripheral vasodilation
renal vasodilation
suppression of aldosterone-mediated volume expansion

Question 6

angiotensin converting enzyme inhibitors (ACE) effects

Answer 6

peripheral/renal vasodilation

suppression of aldosterone mediated volume expansion

Question 7

blocking aldosterone receptors in kidney promotes ____ excretion=___blood volume

Answer 7

sodium/water excretion= decreased blood volume

Question 8

(HTN) what medication should patients with renal disease take?
aa?
pregnant?

Answer 8

renal disease-take ace/arb (renal protective)
AA-diuretic (thiazide)/ ccb+bblocker (monotherapy less effective)
pregnant-methlydopa/labetolol

Question 9

CHF drugs

Answer 9

diuretic
RAAS inhibitors 
BB 
digoxin
dopamine
hydralazine

Question 10

RAAS inhibitors

Answer 10

ACE/ARB
Angio receptor-neprilysin inhibitors (ARNI)
(valsartan/sacubitril)
Aldosterone antagonist
Direct Renin inhibitors

Question 11

Beta blockers used for CHF

Answer 11

carvedilol
bisoprolol
metoprolol

Question 12

what symptomatic CHF drug is used if maxed out on Bblockers w HR >70

Answer 12

Ivabradine

Question 13

What role does digoxin/inotropes have in CHF treatment?

K/dig compete

Answer 13

^CO/Contractility
alter conduction (vNA/ATPase action)
favorable affect neurohormonal systems (
xxxxProlong life/ stop remodeling

Question 14

Cardiac drug for black patients only

Answer 14

isosorbide/dinitrate

Question 15

Stage A CHF tx

Stage B CHF tx

Answer 15

stage a- risk mgmt
stage B (remodeling w/o sx)- ACE/ARB
can add BB w vEF/MI hx

Question 16

Stage C CHF tx

Answer 16

(w sx)
diuretic
ACE/ARB
Aldosterone antagonist
BB
Dig
Isosorbide/hydralazine- BLACK pts

Question 17

Stage D CHF tx

Answer 17

(marked sx/structural changes)
heart transplant/mechanical valve assist
fluid: loop/thiazide, dopamine, dobutamine
palliative
NO B blockers!!!!