pharm 10-15 CHF DRUGS

Question 1

Name the Drugs you use to treat

[ACUTE CHF]

and

ADHF (Acute Decompensated Chronic Heart Failure)

(6)

Answer 1

” BNP / FND” <–kinda rhymes

1. Furosemide
2. Nitrates (NTG and NitroPrusside)
3. Niseritide
4. Beta Adrenergic Agonist (Isoproterenol/Dopamine/Dobutamine/NorEpi)
5. Digoxin
6. Phosphodiesterase Inhibitors (Inamrinone / Milirone)

Question 2

Name the Drugs you use to treat [Chronic CHF] (5)

Answer 2

“smokin Chronic Bomb DADA”

1. Digoxin
2. Diuretics (Spironolactone and Eplerenone)
3. ACEk2 inhibitors
4. ARBs
5. Beta Adrenergic BLOCKERS (_C_arvedilol/_M_etoprolol/_B_ucindolol)

Question 3

Contraindications for using these drugs in [Acute CHF/ ADHF]

A: Beta Adrenergic Agnoist (2)

B: Digoxin (2)

Answer 3

A: Beta Adrenergic Agnoist:

Ventricular arrhythmias

severe PVD- peripheral vascular disease

B: Digoxin:

Ventricular arrhythmias

hypOkalemia

Question 4

Digoxin Adverse Effects (4)

Answer 4

• Arrhythmias;
• heart block;
• anorexia;
• N/V

Question 5

Phosphodiesterase Inhibitors

A: Cardiac related Indication

B: Side Effects (2)

Answer 5

A: ADHF

Acutely decompensated chronic CHF in hospitalized patients, (esp. if on beta blockers)

B:

• hypOtension (from vasoDilation)
• Arrhythmias

Question 6

A: Most common cause of CHF

B: Which Drug is best indicated for Reducing Afterload in [Acute CHF / ADHF] ?

B2: What will this do for the Dz process

Answer 6

Ischemic Cardiomyopathy

B: NitroPrusside –> Reduces Afterload —> INC Cardiac Ouput in a failing heart

Question 7

How does Diuretics affect preload during the tx of [Acute CHF/ADHF]? Is this bad or good?

Answer 7

Preload will DEC from using Diuretics in [Acute CHF/ADHF] BUT THIS HAS little effect on cardiac output!

So it’s ok to use them for DEC pulmonary edema/congestion

:-)

Question 8

Why are [Ca+ Channel Blockers] Contraindicated in Acute CHF?

Answer 8

[Ca+ Channel Blockers] have NEGATIVE INOTROPIC EFFECTS!

Question 9

A: Desired Systemic Effects of Digitalis Glycoside in CHF (3)

B: Why is this drug difficult to use?

C: Adverse Effects (3)

Answer 9

• Increased cardiac output
• Increased renal perfusion
• Decreased sympathetic tone (reduced HR and vasoconstriction)

B: VERY NARROW THERAPEUTIC WINDOW!

C:

(x) Abnormal automaticity ([Delayed Afterdepolarizations] /Tachy/Vtach)

Question 10

Digitalis Glycoside

Indication (2)

Answer 10

CHF and Atrial Fibrillation with rapid ventricular response (since it slows ventricular rate)

Question 11

Which Drugs prolong survival in Chronic CHF? (4)

Answer 11

• ACEk2 Inhibitors
• [Nitrates + Hydralazine]
• Beta Blockers (metoprolol, carvedilol)
• Aldosterone Blockers (spironolactone, eplerenone)