Pharmacology - Chapter 47 - Drugs for Heart Failure Flashcards
What are some complications of Heart Failure (CHF)? (4)
Ventricular dysfunction, reduced cardiac output, insufficient tissue perfusion, fluid retention.
What are some major causes of heart failure? (6)
Chronic Hypertension, Myocardial Infarction, Valvular Disease, Coronary Artery Disease, Congenital Heart Disease, Aging of Myocardium.
What are some early symptoms of Heart Failure? (5)
Fatigue, Shortness of Breath, Venous Distention, Peripheral Edema, Pulmonary Edema
Cardiac remodeling - what is it?
After initial heart failure, the heart undergoes remodeling, where ventricles enlarge and become more spherical, which puts more strain on the heart.
Remodeling is mediated by….(3)
Renin-angiotensin system, cardiac fibrosis and myocyte death, decline in heart function.
Reduced Cardiac Output leads to…(4)
Cardiac dilation, activation of sympathetic nervous system, activation of renin-angiotensin system, and retention of water and expansion of blood volume.
Excessive heart rate leads to….(2)
Reduced ventricular filling, excessive arterial pressure, which can cause pulmonary and peripheral edema.
Classification of Heart Failure Severity - How many are there?
4 - Class 1, 2, 3, 4.
Describe the classes of heart failure severity -
1 - No limitation of ordinary physical activity.
2 - Slight limitation of physical activity; normal activity produces fatigue, angina, etc.
3 - Marked limitation of physical activity; mild activity produces symptoms.
4 - symptoms occur at rest.
What are some therapeutic goals for treating Heart Failure? (4_
Relief of pulmonary and peripheral congestive symptoms, improvement of functional capacity, improvement in quality of life, prolongation of life expectancy.
What are some non-drug therapy options for heart failure?
Limit salt intake, reduce calories, bed rest, avoid alcohol and excessive fluids, etc.
Drug Therapy for Treating Heart Failure? (Some..)
ACE inhibitors, nitrates, diuretics, etc.
Vasodilators/Ace Inhibitors - Drugs that dilate veins ___ venous pressure. This ___ venous return and cardiac filling, which decreases ventricular stretching and cardiac 02 demand. Also ___ pulmonary congestion and peripheral edema.
Decrease.
Decreases.
Decreases.
Vasodilators/Ace Inhibitors - reduce cardiac ___ and allows stroke volume and cardiac output to ____. By ____ cardiac output and dilating arterioles in the kidney, these drugs ___ renal perfusion and promote loss of fluid.
afterload.
increase.
increasing.
increase.
Heart Failure & Diuretics - ___ ___ drugs for patients with signs of volume overload. By reducing blood volume, these drugs decrease ___ ____, arterial pressure, pulmonary edema, peripheral edema, and cardiac dilation.
First line.
venous pressure.
