pharmacology: heart failure

Question 1

pharmacotherapy aimed at what in CHF?

Answer 1

decreased preload, decreased afterload, increased contractility, decreased remodeling

Question 2

which drugs decrease preload?

Answer 2

diuretics, ACEIs, ARBs, venodilators

Question 3

which drugs decrease afterload?

Answer 3

ACEIs, ARBs, arteriodilators

Question 4

which drugs increase contractility?

Answer 4

digoxin, beta agonists

Question 5

which drugs decrease remodeling of cardiac muscle?

Answer 5

ACEIs, ARBs, spironolactone, beta blockers

Question 6

digoxin mechanism

Answer 6

inhibits cardiac Na-K ATPase (causes increased Ca, increased Ca release from SR, increased actin-myosin interaction, increased contractile force)

also increased vagal activity (same mechanism on nerve terminals)

Question 7

digoxin uses

Answer 7

CHF and supraventricular tachycardias

Question 8

digoxin side effects

Answer 8

early signs: anorexia, nausea, EKG changes
later signs: disorientation, visual effects (halos), yellow-green distortion
toxic doses: cardiac arrhythmias

Question 9

how is management of digoxin toxicity managed?

Answer 9

Fab antibodies

Question 10

digoxin drug interactions?

Answer 10

diuretics: decreased K and Mg and increased Ca

quinidine and verapamil

Question 11

inamironone and milrinone mechanism

Answer 11

phosphodiesterase inhibitors (increased cAMP = increased inotropy and vasodilation)

Question 12

what are the sympathomimetics?

Answer 12

dobutamine and dopamine