Pharmacology of Drugs Used in Heart Failure

Question 1

What are the main drugs used in chronic heart failure?

Answer 1

Diuretics

Question 2

What is the MOA of digoxin?

Answer 2

Inhibits the Na/K ATPase to increase intracellular Ca2+ and heart contractility

Question 3

What is the MOA of milrinone?

Answer 3

PDE-3 inhibitor - this causes increased cAMP, increased activity of PKA, and finally increased Ca2+ influx

Question 4

What receptors mediate the negative chronotropic effect of digoxin?

Answer 4

M2 receptors

Question 5

How do ACE inhibitors (-pril) and angiotensin receptor blockers(-sartan) treat chronic heart failure?

Answer 5

Reduce preload and afterload

Question 6

What ADRs are associated with digoxin?

Answer 6

Tachycardia, arrhythmias

Question 7

How do diuretics, ACEIs, and ARBs reduce preload in chronic heart failure?

Answer 7

By reducing venous pressure through reduced salt and water rentention

Question 8

True/False. Non-cardiac drugs are more helpful in treating chronic heart failure.

Answer 8

True. Positive inotropic drugs are more helpful to treat acute heart failure.

Question 9

Dobutamine increases heart contractility in heart failure. In what other situation may it be used?

Answer 9

Hypotension

Question 10

What are the main cardiac actions of digoxin?

Answer 10

Positive inotropic effects (increased contraction force) and negative chronotropic effects (decreased HR)

Question 11

This drug acts as a beta 1 agonist to increase cardiac contractility.

Answer 11

Dobutamine