PHARMACOTHERAPY

Question 1

decrease Na and Cl reabsorption

reduce volume overload

furosemide
bumetanide
torsemide

Answer 1

loop diuretics

Question 2

this drug breaks down NPs?

Answer 2

neprilysin

Question 3

this drug is converted to an active neprilysin inhibitor leading to more NP activity?

Answer 3

sacubitril

Question 4

this drug is an angiotensin receptor blocker?

this inhibits vasoconstriction and hormonal effects of the RAAS?

Answer 4

valsartan

reduced primary composite end point of:
cardiovascular death
heart failure hospitalization
all cause mortality

Question 5

ace inhibitors reduce the risk of?

Answer 5

death and hospitalization in patients with HFrEF

Question 6

contraindications to ARNI, ACE inhibitor, ARB then we use?

what should we watch for?

Answer 6

nitrates and hydralazine

hypotension
hyperkalemia
worsening renal fxn
angioedema

Question 7

BBs limit the following effects of sympathetic activation in heart failure how?

Answer 7

elevated heart rate and dysrhythmias

increased myocardial energy demands

adverse remodeling due to cardiac myocyte hypertrophy and death

Question 8

beta blocker CI?

Answer 8

symptomatic bradycardia
advanced HF
cardiogenic shock
active bronchospasm
low blood pressure

Question 9

initial therapy for HFrEF?

secondary therapy?

Answer 9

diuretic
angiotensin system blocker
beta blockers

mineralocorticoid receptor antagonists

dapagliflozin

ivabradine

hydralazine + nitrates

digoxin

Question 10

these block the effects of aldosterone and increase the secretion of water and sodium, while decreasing the excretion of potassium

spironolactone
eplerenone

Answer 10

MRA

mineralocorticoid receptor antagonists

Question 11

lowers glucose levels by increasing urinary glucose excretion

induces diuresis in diabetics and non diabetics leads to reduce preload

promotes vasodilation and improves cardiac efficiency

isosorbide and hydralazine

Answer 11

SGLT2 inhibitor: Dapagliflozin

indictions: HFrEF and elevated BNP

Question 12

inhibits Na-K-ATPase pump in myocardial cells
-augment intracellular Ca and increases inotropy

antiadrenergic effect

upregulates parasympathetic tone

studies have shown less hear failure admissions

Answer 12

digoxin

Question 13

inhibitor of pacemaker activity within SA node

approved for patients who have stable HFrEF and resting HR 70 on maximally tolerates BB?

• reduction in CV death or HF hospitalization
• improves LV function
• improves QOL

Answer 13

Ivabradine