Question 7 Flashcards
1
Q
Beta Blockers
A
- reduce heart rate and cardiac output
- suppress renin activity
- reduce SNS system activity
2
Q
Beta Blockers MOA
A
Bind adrenergic receptors to prevent their activation. They also inhibit the sympathetic nervous system.
3
Q
2 categories of Beta Blockers
A
- Selective- bind beta 1 receptors
2. Non-selective- bind both beta 1 and 2 receptors
4
Q
Beta Blocker Recommendations
A
- prescribed to patients with stage c/NYHA class 1-4 HFrEF upon diagnosis.
- initiated at low doses
- long term treatment should be maintained and avoid abrupt withdrawal
- patient has history or current fluid retention, diuretics should be prescribed as well.
5
Q
Angiotensin Converting Enzyme Inhibitors (ACEis)
MOA & Examples
A
- suppresses the Raas system by blocking the formation of angiotensin II.
- this decreases vasoconstriction and the secretion of aldosterone.
- ex: enalapril
6
Q
ACEis Recommendations
A
- initiates at low doses and increases as tolerated.
- They’ve shown to reduce the risk of death and hospitalizations in patients w/ stage C/NYHA class 1-4 HFrEF
- ACEis have lower effects on BP in black patients.
7
Q
Angiotensin II Receptor Blocker (ARBs)
A
Decrease vasoconstriction and reabsorption of salt/water, which leads to decreased bp.
8
Q
ARB MOA and Example
A
- Block vasoconstrictor and aldosterone secreting effects of ang 2 by selectively blocking binding of ang 2 to AT1 receptor in tissues
- Ex: valsartan
9
Q
ARB Recommendations
A
- start at a low dose and titrate up
- recommended for patients w/ stage c/ NYHA class 1-4 HFrEF who are
- intolerant to ACE b/c of cough or angioedema
- already taking ARB for another condition
10
Q
Diuretics
A
- inhibit the reabsorption of sodium in renal tubules.
- this increases diuresis leading to reduced blood volume
11
Q
Different types of diuretics
A
loop
thiazide
potassium
12
Q
Diuretics recommendations
A
- can be added on to an ACE/ARB/BB
- recommended for patients w/fluid retention and fall in stage c/NYHA class 1-4 HFrEF
