Transition Heart Failure

Question 1

Pioglitazone (Actos)

Answer 1

Antidiabetic
BBx: fluid retention & Heart failure

Question 2

EF

Answer 2

Ejection Fraction
Amount of blood pumped by Left Ventricle

Question 3

reduced EF indicates

Answer 3

Reduced ability of left ventricle to do its job

Reduced cardiac output and left ventricular function

Question 4

Normal EF

Answer 4

60-70%

Question 5

EF percentage means

Answer 5

The percentage of blood that is pumped out of the left ventricle with each heart beat

Question 6

Pioglitazone (brand name)

Answer 6

Actos

Question 7

Glitzies do what

Answer 7

Increase the uptake of glucose into cells (adipose, skel msc, liver)

Gets glucose out of the blood

No effect on insulin

Often in combo with Metformin

Question 8

Glitzies BBx

Answer 8

Heart Failure & Fluid retention

Question 9

Vasotec (generic)

Answer 9

Enalapril

Question 10

Enalapril MOA

Answer 10

ACE Inhibitor

Prevent Angiotensin 1 from being converted to Angiotensin 2

Causes systemic vasodilation by blocking the production of Angiotensin 2 which is a vasoconstrictor

Decrease Aldosterone

Increase sodium and water excretion through tubules

Reduce Preload and Afterload

Question 11

First Dose Effect

Answer 11

Sudden drop in BP after first taking ACE -Is

Question 12

Labs to monitor for Furosemide

Answer 12

Electrolytes (may dcrs):
- Sodium
- Potassium
- Magnesium

Serum Glucose: can become hypERglycemia

Question 13

Carvedilol

Answer 13

Beta Blocker

Reduce cardiac stimulation from catecholamines

Ease workload of the heart, how hard it’s working

Catecholamine stimulation on the heart can increase rate, incrs conduction and contractility - this all stresses a failing heart - bad news

Question 14

Which condition is contraindicated for Carvedilol: Angina, Asthma, Glaucoma, or Hypertension

Answer 14

Asthma

It is a non-selective Alpha and Beta blocker causing bronchoconstriction in the lungs to worsen

Question 15

Digoxin MOA

Answer 15

Increases cardiac contractility and cardiac output

Positive Inotropic medication

Cardiac Glycoside

Does this by increasing the calcium in the myocytes via inhibiting cAMP - calcium causes muscle contraction - therefore cardiac muscle beats more effectively

Question 16

Which finding indicates possibility of Digoxin toxicity?

Dig lvl 1.6
Sodium 139
Apical HR 64
Potasium 2.2

Answer 16

K+

dig does not cause low K+

But if has low K+ = dig can be toxic

Question 17

MAWDS

Answer 17

Meds
Activity
Weight
Diet
Symptoms

Take meds exactly as prescribed - call doc if any problem, don’t skip

Activity as tolerated

Weigh in morning, daily, same clothes - trending up prob

High potassium, fluid restriction (1500-1800ml)