Txt MI: HF Drugs Flashcards
What type of drug is Captopril?
ACE inhibitor
ACE stands for Angiotensin-Converting Enzyme.
What is the mechanism of action of Captopril?
- Inhibits conversion of angiotensin I to angiotensin II, leading to vasodilation and decreased preload/afterload
- accumulation of bradykinin in the heart stimulates myocardial fibrinolysis that reduces cardiac remodeling, prolonging life of HF pts
What is the effect of bradykinin accumulation due to Captopril?
Stimulates myocardial fibrinolysis that reduces cardiac remodeling, prolonging life of HF pts
List three conditions Captopril is used for.
- Heart failure
- Post-MI remodeling
- Hypertension
What are some potential side effects of Captopril?
- Dry cough
- Angioedema
- Hyperkalemia
- Hypotension
cough is d/t bradykinin build up
Fill in the blank: Captopril should be used cautiously in patients with _______.
renal impairment or bilateral renal artery stenosis
What type of medication is Losartan?
Angiotensin Receptor Blocker (ARB)
angiotensin II receptor antagonists
What does Losartan block?
AT1 receptors
AT₁ (Angiotensin II Type 1) receptor
Blocking AT1 receptors prevents the action of angiotensin II.
What are the effects of blocking AT1 receptors?
AT₁ (Angiotensin II Type 1) receptor
Prevents angiotensin II–mediated vasoconstriction and aldosterone secretion
causes accumulation of bradykinin ftimulates myocardial fibrinolysis that reduces cardiac remodeling
This leads to decreased blood pressure and reduced fluid retention.
Which conditions is Losartan used to treat?
Heart failure, hypertension, post-MI remodeling
It is indicated for managing these cardiovascular conditions.
What side effects can occur with Losartan?
Dizziness and hyperkalemia
These are potential side effects associated with its use.
How does the incidence of cough with Losartan compare to ACE inhibitors?
Lower incidence of cough
This is a significant advantage over ACE inhibitors, which often cause cough.
What class of drug is Hydrochlorothiazide (HCTZ)?
Thiazide diuretic
Thiazide diuretics are commonly used to treat hypertension and fluid overload.
What is the mechanism of action of Hydrochlorothiazide (HCTZ)?
Inhibits Na⁺/Cl⁻ reabsorption in the distal convoluted tubule, reducing blood volume
This mechanism helps to lower blood pressure and reduce fluid retention.
What are the primary uses of Hydrochlorothiazide (HCTZ)?
First line diuretics for fluid overload in HF, usually combined with ACEI or ARB; hypertension
What electrolyte imbalances can Hydrochlorothiazide (HCTZ) lead to?
Hypokalemia, hyponatremia
and dehydration
What type of diuretic is Furosemide?
Loop diuretic
Furosemide is classified as a loop diuretic, which acts on the loop of Henle in the kidneys.
What does Furosemide inhibit in the kidneys?
Na⁺/K⁺/2Cl⁻ transporter in the thick ascending limb of the loop of Henle
This inhibition leads to reduced reabsorption of sodium, potassium, and chloride.
What is the effect of Furosemide on the heart and filling?
Reduces preload
By inhibiting the reabsorption of sodium and water, Furosemide decreases the volume of fluid returning to the heart.
What are the primary indications for Furosemide?
First line diuretics for fluid overload in HF, usually combined with ACEI or ARB; Acute decompensated heart failure, pulmonary edema
Furosemide is commonly used in patients with heart failure and fluid overload.
What are the risks associated with Furosemide use?
Electrolyte imbalances, dehydration, and ototoxicity
Monitoring of fluid and electrolyte status is essential to prevent these complications.
What is Eplerenone?
Aldosterone antagonist (K⁺ sparing)
How does Eplerenone work?
Blocks aldosterone receptors, reducing Na/H2O retention and myocardial fibrosis
therefore reducing edema and fibrosis by blocking aldosterone’s role in remodeling
What conditions is Eplerenone used to treat?
Heart failure post-MI, hypertension
What are the concerns associated with Eplerenone?
Hyperkalemia and renal impairment
Fill in the blank: Eplerenone is used in the management of _______ after myocardial infarction.
Heart failure
What is Tolvaptan?
Vasopressin (V2) receptor antagonist
What is the mechanism of action of Tolvaptan?
Blocks V2 receptors in the kidney, promoting free water excretion (aquaretic)
In which condition is Tolvaptan commonly used?
Heart failure with hyponatremia and volume overload
What are common side effects of Tolvaptan?
Thirst, polyuria, and possibly osmotic demyelination if Na raised too quickly
Fill in the blank: Tolvaptan is a _______ receptor antagonist.
Vasopressin (V2)
What type of drug is Metoprolol?
Selective β₁ blocker
What are the primary effects of Metoprolol?
Reduces heart rate and contractility, thereby decreasing myocardial oxygen demand
List three indications for Metoprolol use.
- Heart failure
- Post-MI angina
- Hypertension
What is a key consideration when dosing Metoprolol?
Carefully monitored to prevent heart failure
prevent worsening heart failure bc will cause it if too high
reduce sympathetic stress on failing heart
What are common side effects of Metoprolol?
- Bradycardia
- Hypotension
- Fatigue
True or False: Caution should be taken when prescribing Metoprolol to patients with conduction disorders.
True
What is Ivabradine also known as?
Corlanor
Ivabradine is marketed under the brand name Corlanor.
What type of channel does Ivabradine inhibit?
If channel
It’s a Na+/K+ channel blocker.
Ivabradine inhibits the ‘funny’ (If) current in the SA node.
What effect does Ivabradine have on heart rate?
Inhibits the “funny” (If) current in the SA node to reduce pacemaker activity (HR) without affecting contractility
In what condition is Ivabradine indicated?
Chronic heart failure with elevated resting heart rate
Ivabradine is used in patients with chronic heart failure who have a high resting heart rate.
What side effects can Ivabradine lead to?
Bradycardia and luminous phenomena (phosphenes) in your vision
Patients may experience bradycardia and visual disturbances known as phosphenes.
True or False: Ivabradine affects heart contractility.
False
Ivabradine reduces heart rate without impacting the strength of heart contractions.
What is Digoxin?
Cardiac glycoside
Digoxin is a medication used to treat heart conditions such as heart failure and atrial fibrillation.
What is the mechanism of action of Digoxin?
Inhibits Na⁺/K⁺ ATPase, increasing intracellular calcium to enhance contractility and slows AV nodal conduction
+intrope
-chronotrope
This mechanism leads to an increase in cardiac output and helps in maintaining tissue perfusion.
What are the effects of Digoxin on heart function?
positive intrope effect and negative chronotropic effect
The positive inotropic effect increases the force of heart contractions, while the negative chronotropic effect decreases heart rate.
What conditions is Digoxin used to treat?
- Heart failure
- Atrial fibrillation
Digoxin is commonly prescribed to manage these heart conditions.
What is a key safety consideration when using Digoxin?
Narrow therapeutic index; monitor for signs of toxicity
Toxicity can manifest as arrhythmias, gastrointestinal upset, and visual disturbances.
What should be regularly checked when a patient is on Digoxin?
Serum levels regularly
Monitoring serum levels helps prevent toxicity due to its narrow therapeutic index.
What is Entresto?
Entresto is a combination drug containing Sacubitril and Valsartan.
What is the role of Sacubitril as part of Entresto?
Sacubitril is a neprilysin inhibitor.
inhibits neprilysin (preventing breakdown of natriuretic peptides)
What is the role of Valsartan in Entresto?
Valsartan blocks AT1 receptors.
Angiotensin 2 Type 1 receptors
How do Sacubitril and Valsartan work together?
They reduce preload and afterload.
What condition is Entresto primarily used to treat?
Heart failure with reduced ejection fraction (HFrEF).
What are the risks associated with Entresto?
Risk of hypotension, hyperkalemia, and renal impairment.
With which type of medication is Entresto contraindicated?
ACE inhibitors.
What should be monitored when a patient is on Entresto?
Blood pressure.
