Vasodilators Flashcards
Vasodilators used for heart failure - 1 group, 1 drug combination, 1 drug
Angiotensin inhibitors (ACEIs + ARBs).
Hydralazine + isosorbide dinitrate.
Nesiritide.
Vasodilators - beneficial effects in heart failure
Reduces venous and arterial pressure which in turn decreases edema and cardiac afterload, and increases CO.
Additional benefit of using angiotensin inhibitors for heart failure
Slow or reverse the cardiac remodeling associated with angiotensin II
ACE inhibitors - indications
Diabetic nephropathy. Hypertension. Heart failure. Asymptomatic heart failure. Acute MI
ACE inhibitors - 7 drugs
Captopril Fosinopril Ramipril Enalapril Lisinopril Benezapril Quinapril
ACE inhibitors - effects
Reduced plasma volume, venous pressure, edema.
Increased CO by decreased arterial resistance and cardiac afterload.
Counteract ventricular remodeling.
Do ACE inhibitors improve survival in heart failure?
Yes
ARBs - 5 drugs
Candesartan Valsartan Irbesartan Losartan Talmisartan
ARBs - indications in heart failure
Pts who cannot tolerate ACE inhibitors.
Hydralazine + isosorbide dinitrate: why are they used together for heart failure
Isosorbide dinitrate relaxes venous smooth muscles, while hydralazine relaxes arterial smooth muscle.
Hydralazine + isosorbide dinitrate: effects
Reduced pre- and afterload.
Reduced venous pressure and edema.
Increased CO.
Hydralazine and isosorbide dinitrate is especially useful for
Pts with African heritage. ACE inhibitors are less effective for these pts, and its the other way around for caucasians.
Nesiritide - classification
Human B-type natriuretic peptide.
Nesiritide - indications
Acutely decompensated heart failure with dyspnea at rest/minimal activity.
Nesiritide - MOA
Binds guanylate cyclase receptors causing increased cGMP and dilation of arterial and venous smooth muscle.
