Shared Flashcard Set

Details

Heart Failure Pharmacotherapy Overview
Heart Failure Pharmacotherapy Overview
28
Pharmacology
Professional
09/18/2012

Additional Pharmacology Flashcards

 


 

Cards

Term

What do patients with "congestive" heart failure receive what to reduce blood volume in order to reduce fluid retention and venous pressure?

Definition

Diuretics (primarily loop diuretics, such as furosemide)

Term

Along with diuretics, standard therapy for heart failure includes drugs that block the RAAS system. What class of drugs are these?

Definition
ACEIs, ARBs, Aldosterone antagonists
Term

Those with heart failure also receive drugs to block the SNS. What class of drugs are this?

Definition
Beta Blockers
Term
What enzyme converts angiotensinogen to angiotensin I?
Definition
renin
Term
What converts angiotensin I to angiotensin II?
Definition
angiotensin converting enzyme
Term
How do ACEIs work?
Definition
ACEI block ACE and prevent the conversion of ATI to ATII
Term
ARBs block what?
Definition
Block ATII directly at a receptor site on the smooth muscle wall of the vessel
Term
Blocking the RAAS system will do what phsiological systems?
Definition

Will relax and dilate blood vessels (vasodilation), making it easier on the heart to pump. This is called reducing afterload. These drugs also reduce blood volume and decrease preload.

 

Term
What is raised whilst on ACEIs and ARBs?
Definition

Increased potassium - which in many cases of heart failure is offset by the use of loop diuretics.

 

Term
How do beta blockers work?
Definition

Bind to beta receptors and block epinephrine and norepinephrine. Causes vasodilation, decreases HR and makes it easier for the heart to pump.

 

Term
Which beta blocker is commonly used for heart failure?
Definition
Metoprolol (Toprol XL &c.), it's beta-1 selective at typical doses.
Term
Name some aldosterone blockers?
Definition

spironolactone;

Eplerenone

Term
Brand name for spironolactone
Definition
Aldactone
Term
Brand name for eplerenone
Definition
Inspra
Term
When are aldosterone used in heart failure?
Definition

Advanced cases of heart failure (in addition to ACEIs, ARBs and beta blockers)

 

Term
Aldosterone blockers can decrease what and increase what?
Definition

Decrease: mortality

Increase: Potassium

Term
What is another agent used in advanced cases, especially black patients?
Definition
isosorbide dinitrate/hydralazine
Term
Brand name for isosorbide dinitrate/hydralazine?
Definition
BiDil
Term
Hydralazine and nitrates are what (phsiologically)?
Definition

arterial and venous dilators

 

Term
Bidil is contraindicated with what other drug?
Definition
PDE-5 inhibitors
Term
Digoxin is used for what?
Definition
symptom control and occasionally for arrhythmias
Term
What physiological effects does digoxin have on the heart?
Definition

Digoxin is a positive inotrope, which means it increases the force of the heart's contractions and is a negative chronotrope, which means it decreases heart rate

 

Term
What must patients on digoxin monitor?
Definition

Heart rate to make sure the rate does not get too low, which could indicate digoxin toxicity

Term
How is digoxin primarily cleared?
Definition

~85% renally cleared

 

Digoxin can become toxic with poor renal clearance

Term
Low levels of what can make digoxin toxic?
Definition

hypokalemia (low potassium)

 

Term
Digoxin toxicity can lead to what?
Definition
CNS effects, GI effects and arrhythmias
Term

Name some drugs that can worsen heart failure, and describe signs and symptoms of heart failure

Definition
[image]
Term
What are the classifications of heart failure?
Definition
[image]
Supporting users have an ad free experience!