Drugs For HF Flashcards
What is digoxin? What effect does it have on the heart?
Digoxin is a cardiac glycoside that increases myocardial contractile force, and thus CO. The sympathetic tone declines, urine production increases, and renin release declines reversing s/s of HF.
What are benefits of digoxin?
Decreases HR and heart size, constriction of arterioles and veins decreases, water retention reverses, blood volume declines, peripheral and pulmonary edema decrease, and water weight is lost.
What drug interactions should be considered when using digoxin?
Thiazide and loop diuretics because the loss of potassium can increase the risk for digoxin induced dysrhythmias.
ACEIs and ARBs can increase potassium levels and decrease the therapeutic responses of digoxin.
What antidysrhythmic drug should be avoided when using digoxin because it causes toxicity?
Quinidine
Digoxin dose should be reduced 30-50% if this medication is added.
Amiodarone because it may increase the digoxin concentration
What harmful effects does aldosterone have on the heart?
It can cause myocardial fibrosis so there is an increased risk of dysrhythmias, and they promote vascular fibrosis.
How does ACEIs, ARBs, DRIs, and aldosterone antagonist affect the heart?
ACEIs, ARBs, and DRIs decrease aldosterone production. Spironolactone and Eplerenone block aldosterone receptors. Combination of an aldosterone antagonist with and ACEI or ARB can improve symptoms of HF.
**MONITOR POTASSIUM LEVEL!!
What cosmetic side effect does Spironolactone have in men?
Gynecomastia which can be intolerable and painful
What is stage C HF? What therapy is recommended with reduced EF?
Stage C HF is structural heart disease with prior or current symptoms of HF.
Therapy for routine use: diuretics for fluid retention, ACEI or ARB, beta blockers, aldosterone antagonists
Drugs for selected pts: Hydralazine/isosorbide dinitrate, ACEI and ARB, Digitalis
