Adrenergic & Angiotensin Block in CHF

Question 1

Angiotensinogen is produced by the _________.

Answer 1

liver

Question 2

ACE inhibitors have an unfortunate common side effect: ___________.

Answer 2

coughing, especially at night, and commonly seen in Asian women

Question 3

Duration of action of the three main ACE inhibitors is ____________.

Answer 3

captopril

Question 4

Other side effects of ACE inhibitors are __________.

Answer 4

renal dysfunction, hyperkalemia, hypotension, angioedema, and neutropenia

Question 5

NSAIDs are contraindicated in patients with ____________.

Answer 5

congestive heart failure

Question 6

Drug interactions with ACE inhibitors include __________.

Answer 6

lithium, salt substitues, loop diuretics, and potassium-sparing diuretics

Question 7

Pregnant women should not be given _________.

Answer 7

ACE inhibitors

Question 8

ACE inhibitors reduce death by _______; they also reduce __________.

Answer 8

16%; hospitalizations

Question 9

Candesartan and losartan are dosed _______, while valsartan is dosed _______.

Answer 9

once daily; twice daily

Question 10

The -sartans are ___________.

Answer 10

ARBs (angiotensin II receptor blockers)

Question 11

The ARBs do not have the ___________ side effects.

Answer 11

cough or angioedema

Question 12

Combining ACE inhibitors with ARBs ___________ mortality.

Answer 12

does not; it does reduce incidence of events, but the benefits do not outweigh the risks

Question 13

ARBs are recommended for __________.

Answer 13

HFrEF patients who cannot tolerate ACE inhibitors

Question 14

Norepinephrine levels are _________ in CHF.

Answer 14

elevated (those with higher levels have lower survival probability)

Question 15

Why are ß-blockers given to those with CHF?

Answer 15

Because ß1 receptors are down-regulated, and giving small amounts of ß-blockers causes ß1 to increase, thus improving ejection fraction

Question 16

_________ is the most selective ß-blocker for ß1.

Answer 16

Nebivolol

Question 17

Patients have to receive __________ in addition to ß-blockers.

Answer 17

diuretics and ACE inhibitors (to pull off volume overload)

Question 18

If a patient has reactive airway disease and needs a ß-blocker, give them ___________.

Answer 18

bisoprolol

Question 19

Patients with ________ should not be given ß-blockers.

Answer 19

hypotension, bradycardia, or heart block

Question 20

Only three ß-blockers have been shown to improve mortality: ____________.

Answer 20

metoprolol, bisoprolol, and carvedilol

Question 21

Patients receiving ACEI should have their ___________ monitored.

Answer 21

Mg, Ca, BP, and CBC