Heart Failure Medications

Question 1

Digoxin MOA

Answer 1

Inhibits Na/K+ ATPase. Prevents outward current of Na+. Na+/Ca+ exchanger works instead resulting in an influx of Ca+ and increased cardiac contractility

Question 2

Digoxin “accessory” MOA

Answer 2

Direct vagal stimulation. Acts as an anti-arrhythmic agent

Question 3

Does Digoxin cause hyper or hypokalemia?

Answer 3

Hyperkalemia

Question 4

Digoxin adverse effects

Answer 4

Arrhythmia's
Concave ST segments
Bradycardia (via vegas)
Heart block (AV node)
GI issues
Visual disturbances

Question 5

Digoxin toxicity antidote?

Answer 5

Fab

Question 6

What does digoxin treat?

Answer 6

Chronic systolic heart failure

Question 7

What does Milrinone and Nesiritide treat?

Answer 7

Acute heart failure

Question 8

Milrinone MOA

Answer 8

Inhibition of phosphodiesterase, increased cAMP, and increased cardiac contractility. `

Question 9

Milrinone effect on the heart?

Answer 9

Arteriolar dilation and decreased afterload

Question 10

Nesiritide MOA

Answer 10

Synthetic BNP that increases cGMP.

Question 11

Nesiritide effect on the heart?

Answer 11

Arteriolar and venous dilation resulting in reduced afterload and preload.

Question 12

Explain renin

Answer 12

Renin is synthesized, stored, and released by the JGA. It converts angiotensinogen to angiotensin 1.

Question 13

Explain ACE

Answer 13

ACE is located in vascular endothelium of the lungs. ACE converts angiotensinogen I to angiotensinogen II

Question 14

Effects of Angiotensinogen II

Answer 14

Vasoconstriction
Increased GFR by constricting the efferent arteriole.
Increased sodium/bicarbonate reabsorption at the PCT.
Causes release of aldosterone.

Question 15

Effects of Aldosterone

Answer 15

Increased Na+ and H2O retention.

Increased K+ excretion

Question 16

ACE-Inhibitors names?

Answer 16

All end in -pril

Question 17

ACE-Inhibitors MOA

Answer 17

Prevents the conversion of Ang-I to Ang-II.

Overall decreased pressor effects of Ang-II

Question 18

Do ACE-Inhibitors increase or decrease Creatinine?

Answer 18

Increase

Question 19

ACE-I adverse effects?

Answer 19

Hypotension
Hyperkalemia
Dry cough
Teratogenic

Question 20

ACE-I are used to treat?

Answer 20

Heart failure
Decreased cardiac remodeling
MI
Hypertension
Slow progression of diabetic neuropathy

Question 21

ACE-I contraindication

Answer 21

Hereditary angioedema
NSAID use
Bilateral renal stenosis

Question 22

ARB MOA

Answer 22

ARBs block the angiotensin receptors

Question 23

Aliskiren MOA

Answer 23

Direct renin inhibitor