Heart Failure Drugs

Question 1

Symptoms of Left side HF

Answer 1

Decreased CO and increased pulmonary pressure

Question 2

Symptoms of right side HF

Answer 2

fluid retention, pitting edema, hepatic congestion

Question 3

To treat passive congestion due to backward HF

Answer 3

Give a diuretic to decrease fluid retention

Question 4

To treat forward symptoms of HF

Answer 4

Give sympathomimetics and digoxin to increase contractility

Also need beta blockers, ACE inhibitors and ARBs to decrease workload on the heart

Question 5

Drugs to decrease preload in HF patients

Answer 5

Diuretics, ACEI, ARB

Question 6

Drugs to decrease afterload in HF patients

Answer 6

ACEI and ARB

Question 7

Drugs to increase contractility in HF

Answer 7

Digoxin and beta agonists

Question 8

Initial treatment for HF patients

Answer 8

Diuretic and ACEI and early addition of beta blocker

Question 9

ACEI + ARB + spiranolactone

Answer 9

Causes hyperkalemia

Contraindicated

Question 10

Thiazolidinediones in HF

Answer 10

Can worsen HF

Contraindicated

Question 11

Ca channel blockers in HF

Answer 11

decreases CO more

Contraindicated

Question 12

NSAIDs and COX-2 inhibitors in HF

Answer 12

Worsens renal function

Contraindicated

Question 13

Digoxin

Answer 13

Inhibition of Na/K ATPase, increases intracellular Ca and increases contractile force

Question 14

What monitoring is needed with digoxin

Answer 14

Digoxin levels and potassium levels as hypokalemia can increase digoxin toxicity

Question 15

Early symptoms of digoxin toxicity

Answer 15

Nausea/Vomiting, diarrhea, anorexia

Question 16

Late symptoms of digoxin toxicity

Answer 16

Disorientation and visual disturbances

Question 17

How to manage digoxin toxicity

Answer 17

Fab antibodies

Question 18

What electrolyte imbalances can increase digoxin toxicity

Answer 18

Hyperkalemia, hypomagnesia and hypercalcemia

Question 19

What diuretics to use in HF

Answer 19

loop diuretics

Question 20

First line treatment for pulmonary hypertension

Answer 20

Oral calcium channel blockers and treatment of underlying disorder

Question 21

Milrinone

Answer 21

Can be used to treat acute HF

Causes arterial dilation and increased CMP, which increases contractility

Question 22

Nesiritide

Answer 22

Acts like BNP–arterial and venous dilation and increased natriuresis