Flashcards in adrenergic 2 Deck (19)
Beta blocker, which is the most selective?
Beta blocker: which patients do you give it to?
1. Mild to severe symptoms of heart failure.
2. Systolic dysfunction of the left ventricle (EF<40%)
3. Receiving treatment with an ACE inhibitor and a diuretic
4. Any age and either sex.
5. CAD or nonischemic dilated cardiomyopathy.
6. Diabetic and nondiabetic
7. COPD without reactive airway disease.
use of 1 of 3 BB are proven to
reduce mortality. They are
bisoprolol, carvedilol, sustained release metoprolol succinate
These are recommended for all pt with current or prior symptoms of HFrEF to reduce morbidity and mortality
mechanism of neprilysin
degrades BNP to inactive fragments. BNP typically help against heart failure
Digoxin half life
1. age, renal, cardiac function dependent
2. 38 hours
when should Digoxin be considered
1. HF with reduced systolic function
2. HF with preserved systolic function
Digoxin toxicity causes
Digoxin: hypokalemia caused by
Results in increased digoxin binding increasing its therapeutic and toxic effects.
Digoxin: hypercalcemia caused by
Digoxin enhances Ca+2 absorption into cardiac myocytes, which is one of the ways it increases inotrophy.
This can also lead to Ca+2 overload and increased susceptibility to digitalis-induced arrhythmias.
Digoxin: hypomagnesemia caused by
Can sensitize the heart to digitalis-induced arrhythmias (includes any arrhythmia except supraventricular tachydysrhythmias).
digoxin can be beneficial in pt with
HFrEF to decrease hospitalizations for HF
Milrinone is a
1. phosphodiester type 3 inhibitor
2. found in vasculature and myocyte.
3. This causes a rise in cAMP and rise in Ca, so this can lead to increase in force of contraction but also increase afterload because it increases vasoconstriction because it also effects the vessels.
inotropic therapy drugs
1. B-1agonist to increase contractility,
2. slight peripheral vasodilation
ADHF short-term management - “Cold & wet”
dobutamine half life
dobutamine is recommended if