Chapter 20: Drugs for HF + other stuff

Question 1

What signs and symptoms are a primary result of in acute heart failure?

Answer 1

pulmonary edema due to elevated LEFT cardiac output

Question 2

What is a new onset of AHFS is tachycardia due to?

Answer 2

Strong sympathetic response

Question 3

What are 4 non-drug treatments for HF

Answer 3

Reduce sodium—DASH DIET
Fluid restrictions (2-3L)
Weight management (BMI)
Exercise

Question 4

What drug improves contractility and pumping ability of the heart. It increases force of contraction by inhibiting sodium, potassium, adenosine triphosphate. Calcium enters the cell In exchange for sodium, which increases contractility

Answer 4

Digoxin

Question 5

When do you not give Digoxin?

Answer 5

If heart rate is less than 60 do not give.

Question 6

What do Inotropes (Cardiac Glycosides) indirectly stimulate?

Answer 6

Vagus Nerve

Question 7

What is first-line drug for those those first diagnosed with HF- cardiac function

Answer 7

Inotropes (Cardiac Glycosides)

Question 8

When are Inotropes (Cardiac Glycosides) contraindicated? (4)

Answer 8

patients with severe myocarditis, ventricular tachycardia, ventricular fibrillation

Question 9

What is the therapeutic serum digoxin level is ***??? in Inotropes (Cardiac Glycosides)

Answer 9

0.8-2.0ng/mL

Question 10

What is a drug that increases CO and decreases preload?

Answer 10

Thiazide diuretic:

Question 11

With what drug do you want to weigh patient daily?

Answer 11

Loop diuretics

Question 12

What drug decreases edema in patients with HF?

Answer 12

Aldosterone Antagonist- potassium sparing diuretic

Question 13

What drug blocks conversion of angiotensin 1 to production of angiotensin 2?

Answer 13

Angiotensin Converting Enzyme (ACE)

Enalapril (Vasotec)

Question 14

What drug suppress the SNS and the resulting catecholamine excess that eventually damages myocardial cells

Answer 14

Beta blockers

Question 15

What drug causes vasodilation by exerting direct relaxant effect on vascular smooth muscle, decreasing both preload and afterload

Answer 15

Cardiotonic- Ionotropic Agents

Prototype: Milrinone lactate (Primacor)

Question 16

What drug in low doses it is not a beta 2 adrenergic drug, but if given in increased doses, it can cause bronchoconstriction.

Answer 16

Beta blockers

Question 17

What drug reduces myocardial beta receptors reduces cardiac output?

Answer 17

Beta blockers

Question 18

What drug’s prototype is Losartan potassium (Cozzar)

Answer 18

ARBs (Angiotensin 2 Receptor Blocker)

Question 19

What is one drug not compatible with other medications?

Answer 19

Cardiotonic- Ionotropic Agents

Question 20

What is Atenolol?

Answer 20

Beta blocker: beta 1 selective (cardioselective), beta adrenergic blocker, cardioselectivity is diminished at higher doses, where it inhibits beta 2 in bronchial and vascular musculature

Question 21

What do you give if a patient presents without signs and symptoms of heart failure but has cardiac changes that place patient at risk for heart failure—

Answer 21

treat with ACE or ARB!!!

implantable defibrillator if indicated, avoid alcohol and smoking

Question 22

What do you do if:  Patient presents without signs or symptoms but is at high risk for developing HF?

Answer 22

— treatment of hypertension with ACE or ARB, control blood sugar, stop smoking, avoid alcohol

Question 23

What drugs should NOT be used if:  Patient presents with symptoms of HF, most commonly including dyspnea, fatigue, peripheral edema-

Answer 23

Nonsteroidal anti-inflammatory agents and calcium channel blockers should NOT be used.

sodium restriction, alcohol avoidance and smoking cessation, treatment with ACE and beta blockers, ARBS.