CHF Drugs

Question 1

What drug classes can be used to treat CHF?

Answer 1

beta blockers, vasodilators, loop diuretics, ARBs, ACE inhibitors

Question 2

What are the inotropes used to treat CHF?

Answer 2

digoxin, inamrinone, milrinone, dobutamine

Question 3

Digoxin’s mechanism of action?

Answer 3

• inhibits Na/K ATPase –> increase in Ca2+, increase inotropy
• increases vagal stimulation –> decrease HR and AV conduction

Question 4

What plant is digoxin derived from?

Answer 4

foxglove plant

Question 5

With what electrolyte disturbance is digoxin toxicity increased?

Answer 5

hypokalemia

Question 6

Side effects of digoxin? Treatment?

Answer 6

-mental status, distorted color vision, decreased QT, increased PR, ST depression, arrhythmias
Tx: correct K/Mg deficiency, anti-digitalis antibodies (NEVER Calcium)

Question 7

What are inamrinone and milrinone used for in CHF? And why?

Answer 7

-short term CHF management –> given IV, increased morbidity and mortality with long-term use

Question 8

Mechanism of action for inamrinone and milrinone?

Answer 8

-decrease in PDE, decrease in cAMP –> arteriolar vasodilation, increase inotropy

Question 9

What is dobutamine used for in CHF? Drug class?

Answer 9

• used in terminal heart failure to increase cardiac output and less reflex tachycardia
• it’s a B1 and alpha1 agonist

Question 10

Side effects of using dobutamine?

Answer 10

PVT, sinus tachycardia, angina

• has to be given IV
• can also get desensitized/tolerant to it