CHF drugs Flashcards
(12 cards)
Furosemide
Class:
Diuretic
MOA:
Inhibit NKCC2 in thick ascending limb of Henle, rapid water and salt excretion
Clinical uses:
HTN, edema, hypercalcemia
Toxicity:
Hypokalemia, ototoxcitiy, dehydration
Notes:
Rapid onset
Lisinopril
Class:
ACE inhibitor
Other names:
Ramipril, enalapril, valsartan, captopril
MOA:
binds and deactivates ACE, decreases SNS and water and salt retention, decreasing after and preload
Clinical Uses
Stage 1/2 HTN, CHF, diabetic renal disease
Toxicity:
Hyperkalemia, teratogenic, bradykinin cough reflex
Notes:
Produces a persistent dry cough due to bradykinin metabolism, oral
Valsartan
Class:
Angiotensin receptor antagonist
Other names:
Telmesartan, olemsartan, valsartan, losartan
MOA:
selectively binds to angiotensin II type 1 (AT1) receptor
Clinical uses:
Stage 1/2 HTN, CHF
toxicity:
hyperkalemia, tetrogenic
Notes:
oral, no cough
Spironolactone
Class:
Aldosterone Receptor antagonist
Other names:
eplerenone
MOA:
Competitively blocks the actions of aldosterone
Clinical uses:
Hyperaldosteronism, CHF, HTN
toxicity:
hyperkalemia, endocrine effects
Notes:
used in combo with loop or thiazides to prevent hypokalemia, eplerone lacks anti-androngen effects
Metoprolol
Class:
beta blocker
Other:
Atenolol
MOA:
beta-1 selective antagonist
Clinical uses:
CHF, HTN, angina
Toxicity:
bradycardia, AV block, CNS sedation
notes:
Show to reduce mortality in HF patients, widely used for stage 1/2 HTN, less bronchial effects
Carvedilol
MOA:
Alpha 1 and beta non-selective antagonist
Other:
labetalol
Clinical uses:
HTN, CHF, angina
Toxicity:
bradycardia, AV block, CNS sedation, less bronchospasm
notes:
composed of 4 stereoisomers, show to reduce mortality in HF patients
Dobutamine
Class:
inotrope
MOA:
beta 1 selective agonist
Clinical uses:
Increase CO and BP in episodes of acute HF
Toxicity:
Tachycardia
Notes:
IV for acute decompensated heart failure, short duration (minutes)
Milrinone
Class:
Inotrope
Other names:
Primacor
MOA:
Phosphodiesterase-3 inhibitor, more activation of Gs pathway –> increased contractility
Clinical uses:
Acute decompensated heart failure
Toxicity:
Arrhythmia
Notes:
IV for acute decompensated heart failure, short duration
Digoxin
Class:
Inotrope
MOA:
Na/K ATPase inhibitor
Clinical uses:
CHF, arrhythmia,
Toxicity:
Arrhythmia, nausea, malaise, diarrhea, vision problems
Notes:
only approved cardiotonic agent, no net effect CHF mortality, low therapeutic index
Isosorbide Dinitrate
Class:
Vasodilators
other names:
Isordil Titradose
MOA:
Nitrovasodilator/ NO donor (cGMP)
clinical uses:
acute decompensated heart failure
toxicity:
tachycardia, hypotension
notes:
combined with hydralazine for HF
Sacubitril
Class:
Vasodilator
MOA:
Neprilysin inhibitor
(decreases ANP)
Clinical uses:
CHF
Toxicity:
Hyperkalemia, cough, hypotension,
Notes:
Combined with hydralazine for HF
Hydralzine
Class:
Vasodilator
Other names:
minoxidil
MOA:
Vascular K channel opener –> decreases RMP resulting in less activation via Ca
Clinical uses:
CHF, decreases afterload
Toxicity:
Tachycardia excessive hypotension, headache
notes:
oral, long duration of action, combined with isosorbide dinitrate for HF
