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Pharm II MHM - FINAL > Chronic HF > Flashcards

Flashcards in Chronic HF Deck (45)
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1

Heart Failure:

inability to provide enough oxygenated blood to the rest of the body

2

Risk factors for chronic heart failure

HTN
Male
Valve disorder
Pregnancy
Smoking
Rx Drugs
Alcohol/drugs
pericarditis
hyperthyroidism
DM
obesity

3

Presentation of chronic heart failure

SOB
Edema-peripheral/pulm
DOE
Orthopenia
Ascites
Hepatomegaly
heart murmurs

4

Describe systolic heart failure

-problem with ejection of blood to the lungs or systemic circulation
-result of hypertrophy and dilation of ventricle
-EF less than 40

5

Describe diastolic heart failure

-inability of the heart to fill appropriately
-results from stiffness of the myocardium
-more difficult to treat
-EF >55%

6

What is MC systolic or diastolic heart failure?

Systolic

7

What class is more effective in HF?

Loop Diuretics

8

Beta blockers to treat heart failure?

Metoprolol succinate
bisprolol
carvedilol

9

MOA BB?

blockage of beta receptors lead to decrease heart rate, decrease BP, increase coronary artery blood flow

10

BB indications (stages)

Can be used in stages A and B
Should be used in stage C

11

ADE BB

bradycardia
worse HF if dose is too high
respiratory issues

12

ACE I/ARB names

lisinopril
prils-sartans

13

ACE I/ARBS MOA

interference with RAAS ending with disrupting angiostensin II, produce decrease BP, Sodium/H2O retention, after load reducer

14

ACE I/ARBS indications

all stages of HF
goal dose is needed to max mortality/morbidity benefit

15

What meds are used in ALL stages of heart failure?

ACE I/ARBs

16

ADE ACE I/ARBsCI

ADE: hyperkalemia, cough, hypotension
CI: prego, hyperkalemia-K greater than 5.0, bilateral renal artery stenosis, angioedema

17

ACE I/ARBs excreted in the:

Kidneys

18

Spironolactone Eplirione

Aldosterone blockers

19

MOA spironlactone/eplirione?

compete w/aldosterone for intracellular mineralcortocoid receptor causing Na/H2O to excrete which decreases preload

20

Aldosterone blockers in indicated for which stages of HF?

C and D HF

21

ADE aldosterone blockers

hyperkalemia
gynecomastia
CI: hyperkalemia

22

Are aldosterone blockers protein bound?Where are they excreted?

Yes, Highly
Kidneys

23

Vasodilator drugs

hydralazine
isosorbide dinitrate

24

hydralazine MOA

direct arterial vasodilator- coronary, cerebral and renal arteries
HA (hydralzaine arterial)

25

Isosorbide dinitrate MOA

direct venodilator - convert into NO for vasodilation

26

Vasodilators are indicated for what patients?

African American pts with stage C HF (along w/ ACE, BB etc)
used in B/C/D HF
Not CI to ACE I
Any race!

27

ADE of vasodilators

Tolerance to nitrates
hypotension
CI: not really excreted

28

Are vasodilators dosed multiple times a day?

Yes so they have bad compliance

29

What are the Loop Diuretics?

Furosemide
butmetanide
torsemide

30

Whats the MOA of Loops?

Exert action at loop of henle
increases Na + H2O excreted
reduces preload and edema