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Pharm Unit 4 by Hans Kim > clinical case for cardiac > Flashcards

Flashcards in clinical case for cardiac Deck (15)
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1

heart failure is a progressive clinical syndrome that can result from any abnormality in cardiac pump function, what 2 functions are important?

1. impaired ventricular filling
2. impaired ventricular systolic function
--> result in impaired in cardiac

2

what is the numerical def of heart failure?

reduced ejection fraction less than 40%

3

3 main goals of heart failure management?

1. treat the underlying risk factors
2. slow progression of heart failure
3. prolong survival and quality of life

4

what is stage A?

1. at high risk for heart failure but without risk of structural heart dz or symptoms of heart failure
2. hypertension, atherosclerotic dz, diabetes

5

what drugs can be used for stage A?

ACEI, ARB, thiazide

6

how is stage B diff from stage A?

asymptomatic valvular disease

7

drug of choices for stage B?

beta blockers, ACEI

8

what is stage C?

1. structural heart dz with prior or current symptoms of heart failure
2. known structural heart dz and symptoms of heart failure

9

what are the drug of choices for stage C?

diuretics, ACEI, beta blockers, aldosterone antagonist, hydralazine/nitrate

10

what is stage D?

1. refractory heart failure requiring specialized intervention plus usual therapy
2. marked symptoms at rest despite maximum therapy. Recurrent hospitalization and unsafe discharge

11

what is ADHF?

acute decompensated heart failure

12

what are the 4 major drugs for ADHF?

1. diuretics (reduce preload)
2. inotropes (increase contractility)
3. vasodilators (reduce both preload and afterload)
4. natriuretic peptide

13

what are the 3 diuretics used for ADHF to reduce preload?

1. furosemide
2. bumetanide
3. torsemide

14

what are the 2 inotropes that can be used for ADHF to increase contractility?

1. dobutamine
2. milrinone

15

what are the vasodilators and natriuretic peptide that can be used for ADHF to reduce both preload and afterload?

1. nitroglycerin
2. nitroprusside
3. nesiritide