CV Drugs Flashcards
What are positive inotropes used in heart failure?
Digoxin, Dobutamine, Dopamine, Milrinone
What kind of drug is Dopamine?
It is a Beta adrenergic agonist that stimulates release of catecholamines.
What are the indications for Dopamine?
Acute Heart Failure when the patient has normal afterload and decreased CO
What are the different effects of Dopamine based on dosage?
At low doses (2-5) it affects dopamine and beta receptors. At doses greater than 6 it causes tachycardia without increased isotropy (so it only increases oxygen consumption).
At higher doses than 10 the afterload increases due to effects on alpha receptors (vasoconstriction)
What is the mechanism of Dobutamine?
What is it indicated for?
What are side effects of Dobutamine?
It is a B1 agonist and week B2 agonist. It increases contractility with minor vasodilatory effects.
It is indicated for acute heart failure when afterload is normal.
The side effects include arrhythmia, angina, hypertension and tachycardia.
What is the mechanism of Milrinone?
What is it indicated for?
What are the side effects of Milrinone?
It is a phosphodiesterase inhibitor that inhibits catabolism of cAMP to AMP. Increased cAMP causes an increase in Calcium which increases contractility. It also has vasodilator properties. Milrinone is an inodilator.
It is indicated for acute heart failure when afterload is normal.
The side effects of Milrinone are arrhythmia and tachycardia and hypotension (attenuate by withholding bolus)
What is the mechanism of Nitroglycerin?
What is it indicated for?
What are the side effects of Nitroglycerin?
Primarily a venodilator that decreases filling pressures at low doses. Arterial vasodilator at high doses that decreases SVR and increases CO.
Used for acute heart failure. Can be given oral or IV.
Side effects include headache, hypotension, tachyphylaxis, and 20% are non responders.
What is the mechanism of Nitroprusside?
What is it indicated for?
What are the side effects of Nitroprusside?
Balanced vasodilator that decreases filling pressure, SVR, PVR and increases CO.
Used for acute heart failure.
S/E include Cyanide toxicity (Nausea/feeling weird) and accumulation of thiocyanate (chronic use/impaired renal fxn)
