Heart failure drugs

Question 1

Cause of heart failure

Answer 1

• coronary artery disease
• heart attack
• cardiomyopathy
• hig BP, thyroid, kidney, diabetes, defects

Question 2

S/S of heart failure

Answer 2

• dyspnea
• fatigue
• fluid retention
• pulmonary edema

Question 3

Progressive heart failure

Answer 3

• Left or right sided (left sided more common and usually causes right sided)
• reduced blood flow to the organs
• chronic renal failure (puts more stress on heart)

Question 4

ACE Inhibitors MOA

Answer 4

• ACE = angiotensin-converting enzyme
• block the enzyme that converts angiotensin I into II
• inhibit aldosterone
• decrease Na retention
• promote diuresis
• decrease preload

Question 5

ACE inhibitors also used for ___

Answer 5

hypertension and post MI to prevent the remodeling that can lead to HF

Question 6

Lisinopril and catropril drug class

Answer 6

ACE inhibitors (for HF)

Question 7

🧠 ACE inhibitor AE

Answer 7

• renal failure
• angioedema near airway (rare but life-threatening)
• fatigue, dizziness, HA, mood change, loss of taste
• hyperkalemia
• dry cough
• first dose hypotensive effect

Question 8

🧠 ACE inhibitor interactions

Answer 8

• NSAIDS reduce BP, risk for acute kidney failure
• other antihypertensives and diuretics
• lithium
• K supplements/ K sparing diuretics

Question 9

Angiotensin receptor blockers (ARB) MOA

Answer 9

• block angiotensin II
• potent vasoldilating effect
• decrease systemic vascular resistence (SVR)

Question 10

• Valsartan, Irbesartan, Losartan, and Candesartan classification

Answer 10

ARBs

Question 11

ARBs also used for ___

Answer 11

chronic kidney disease and prescribed after a heart attack

Question 12

Beta blockers MOA

Answer 12

• cardioprotective
• decrease HR
• delay AV conduction
• decrease contractility
• decrease automaticity

Question 13

Metoprolol and Carvedilol drug class

Answer 13

Beta-blockers (for HF)

Question 14

Cardvedilol precautions

Answer 14

nonselective
also a calcium channel blocker

Question 15

Hydralazine drug class

Answer 15

vasodilator

Question 16

Hydralazine precaution

Answer 16

monitor for Lupus (SLE)

Question 17

🧠Vasodilator precautions

Answer 17

• monitor neuro status (confusion, dizziness, syncope, hemorrhagic stroke)
• drastic BP changes
• elderly pt

Question 18

Milrinone (Primacor) classification and MOA

Answer 18

vasodilator
inotrope
Phosphodiesterase inhibitor (PDI, relaxes smooth muscle)
Increase Ca in the heart

Question 19

Milrinone (Primacor) contraindications

Answer 19

• allergy
• severe aortic/pulmonary valve disease
• HF from diastolic dysfunction

Question 20

Milrinone (Primacor) used for

Answer 20

short term treatment of acute HF in the ICU

Question 21

Milrinone (Primacor) AE

Answer 21

• hypokalemia
• hypertension
• angina
• tremor
• thrombocytopenia
• ventricular dysrhythmia

Question 22

Milrinone (Primacor) interactions

Answer 22

Diuretics (hypovolemia)
Digoxin (increased inotropic effects)

Question 23

🧠Digoxin and Lanoxin classification

Answer 23

Cardiac glycosides (digitalis glycosides)

Question 24

🧠Digoxin and Lanoxin used for

Answer 24

HF and a fib

Question 25

🧠Digoxin and Lanoxin MOA

Answer 25

positive inotropic (harder contraction for more filling to allow HR to slow) decreased conduction

Question 26

Digoxin and Lanoxin contraindications

Answer 26

- 2nd/3rd degree heart block - ventricular fib

Question 27

Digoxin and Lanoxin AE

Answer 27

- bradycardia - hypotension - HD, fatigue, confusion, convulsion - colored/halo vision - anorexia, N/V/D

Question 28

🧠Digoxin and Lanoxin toxicity

Answer 28

normal serum level is 0.5-2ng S/S include AE and heart block, atrial tachycardia, ventricular dysrhythmias

Question 29

🧠Digoxin and Lanoxin interactions

Answer 29

- Amiodarone - Quinidine - Verapamil - Dietary fiber (bran)🧠 - Herbal supplements - Drugs that cause low K and Mg

Question 30

🧠Digoxin and Lanoxin toxicity antidote

Answer 30

Digoxin immune fab (Digifab) or Digoxin-specific antibody (Digibind) used for hyperkalemia and life-threatening dysrhythmias or OD

Question 31

Digoxin and Lanoxin nursing precautions

Answer 31

- monitor electrolytes - digoxin levels - CNS effects - BP and apical - extra heart sounds - vision changes

Question 32

🧠Antihypertensives assessment

Answer 32

- Full exam, history - Vitals - EKG, - CBC, - basic metabolic panel (MBP) for electrolytes - cholesterol - LFT - Eye/retina exam (d/t the small blood vessels of the eye)

Question 33

🧠Antihypertensives education

Answer 33

- Don't stop taking abruptly to avoid rebound HTN (may cause stroke) - Impotence - Usually lifelong therapy

Question 34

🧠Digoxin and Lanoxin medication administration

Answer 34

PO IV (usually with a loading dose)