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Flashcards in Heart failure drugs Deck (12):

Diuretics, ACE inhibitors, vasodilators - what do they do to help?

Reduce afterload on the heart (ie the resistance to blood being pushed out)
Donkey analogy: reducing the number of sacks on the wagon


ACE inhibitors - examples and side effects

Lisinopril, enalapril, perindopril, ramipril
Renal failure, cough


Angiotensin II antagonist - examples and side effects

Losartan, valsartan, candesartan, irbesartan
Renal failure


Diuretics - examples and side effects

Loop diuretics:
• Frusemide, bumetanide
• Dehydration, rashes
Thiazide diuretics:
• Bendrofluazide, indapamide, metalozone
• Renal impairment
Should not be on a loop diuretic and a thiazide diuretic
Aldosterone antagonists:
• Spironolactone, eplerenone
• Dehydration, hyperkalaemia, renal failure, gnaecomastia



Often used in acute heart failure alongside diuretics
Beneficial especially in patients who can't have ACE inhibitors due to renal failure


Beta blockers - what do they do to help?

Block adrenaline receptors to control heart rate and reduce workload and O2 requirement
Donkey analogy: limit donkey's speed thus saving energy
Prolong life


Beta blockers - examples and side effects

Carvedilol, bisoprolol, metoprolol
Fatigue, exacerbation of asthma, cold peripheries, impotence



Slows heart rate via inhibition of funny channel


Positive inotropes - what do they do to help

Make the heart work harder
Donkey analogy: carrot in front of the donkey


Positive inotropes - examples and side effects

Digoxin only one used
Some GI effects, some drowsiness, dizziness


Resynchronisation therapy

New idea
Increase efficiency
Criteria: LBBB, NYHA III or IV, EF <35%, uptitrated medications
Basically, intraventricular activation of contraction to allow ventricals to contract together in an organised way → improved active filling


Left ventricular assist device

New idea
Bridge gap to transplantation
Complications: infection, device failure, bleeding, thromboembolism, RV failure
Pump connected to heart and aorta via an inflow and outflow cannula, a driveline that exits the skin on the right and a system controller that is typically worn on a belt.
Note: continuous flow - no pulse or blood pressure