Heart Failure Drugs Flashcards
Heart Failure Pathophysiology
Preload: too much coming back to the heart
Afterload: pressure going out
Right-Sided Heart Failure
Blood backs up in periphery
Fatigue, increased peripheral venous pressure, ascites, enlarged liver and spleen, dependent edema, distended jugular veins
Left-Sided Heart Failure
Blood backs up into the lungs
First left-sided failure, then progresses to right
Restlessness, confusion, tachycardia, cyanosis, cough, crackles, wheezes
Brain Natriuretic Peptide
Should be < 100
> 500 is significant
Atrial Fibrillation
SA node fires but every cell in the heart sends impulses, atria quiver, and clots are more likely
Ventricular Fibrillation
No cardiac output
Tamponade
Heart bleeds into the pericardium
Drugs Used for Heart Failure
ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, positive inotropes, loop diuretics, aldosterone inhibitors
Spironolactone (Aldactone)
Aldosterone antagonist
Potassium-sparing diuretic and aldosterone antagonist shown to reduce the symptoms of heart failure
Don’t use with an ACE inhibitor due to increased potassium
B-Type Natriuretic Peptides
Short-term therapy due to causing EXTREME HYPOTENSION
Separate pump from IV
Used for decompensated heart failure
Only used as a final effort to treat severe, life-threatening heart failure
Digoxin (Lenoxin)
Cardiac glycoside used in heart failure and to control ventricular response to atrial fibrillation or flutter
IV push or PO
Digoxin levels must be between 0.5 and 2 nanograms/mL; take HR for a FULL MINUTE APICALLY
LOW POTASSIUM LEVELS INCREASE ITS TOXICITY
Digoxin Toxicity
COLORED VISION, HALO VISION, FLICKERING LIGHTS
ANOREXIA, NAUSEA, VOMITING, DIARRHEA
Use Fab (Digibind) therapy
Hydralazine/Isosorbide Dinitrate (BiDil)
APPROVED SPECIFICALLY FOR THE USE IN THE AFRICAN-AMERICAN POPULATION
Cardiac Glycosides Drug Effects
Increases myocardial activity; positive inotrope, negative chronotrope and negative dromotrope
PAROXYSMAL NOCTURNAL DYSPNEA
