Heart Failure Drugs

Question 1

spironolactone effects

Answer 1

K+ sparing diuretic - blunts ability of aldosterone to promote Na+/k+ exchange

Question 2

spironolactone MOA

Answer 2

competitive antagonist of aldosterone receptors

Question 3

spironolactone clinical app

Answer 3

• counteracts K+ loss induced by other diuretics - tx of primary aldosteronism

Question 4

toxicities of spironolactone

Answer 4

• hyperkalemia - amenorrhea, hirsutism, gynecomastia, impotence

Question 5

furosemide MOA

Answer 5

blocks NaKCCl2 transporter in thick ascending loop

Question 6

furosemide effects

Answer 6

increased excretion of water, sodium, potassium, chloride, magnesium, Ca2+

Question 7

furosemide clinical app

Answer 7

• edema - decreases preload - rapid dyspnea relief - HTN - ACUTE DECOMPENSATED HEART FAILURE

Question 8

toxicities of furosemide

Answer 8

• hypokalemia - hyponatremia - hypocalcemia - hypomagnesemia - hyperglycemia - hyperuricemia

Question 9

hydrochlorothiazide MOA

Answer 9

blocks Na/Cl cotransporter in distal convoluted tubule

Question 10

hydrochlorothiazide effects

Answer 10

increases urinary excretion of sodium and water, potassium, and magnesium

Question 11

hydrochlorothiazide clinical app

Answer 11

• HTN - edema

Question 12

toxicities of hydrochlorothiazide

Answer 12

• orthostatic hypotension - hypokalemia - hypomagnesemia - hyponatremia - hypochloric metabolic alkalosis

Question 13

digoxin MOA

Answer 13

inhibits Na/K ATPase in myocardial cells

Question 14

digoxin effects

Answer 14

• suppression of AV conduction - increased contractility - positive inotropic event but decreased ventricular rate

Question 15

digoxin clinical app

Answer 15

control of ventricular respones rate in chronic atrial fib - heart failure

Question 16

toxicities of digoxin

Answer 16

• hyperkalemia - accelerated junctional rhythm - asystole - atrial tach - heart block - dizziness, mental disturbances, HA, confusion - rash - N/V/D - blurred or yellow vision

Question 17

aliskiren

Answer 17

blocks renin

Question 18

ARBs

Answer 18

aldosterone receptor blockers

Question 19

ACE inhibitors cause what sx by maintaining bradykinin in the body

Answer 19

• vasodilation - decrease in GFR - cough - inflammation

Question 20

ACE inhibitors lead to less angiotensin II, the effect of these inhibitors is:

Answer 20

• less vasoconstriction (decreased afterload) - less aldosterone secretion so less water retention (decreased preload) - decreased cell proliferation and remodeling

Question 21

Losartan

Answer 21

angiotensin II receptor antagonist

Question 22

Captopril

Answer 22

ACE inhibitor

Question 23

effects of captopril

Answer 23

• lowers angiotensin II levels –> increased renin activity and decreased aldosterone secretion - lowers BP

Question 24

toxicities of captopril

Answer 24

• cough - hypotension - HA - angioedema

Question 25

effects of Losartan

Answer 25

- inhibition of RAAS - blocks vasoconstriction and aldosterone secretion effects of angiotensin II

Question 26

toxicities of Losartan

Answer 26

- effects common in pts with diabetic neuropathy - hypotension - fatigue, dizziness, fever - cough

Question 27

valsartan/sacubitril

Answer 27

inhibits neutral endopeptidase --\> prolongs natriuretic peptides --\> increased vasodilation

Question 28

toxicities of valsartan/sacubitril

Answer 28

- hypotension - hyperkalemia - increased serum creatinine

Question 29

carvedilol

Answer 29

beta blocker - nonselective beta and alpha adrenergic blocker with no intrinsic sympathomimetic activity

Question 30

toxicities of carvedilol

Answer 30

- hypotension - bradycardia - syncope - AV block - cough

Question 31

carvedilol should only be administered to _____ pts

Answer 31

clinically stable pts

Question 32

pts with left ventricular systolic dysfunction caused by MI should be give ____ with carvedilol

Answer 32

ACE inhibitors

Question 33

ivabradine MOA

Answer 33

inhibition of HCN channels and funny channels in SA node

Question 34

ivabradine clinical app

Answer 34

tx of resting tachycardia

Question 35

toxicities of ivabradine

Answer 35

- bradycardia - hypertension - increased risk a fib - heart block