heart failure drugs (broadhead)

Question 1

action of captopril

Answer 1

hypertension (RAAS), blocks production of aniotesnsin 1 causing arteriolar vasodilation, urinaty excretion of Na and H2O, urinary retention of K

Question 2

prototype ACE inhibitor

Answer 2

captopril (Capoten)

Question 3

indications of captopril

Answer 3

hypertension, heart failure, diabetic nephropathy, LV dysfunction following MI

Question 4

side effects of captopril

Answer 4

severe hypotension with 1st dose, dry, nonproductive cough due to increased bradykinin, rash, metallic taste, hyperkalemia, neutropenia

Question 5

adverse effects of captopril

Answer 5

blood dyscrasias, allergic reation, bronchospasm, angioedema

Question 6

containdications of captopril

Answer 6

pregnancy category D, K sparing diuretics, liver disease

Question 7

special considerations of captopril

Answer 7

monitor BP, monitor for cough, rash, and metallic taste, monitor LFTs, electrolytes and CBC

Question 8

action of losartan

Answer 8

Hypertension (RAAS), blocks angiotensin II receptors causeing arteriolar vasodilation, urinary excretion of NA and H2O and urinary retention of K

Question 9

indications of losartan

Answer 9

hypertension, prevents stroke (losartan only), manages diabetic nephropathy, treats heart failure, prevents migrane

Question 10

side effects of losartan

Answer 10

headache, insomnia, severe hypotension with 1st dose

Question 11

adverse effects of losartan

Answer 11

andioedema, CVA, renal failure, thrombocytopenia

Question 12

contraindications of losartan

Answer 12

pregnancy category D, children

Question 13

special considerations of losartan

Answer 13

monitor BP, report CNS effects, report fainting or dizziness

Question 14

actions phosphodiesterase inhibitors

Answer 14

increases contractility which increases force of contraction and cardiac output

Question 15

prototype ARB

Answer 15

losartan (Cozaar)

Question 16

prototype phosphodiesterase inhibitors

Answer 16

milrinone (Primacor)

Question 17

indications for milrinone

Answer 17

short term treatment of low cardiac output in heart failure

Question 18

side effects for milrinone

Answer 18

hypokalemia, cardiac dysrhythmias, hypotension, angina chest pain

Question 19

adverse effects for milrinone

Answer 19

dysrhythmias, hepatotoxicity, thrombocytopenia

Question 20

contraindications for milrinone

Answer 20

known sensitivity, aortic/pulmonary valve disorder, acute MI

Question 21

special considerations for milrinone

Answer 21

monitor fluid deficits and K, monitor vital signs, monitor chest pain, IV only meds, continuous cardiac monitoring

Question 22

prototypes for heart failure cardiac glycosides

Answer 22

digoxin (Lanoxin)

Question 23

actions for digoxin

Answer 23

positive inotrpoe, neg chronotropr, neg dromotrope; antidote is digoxin immune Fab (Digibind)

Question 24

indications for digoxin

Answer 24

maintenence therapy for heart failure, cardiac dysrhythmias

Question 25

side effects for digoxin

Answer 25

nausea, vomiting, anorexia, headache, visual disturbances, any dysrhythmia may occur

Question 26

adverse effects for digoxin

Answer 26

digoxin toxicity (green/yellow halos, confusion, ab pain, dysrhythmias)

Question 27

contraindications for digoxin

Answer 27

impaired renal functions, ventricular arrythmias

Question 28

special considerations for digoxin

Answer 28

monitor Lanoxin level, normal level 0.5 to 2.0 ng/mL, hypo kalemia potentiates Lanoxin toxicity, monitor for toxicity, take pulse for a full minute is

Question 29

prototype for heart failure K sparing diuretics

Answer 29

spironolactone (aldactone)

Question 30

action of spironolactone

Answer 30

blocks actions of aldosterone which increases excretion of Na, decreases excretion of K and small increases in excretion of water

Question 31

indications of spironolactone

Answer 31

hypertension, edema caused by heart failure, cirrhosis of the liver, nephrotic syndrome, hypokalemia

Question 32

side effects of spironolactone

Answer 32

hyperkalemia, menstrual irregularities, abnormal hair growth, deepining of voice may occur in women, gynecomastia

Question 33

adverse effects of spironolactone

Answer 33

bleeding, liver disease, agranulocytosis

Question 34

special considerations of spironolactone

Answer 34

monitor K levels, endocrine abnormalities, report palpations, avoid K supplements

Question 35

prototype for heart failure thiazide diuretics

Answer 35

hydrochlorothiazide (HydroDiurel)

Question 36

action of hydrochlorothiazide

Answer 36

blocks sodium and chloride resorption causing increased excretion of sodium and chloride increase excretion of water/output, increases excretion of potassium

Question 37

indications of hydrochlorothiazide

Answer 37

heart failure, hypertension, cirrhosis of the liver and renal failure

Question 38

side effects of hydrochlorothiazide

Answer 38

fluid and electrolyte imbalances, hyperglycemia, increased uric acid levels, hypokalemia, nausea, vomiting, diarrhea

Question 39

adverse effects of hydrochlorothiazide

Answer 39

hepatitis, uremia, agranulocytosis, neutropenia

Question 40

contraindications for hydrochlorothiazide

Answer 40

allergy to sulfa and thiazides, electrolyte imbalances

Question 41

special considerations for hydrochlorothiazide

Answer 41

monitor serum electrolytes, monitor uric acid levels, eat high K foods