Heart failure meds

Question 1

Beta Blockers (-lols)

Answer 1

MOA: Reverse remolding, inhibit SNS, reduce afterload and workload.

Side effects: bradycardia, low BP, dizziness, nausea, fatigue, shortness of breath, depression, sexual dysfunction.

Nursing implications: assess for bradycardia and hypotension, orthostatic hypotension especially in older adults, do not give if HR is <50-60 bpm and/or systolic BP is <90-100

Drugs: bisoprolol, carvedilol, metoprolol

Question 2

Diuretics (loop and k sparing)

Answer 2

MOA: increase fluid reabsorption in the kidneys, decrease fluid congestion, increase urine output.

First line drug for volume overload.

Side effects: orthostatic hypotension, loop=hypokalemia, k sparing=hyperkalemia, hypovolemic, dehydration, weakness, dizziness

Nursing implications: k sparing=decrease k intake, monitor for hyperkalemia, weakness, irregular pulse. loop=increase k intake, monitor for hypokalemia

Drugs:
loop=furosemide
thiazide= hydrochlorothiazide
k sparing=spironolactone

Question 3

Digoxin

Answer 3

MOA: increase contractility and myocardial absorption, alter k

Side effects: toxicity, dizziness, headache, slow HR, shortness of breath, electrolyte imbalances

Nursing implications: GI absorption so monitor for toxicity in older adults, monitor for renal excretion of drug, monitor for hypokalemia

Class: cardiac glycoside

Question 4

Vasodilators

Answer 4

MOA: reduce afterload, dilate arterioles of kidneys and increase perfusion and fluid loss.

Drugs: ACE inhibitors, ARBs

Question 5

ACE inhibitors (-prils)

Answer 5

MOA: prevent or reverse remolding, improve renal blood flow, dilate venules and arterioles

First line drug for HF

Side effects: hypotension, hyperkalemia

Nursing implications: monitor for hypotension, monitor hyperkalemia with renal dysfunction pts, do not give if systolic BP below 100

Drugs: captopril, enalapril

Question 6

ARBs (-sartans)

Answer 6

MOA: block angiotensin 2 receptors resulting in vasodilation.

Side effects: hypotension, hyperkalemia

Nursing implications: monitor for hypotension, monitor for hyperkalemia, pts avoid intake of k, do not give if systolic BP below 100

Drugs: losartan, candesartan