Flashcards in Heart Failure Treatment Deck (11)
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1
What 4 drug classes have been proven to decrease mortality in CHF pt
1. ACE inhibitors (-pril)
2. ARBs (-sartans)
3. Aldosterone antagonists (spronolactone)
4. Certain β blockers
2
which 3 β blockers decrease mortality in CHF
1. metoprolol
2. carvedilol
3. bisoprolol
3
What three drug classes only help with symptomatic relief in CHF
1. Diuretics (loop and thiazide)
2. Digoxin
3. Vasodilators (nitrates and hydralazine)
*remember = nitrates are venodilators ( ↓ preload) and hydralazine is a arterial dilator ( ↓ afterload)
4
what is a classic sign of digoxin toxicity? what other two issues can it have
1. blurry yellow vision*
2. Cholinergic effects (vomiting, diarrhea)
3. Bradycardia
* has very low TI so tox happens
5
what metabolic abn can predispose to digoxin tox
hypokalemia
6
treatment of digoxin tox
1. correct hypokalemia
2. Mg+ to help with bradyarrythmia
3. anti-digoxin Ab frag if very severe
7
2 indications for digoxin use
1. chronic heart failure
2. a-fib ( ↓ cond. through AV node)
* NOT a first line tx
8
which diuretics are the go-to for pulmonary edema
Loop diuretics⇒ these are "heavy duty", so used for mod. to severe HF; thiazides are not as potent, but useful for mild cases
9
Tx for acute HF--> decompensating pt who is SOB and sometimes even foaming at the mouth b/c of pulmonary edema ("NO LIP")
1. Nitrates
2. O2 (if hypoxemic)
3. Loop Diuretics
4. Inotropic drugs
5. Position ⇒ get their legs down; decrease preload
* if asked on STEP, prob always say Loop for these situations, if no other options of above
10
What is inotropic agent given often times in acute heart failure tx
Dobutamine ( β1 > β2) agonist
11
