Heart Failure Treatment Flashcards
(11 cards)
What 4 drug classes have been proven to decrease mortality in CHF pt
- ACE inhibitors (-pril)
- ARBs (-sartans)
- Aldosterone antagonists (spronolactone)
- Certain β blockers
which 3 β blockers decrease mortality in CHF
- metoprolol
- carvedilol
- bisoprolol
What three drug classes only help with symptomatic relief in CHF
- Diuretics (loop and thiazide)
- Digoxin
- Vasodilators (nitrates and hydralazine)
*remember = nitrates are venodilators ( ↓ preload) and hydralazine is a arterial dilator ( ↓ afterload)
what is a classic sign of digoxin toxicity? what other two issues can it have
- blurry yellow vision*
- Cholinergic effects (vomiting, diarrhea)
- Bradycardia
- has very low TI so tox happens
what metabolic abn can predispose to digoxin tox
hypokalemia
treatment of digoxin tox
- correct hypokalemia
- Mg+ to help with bradyarrythmia
- anti-digoxin Ab frag if very severe
2 indications for digoxin use
- chronic heart failure
- a-fib ( ↓ cond. through AV node)
- NOT a first line tx
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
Tx for acute HF–> decompensating pt who is SOB and sometimes even foaming at the mouth b/c of pulmonary edema (“NO LIP”)
- Nitrates
- O2 (if hypoxemic)
- Loop Diuretics
- Inotropic drugs
- Position ⇒ get their legs down; decrease preload
- if asked on STEP, prob always say Loop for these situations, if no other options of above
What is inotropic agent given often times in acute heart failure tx
Dobutamine ( β1 > β2) agonist
why are beta blockers useful, even they would decrease HR and contactility potentially–> seems like a bad idea in HF where you already have shitty output
Reduce renin release due to β1 stimulation of kidney also
