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Flashcards in Heart Failure Treatment Deck (11):
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

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

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