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Flashcards in Heart Failure Treatment Deck (11):

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


which 3 β blockers decrease mortality in CHF

1. metoprolol
2. carvedilol
3. bisoprolol


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)


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


what metabolic abn can predispose to digoxin tox



treatment of digoxin tox

1. correct hypokalemia
2. Mg+ to help with bradyarrythmia
3. anti-digoxin Ab frag if very severe


2 indications for digoxin use

1. chronic heart failure
2. 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")

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


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

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