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Flashcards in HF rx Deck (20):
1

Specific HF Goals of Rx

1. Treat cause of HF
2. Elimination of precipitating factors
e.g. infection, anemia, etc
3. Reduction of congestion
4. Improve blood flow
a. Modulate neurohormal activation
b. Devices / transplantation

2

number one thing for heart failure is to

optimize patients on the frank starling curve, this means that you optimize their volume status

3

Regardless of HF Type,

give diuretics

4

Diuretics function to

Reverses fluid retention (Na loss)

5

diuretic: classes

1. Loop diuretics preferred due to potency
(furosemide [Lasix], torsemide, bumetanide, ethacrinic acid)
2. Can be augmented with a thiazide diuretic

6

what is the most common HF therapy?

diuretics

7

diuretic side effects

1. dehydration
2. hypokalemia
3. sulfa
4. tinnitis

8

ACE Inhibitors block

conversion of ATI to ATII

9

ACE inhibitor effects

Direct vasodilation
Decreased aldosterone activation
Other effects beyond ATII?

10

ARB effect

block receptor of angiotensin II

11

ARB clinical use:

In studies have been equivalent to ACEI
Controversial whether use in combination (ARB + ACEI) provides added benefit
Generally used when patients develop cough to ACEI

12

ARB side effects

1. ARBs do not produce kinin potentiation (no cough)
2. Otherwise side effects are similar to ACEI

13

MRA acts to

block mineralocorticoid receptor

14

MRA other effects

antifibrotic

15

MRA side effects

1. hyperkalemia (requires close monitoring)
2. gynecomastia (spiro only)

16

B blocker function is to

Antagonize effect of sypathetic system (epinephrine/norepinephrine)

17

B blockers block

B1 blockage
a1 blockade

18

B- blocker: B1 blockade results in

1. Negative chronotrope (slow heart rate, less arrhythmia)
2. Negative inotrope (decreased metabolic demand)

19

B blocker: a1 blockade results in

vasodilation

20

blocker side effects

1. Negative inotrope: short-term loss for long-term gain
a. Fluid retention
b. Hypotension
c. Decreased cardiac output, even cardiogenic shock
2. Bronchoconstriction