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