Pharmacology CHF Part 1 Flashcards
(49 cards)
heart failure occurs when…
cardiac output is inadequate to provide oxygen needed by the body
differentiate between HFrEF and HFpEF
HFrEF is SYSTOLIC FAILURE – reduced pumping and contractility of the heart (reduced ejection fraction)
HFpEF is DIASTOLIC FAILURE - not enough relaxation
(ejection fraction can normal – preserved ejection fraction - pEF)
4 primary signs and symptoms of all types of heart failure
tachycardia
SOB
cardiomegaly
decreased exercise tolerance
for a patient in CHF, why is a major symptom a fast heart rate?
because the heart is trying to compensate for the lack of cardiac output
in CHF, what happens to renal blood flow and what is the body’s response?
decreased renal blood flow
this causes the release of renin – resulting in angiotensin II formation and sympathetic discharge
causes increased force, rate, preload, afterload, etc – in order to restore cardiac output
name 2 classes of drugs used in acute heart failure
vasodilators and natriuretic peptide
**name 3 loop diuretics
furosemide
torsemide
bumetanide
where do loop diuretics work
in the thick ascending loop of henle
why are loop diuretics generally preferred over thiazides for heart failure
loop diuretics get rid of more fluid - the congestion
explain the MOA of loop diuretics
they block the sodium-potassium-chloride cotransporter in the thick ascending loop of henle
this enhances the excretion of sodium, potassium, and chloride, as well as lot of fluid
true or false
loop diuretics increase the preload on the heart
FALSE - decrease – by decreasing intravascular fluid volume
loop diuretics increase ___ and ____ delivery to the distal convoluted tubule
sodium and water
true or false
thiazide diuretics have limited value in CHF and loop diuretics are preferred
true
more GFR is delivered to the thick ascending loop of henle, so more fluid can be excreted
____ loss occurs more with loop diuretics than with thiazides
(what electrolyte?)
POTASSIUM
(can give with potassium sparing!)
true or false
in CHF patients, diuretics do NOT improve the mortality rate
TRUE
just like a “patch” on the bigger issue
they need other medication
true or false
furosemide can be used in pregnancy
FALSE - it cant
furosemide depletes what 4 electrolytes
hypokalemia (K+)
hyponatremia (Na+)
hypomagnesemia (Mg2+)
hypochloremia (Cl-)
“ELECTROLYTE WASHOUT”
furosemide and other loop diuretics cause metabolic alkalosis or acidosis??
alkalosis
true or false
furosemide can be used in patients with hyperkalemia
true
which food should NOT be given with loop diuretics like furosemide and why
licorice
enhances the hypokalemic effects
bc it enhances aldosterone - sodium retention and potassium loss
loop diuretic DDI with corticosteroids
more potassium loss and hyperglycemia
dofetilide interaction with loop diuretics
enhanced QT prolongation
aldosterone antagonists are also known as….
MRA’s (mineralocorticoid receptor antagonists)
aldosterone antagonists/mineralocorticoid receptor antagonists can be used to treat what 2 conditions
hypertension and CHF
