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40 Cards in this Set
- Front
- Back
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positive inotropes
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digoxin, inamrinone, lilrinone, dobutamine, dopamine
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categories of positive inotropes
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cardiac glycosides, bipyridine pdei, beta receptor stimulants
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cardic glycosides
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digoxin
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bipyridine pdei
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inamrinone, milrinone
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beta receptor stimulants
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dobutamine, dopamine
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MOA digoxin
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reversibly inhibits NA/K ATP ase
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MOA bipyridine pdei
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phosphodiesterase inhibitors
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MOA dobutamine, dopamine
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beta receptor activation leads to increased cAMP mediated calcium conduction
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cardiac effects digoxin
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increased intracellular Ca via uncoupling Na/Ca exchangeer induced Ca outflow, increased excitation
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Therapeutic use digoxin
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alleviates acute symptoms of CHF and progression to chf. Indicated if afib present
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SE digoxin
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narrow therapeutic window, conduction abnormalities, CNS, GI
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cardiac effects of inamrinone and lilrinone
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prevent breakdown of cAMP, increased PKA activity, increased calcium channel phosphorylation, increased calcium entry, increased contractility
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use of inamrinone and lilrinone
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IV acute heart failure, exacerbation of chronic heart failure (refractory CHF)
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tox of inamrinone
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same as digoxin plus nausea vomiting, bone marrow changes and liver tox
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tox of lilrinone
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less bone marrow and liver tox but does cause arrhythmias
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cardiac effects of dobutamine and dopamine
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sympathomimetic like increased intropy, concentration dependent effects
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use of dobutamine and dopamine
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acute management of refractory and end stage heart failure
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diuretics
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furosemide, bumetanide, torsemide, hydrochlorothiazide, sprinolactone
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MOA of sprinolactone
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aldosterone receptor antagonist, prevents sodium and water retention in renal nephron
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cardiac effects of furosemide, bumetanide, torsemide and hydrochlorothiazide
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reduces salt and water volume and thus preload reduces edema and cardiac size
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cardiac effects of sprinolactone
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reduces preload, k sparing good in combo with other diuretics. Anti aldosterone effects reducing remodeling of the heart
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use of furosemide and bumetanide
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first line therapy when edema is present
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use of torsemide and hydrochlorothiazide
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less effacacious that furosimide but similar effects. When preload reduction is important
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use of sprinolactone
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prophylactic for chf, reduces mortality
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which diuretic to use with digoxin
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sprinolactone, k sparing
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ace inhibitors
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prils
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cardiac effects of ace inhibitors
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decreases afterload, decreased preload, decreased sympathetic activity and reduces cardiac remodeling
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use of ace inhibitors
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prophylacticly for CHF, reduces mortality
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tox of ace inhibitors
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angiodema and cough (bradykinin)
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angiotensin II inhibitors
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sartans
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use of angiotensin II inhibitors
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if intolerant to ace inhibitors
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vasodilators
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hydralazine, minoxidil, nitroprusside, nitrates
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cardiac effects of hydralazine and minoxidil
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reduces afterload via arteriol dilation and remodeling
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cardiac effects of nitroprussides and nitrates
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reduces preload via vein and venule dilation
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use of hydralazine and minoxidil
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use in CHF when vent output and symptoms of fatigue are present or in severe CHF along with diuretics and digoxin
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use of nitroprussides and nitrates
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use in CHF when symptoms of pulmonary edema are not controlled with diuretics or when ACE I cannot be used
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ANP and BNP
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nesiritide
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nesitide cardiac effects
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reduce cardiac remodeling
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digoxin antibody
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digiband
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bet blockers
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metoprolol, carvedilol, bisoprolol
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