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27 Cards in this Set
- Front
- Back
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ACE Inhibitors
1) MOA 2)CU 3)AE 4)Contra |
1)block conversion of AT1 to AT2
dec afterload -> dec vasc resistance, dec BP, inc CO dec Na and H20 retention -> dec preload dec long term remodeling of heart 2)First Choice for CHF 3) Persistent Dry Cough d/t Bradykinin; Angioedema, Postural Hypotension 4)Pregnant |
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Angiotensin 2 Antagonist
1)MOA 2)CU 3)AE 4)Contra |
1)competitive anatagonist of angiotensin receptors
2)give if cant tolerate ACE inhib (the cough, or angioedema) 3)Do not effect bradykinin 4)Pregnant |
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B- Blockers
1)MOA 2)Contra |
1)Negative inotropic effects
Inhibits NE -> reverse cardiac remodeling Dec HR and inhibits Renin 2)Acute Heart Failure d/t negative inotropic effects 2) |
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Diuretics
1) What 2 groups of diuretics would you use to treat CHF 2) Should you use diuretics by themselves to treat CHF? |
1) Loop and Thiazides
2) No, there is no mortality benefit with diuretics alone. Must be combined with another treatment for CHF |
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Direct Vasodilators
1)MOA 2)When would you use them? 3)How would you use them |
1)vasodilation ->dec preload
arterial dilation ->dec afterload 2)Use in patients intolerant to ace or beta blockers 3)Need to use the combo of hydralazine and Isosorbide dinitrite |
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Spironolactone
1)MOA 2)When would you use? 3)AE |
1)Aldosterone antagonist ->prevents Na retention and myocardial hypertrophy
2)Advanced cases of CHF 3)endocrine probs (gynecomastia, dec libido, menstrual probs, hyperkalemia) |
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Digoxin
1)MOA 2)Effects at Toxic Dose |
1) inhibits Na/K ATPase -> inc Na in cell ->less driving force for Ca/Na exchanger (norm pumps Ca out and Na in) -> inc Ca in cell
-dec sympathetics and dec TPR -inc Vagal tone on SA/AV node -> dec HR and dec O2 demand, dec AV node conductance -baroreceptor sensitization -> inc afferent inhib activity which dec SNS and dec renin-angiotensin activity 2) Inc refractory period through AV node -> arrhythmia, tachy, fib |
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Digoxin
1) AE on CNS 2) AE, drug toxicity with which drugs 3) Contra |
1)hallucinations, confusion, vision changes with halos on dark objects
2)Quinidine, Verapamil, Amiodarone -> because they displace digoxin from binding sites -> inc plasma conc of digoxin 3)patients with Diastolic, or RHF, Uncontrolled HTN. bradyarrhythmias |
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Captopril
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ACE Inhibitor
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Enalapril
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ACE Inhibitor
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Lisinopril
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ACE Inhibitor
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Carvedilol
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Non selective B clocker
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Metoprolol
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B1 Selective Blocker
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Propranolol
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DONT USE FOR HEART FAILURE
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Hydralazine
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Direct Vasodilator
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Isosorbide dinitrite
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Direct Vasodilator
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Spironolactone
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Aldosterone Antagonist
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Losartan
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Angiotensin 2 Receptor Antagonist
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Valsartan
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Angiotensin 2 Receptor Antagonist
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Dobutamine
1)MOA 2)CU |
1)a1,b1,b2 Agonist -> inc cAMP and inc Ca ->inc contractility
NO EFFECT on HR (dont know why) 2) Inotropic agent for Acute Heart Failure |
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Amrinone
1)MOA 2)CU |
1)Phosphodiesterase 3 inhibitor -> inc cAMP and inc Ca -> inc contractility, and cause arterial and venous vasodilation
2)Inotropic Agent used in Acute HF |
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Milrinone
1)MOA 2)CU |
1)Phosphodiesterase 3 inhibitor -> inc cAMP and inc Ca -> inc contractility, and cause arterial and venous vasodilation
2)Inotropic Agent used in Acute HF |
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Dopamine
1)MOA at low dose 2)MOA at intermediate dose 3)MOA at high dose 4)CU |
1)acts on Dopamine Receptors
d1->dilates renal blood vessels 2)acts on B1 receptors ->inc force and rate of contraction, and inc renin release 3)act on A1 receptors ->inc force of contraction 4)Inotrope for Acute HF |
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Glucagon
1)MOA 2)CU |
1)Inc cAMP and Ca ->Inc contractility
2)used in patients with acute cardiac dysfunction d/t B blocker overdose |
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First Choice for CHF
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ACE Inhibitors
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What to give if cant tolerate ACE Inhibitor side effects?
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Angiotensin 2 Antagonists
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What do you give for the most advanced Heart Failure Cases?
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Spironolactone because the most advance cases have Increased Aldosterone, and this drug antagonizes it
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