Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
What are the classes of drugs used treat CHF?
|
Diuretics
Ionotropics - digoxin, dobutamine, dopamine ACE inhibitors Vasodilators Beta Blockers Phosphodiesterase inhibitors |
|
|
What is the MOA of digoxin?
|
its direct effect is not increase contractility
It inhibits the Na/K ATPase which increases the intracellular Calcium |
|
|
What are effects that digoxin have on an EKG in therapeutic doses?
|
No QRS changes
Increased PR interval Shortened QT |
|
|
What are the effects of digoxin in CHF?
|
increases contractility
increases CO decreases venous pressure and heart size decreases HR decreases oxygen demand decreaases TPR and BP |
|
|
What are the pharmacokinetics of digoxin?
|
important to know because of the low theraputic index
incomplete absorption, renal excretion t1/2 betwen 1.5 - 1.7 days PO and IV administration |
|
|
What are the therapeutic uses for Digoxin?
|
CHF
decrease AV conduction in Atrial flutter and fibrilation |
|
|
What are the adverse effects of digoxin?
|
arrhythmia
GI Visual CNS |
|
|
What factors enhance digoxin toxicity?
|
hypokalemia
renal failure hypercalcemia hypothyroidism acidosis |
|
|
What are some drug interactions to be be aware of with digoxin?
|
diuretics
Quinidine and Verapamil sympathomimetics - all increase effects Cholestyramine, colestipol - decrease effects |
|
|
How do you treat digoxin toxicity?
|
discontinue
-If K is low - discontinue diuretics that deplete potassium, administer potassium lidocaine, phenytoin atropine - antiarythmatics Digibind - Ab for digoxin |
|
|
What are the effects of Dobutamine on CHF?
|
mixed adrenergic agonist
it increase contractility administer IV for CHF |
|
|
What are the effects of Dopamine on CHF?
|
vasodilator and has a positive inotropic effect on the heart
administer IV for acut CHF |
|
|
What are the effects of vasodiators in the treatment of CHF?
|
Venodilators decrease preload which decreases edema
Arteriodilators decrease afterload and improves CO |
|
|
What are the effects of Nitroprusside on CHF?
|
venous and arterial dialation
balanced effects on preload and afterload increase in CO |
|
|
What are the effects of Nitroglycerin on CHF?
|
Venodilation
low doses - decreases preload and edema high doses - decreases afterload to maintain CO |
|
|
What is combined with Nitroglycerin to decrease mortality?
|
hydralazine
|
|
|
What are the effects of hydralazine on CHF?
|
arteriodilator
decreases afterload, increases CO |
|
|
What are the effects of ACEI's/ ATR antagonists on CHF?
|
decreases afterload and preload
decreases mortality associated with CHF |
|
|
What are the effects of Nesiritide on CHF?
|
recombinant peptide
used to treat acute decompressed CHF |
|
|
What are the effects of type III PDE inhibitors on CHF?
|
They increase cAMP, which increases contractility and CO
Milrinone and Inamrinone are used for short term IV treatment of severe refractory CHF |
|
|
What diuretic combinations should be used to treat CHF?
|
thiazides and loops with spironolactone
|
|
|
What are the effects of beta blockers on CHF?
|
metoprolo and bisprolol - moderate CHF
carvedilol is more effective in severe CHF Risk benefit situation with beta blockers and CHF |
