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13 Cards in this Set

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Which groups of drugs should always be used in CHF, if not contraindicated?
-diuretic
-beta blocker(blunts the effects of activated sympathetic system)
-ACEI
-aldosterone antagonists:pt with mod.to sev.HF+reduced EF
Beta blockers proven effective in HF
-metoprolol
-carvedilol
-bisoprolol
Beta blockers in CHF adverse effects/precautions
-worsen HF,fluid retention
-bradycardia esp.w.CCB+amio
-carvedilol: take with food
-bronchoconstriction(esp.coreg
-Ophthamic BB increase effect
-fluoxetine,paroxetine inhibit metabolism of metoprolol,carvedilol
-worsen BG
Treatment of CHF with beta blockers
-start when pt. stable
-start at lower doses
-increase dose no more than every 2 weeks
-adjust diuretic dose if edema occurs
-dont' take at the same time as ACEI or diuretic to reduce chance of hypo
Brand: Inspra
generic: eplerenone
Digoxin facts in CHF
-does not improve survival
-improves symptoms
-positive inotropic
Digoxin Side Effects
-bradycardia/arrhythmia
-changes in vision(yellow,blurred)
-loss of appetite
-N/V/D
-disorientation,confusion
Digoxin toxicity
-occurs at levels >2 ng/mL (desired levels 0.5-1ng/mL)
-If pt. hypokalemic or hypomagnesemic,then toxicity more common(diuretics!!)
Brand:Intropin
generic: dopamine
Brand:Dobutex
generic: dobutamine
Brand:Primacor
Generic:Milrinone
Brand: Nipride
generic: nitroprusside
Brand: Natrecor
generic: nesiritide