Heart Failure Drugs

Front 1

Inotropic Drugs

Back 1

Digoxin

Dobutamine

Dopamine

Milrinone

Front 2

RAAS Drugs

Back 2

Captopril

Enalaprilat

Losartan

Spironolactone

Front 3

Diuretics

Back 3

Furosemide

Thiazides

Front 4

B-blockers

Back 4

Metoprolol

Carvedilol

Front 5

Vasodilators

Back 5

Nitrates

Hydralazine

Nesiritide

Front 6

MoA of Digoxin

Back 6

Inhibit the Na/K ATPase pump which leads to an increased force of contraction of the myocardium, decreased AP duration, and an increase in vascular tone in arterial and venous vessels;
Bradycardial actions result from :
1. stimulation of vagal nucleus,
2. direct depression of SA & AV node,
3. compensation of cardiac insufficiency

Front 7

AE of Digoxin

Back 7

Cardiac ARRHYTHMIAS; anorexia, nausea, vomiting, diarrhea, abdominal pain;
Other: visual disturbances (diplopia, blurred vision, green-yellow halos around bright objects); gynecomastias

Front 8

CI of Digoxin

Back 8

Hypertrophic cardiomyopathy, diastolic dysfunction, COPD-induced hypoxia, WPW, ventricular arrhythmias, MI, hypothyroidism

Front 9

Therapeutic Uses of Digoxin

Back 9

Acute and chronic systolic heart failure; atrial flutter, fibrillation, and tachycardia

Front 10

MoA of Dopamine

Back 10

@ low doses - activation of D1;
@ intermediate doses - activation of B1 & B2, release of NORE;
@ high doses - activation of a1 & D2;
**undergoes tolerance**
RoA: IV

Front 11

Therapeutic Uses of Dopamine

Back 11

Acute decompensated heart failure, cardiogenic shock, neurogenic & septic shock (especially useful when there is poor renal perfusion)

Front 12

MoA of Dobutamine

Back 12

Selective activation of B1 adrenoceptors; higher doses may also cause activation of B2 and a1 adrenoceptors
**undergoes tolerance**
RoA: IV

Front 13

Therapeutic Uses of Dobutamine

Back 13

Acute decompensated heart failure or cardiogenic shock when left ventricular function is severely depressed

Front 14

MoA of Milrinone

Back 14

Inhibition of phosphodiesterase3 which leads to increase in cAMP which results in a positive inotropic effect and peripheral vasodilation
RoA: IV

Front 15

AE of Milrinone

Back 15

Dose-related hypotension, syncope; ventricular arrhythmias; thromobcytopenia

Front 16

Therapeutic Uses of Milrinone

Back 16

Acute decompensated heart failure or cardiogenic shock in patients who did not respond adequately to other therapies; never used as long-term therapy and primarily used as last resort

Front 17

MoA of Nesiritide

Back 17

Recombinant ANP which activates guanylyl and increases synthesis of cGMP leading to increased diuresis and arteriolar/venous vasodilation
RoA: IV

Front 18

Therapeutic Uses of Nesiritide

Back 18

Acute decompensated heart failure; not recommended for long-term use; AE include excessive hypotension and life-threatening renal failure