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15 Cards in this Set
- Front
- Back
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Digoxin
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MOA: increases calcium availability
+ inotrope - dromtrop + increases contractility - allows for more filling time |
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what happens in CHF?
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heart losses contractility, blood backs up in heart, less to body,kidney retain more fluid to increase vascular vol in an attempt to increase perfusion. fluid builds up in extremities.
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how do vasodilators work to help CHF?
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DECREASE PRELOAD AND AFTERLOAD
OPEN THE VESSELS DECREASING BLOOD FLOW RESISTANCE |
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how do rx work to help CHF?
eg: digoxin |
improve contractility of heart and decrease hearts work
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how do diuretics work to help CHF?
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remove Na and H2O decreasing preload
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how do Ace inhibitors work to help CHF?
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Vasodilators by decreasing angiotensin II levels.(angiotensin II is a vasoconstrictor).
Thus decreasing afterload. promotes Na retention S.E. = Dry NPC, possible worsening of renal function, proteinuris (lots of protein in urine), hyperkalemia (high K) that can be beneficial when used with non K sparing diuretics |
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Dobutamine
iv use only |
Beta 1: + inotrope, increases C.O. and supports BP without peripheral vasoconstriction.This decreases afterload.
increases CO and decreases L. ventr filling pressure. adv over nor epi and dopamine no increase in o2 demand. |
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Dopamine
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At high doses is an Inotrope and increases C.O.
dose related effect on SVR. Small doses decreases BP by vasodilation . Higher doses increases BP by vasoconstriction. |
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Nitroprusside: Nipride
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Vasodilator, reducing afterload and preload.
Main S.E. is hypotension. hazard light and heat |
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Beta Antagonist (beta blocker)
Carvedilol (coreg) |
Slows HR, allowing more time for ventricular filling, and reducing Mycardial o2 demand.
Blocking sympathetic outflow will vasodilate as well |
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Primacor (Milrinone)
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phosphodiesterase inhibitor
+ inotrope vasodilator increase C.O. & decrease SVR |
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Inocor (Amrinone)
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A phosphodiesterase inhibitor, increase cAMP.
Improves LV function in CHF w/o causing myocardial ischemia. + inotrope & vasodilator, increase C.O. decreases preload and afterload by relaxing vascular smooth muscle. Used for short term management of CHF in pt who are unresponsive to Dig, diuretics or vasodilators. |
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Epinephrine
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older CHF RX
Alpha & Beta stimulants Beta 1 increases HR & force. Alpha increases svr, by causing peripheral vasoconstriction. Together they increase BP Beta 2 causes bronchodilation & dilation of blood vessels to deep muscle. Used to treat asystole or V- fib. Given during CPR, IV or direct ET instillation. 1:10,000 soln to reduce bleeding Also used to treat anaphylactic shock. |
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Isoproterenol
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older CHF RX
+ chronotrope & inotrope increasing C.O. but also increase in myocardial O2 consumption. Its beta 2 Decreases SVR Used: emergency control of severe bradycardia that does not respond to atropine |
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svr
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systemic vascular resistance
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