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12 Cards in this Set
- Front
- Back
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Enalapril
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ACE Inhibitor
Side Effects: 1) COUGH! |
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Losartan
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ARB (Angiotensin Receptor Blocker)
Used in Pts unable to tolerate ACE Inhibitor Therapy |
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Spironolactone, Epleronone
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Aldosterone ANTagonists
Reverse the effects of Hyperaldosteronism which include Remodeling. |
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Nesiritide
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B-Type Natriuretic Peptide
Acute IV Infusion for Acute Heart Failure Results in Vasodilation and Natriuresis, and Suppression of RAAS Strictly limited to patients presenting to the hospital with acutely decompensated heart failure who have dyspnea at rest Should NOT be used to: 1) Replace Diuretics 2) For Intermittent Outpatient Infusion 3) For Repetitive Use 4) To Improve Renal Function 5) To enhance diuresis Side Effects: 1) Hypotension 2) Renal Failure |
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Dobutamine
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B1 Agonist (Inotropic)
Short Term ICU Drug - only via continuous IV Prolonged --> Desensitization! Particularly useful in: LVF Complicated by PULMONARY EDEMA Side Effects: 1) May Increase Ischemia and Extend the Zone of Infarction in Poorly Perfused Tissue 2) Predisposes to Arrhythmias |
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Dopamine
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B1 Agonist (Inotropic) (also A1 Agonist and D1 Agonist)
Short-Term ICU Drug - only via continuous IV Prolonged --> Desensitization! Particularly useful in: LVF Complicated by HYPOTENSION (Cardiogenic Shock) Due to D1 Activation, it can PREVENT the occurrence of Acute Tubular Necrosis (ATN) Side Effects: 1) May Increase Ischemia and Extend the Zone of Infarction in Poorly Perfused Tissue 2) Predisposes to Arrhythmias |
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Milrinone
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Peak III cAMP Phosphodiesterase Inhibitor
Positive Inotrope and Vasodilator (w/ little Chronotropic Activity) Continuous IV Infusion for Palliation of Symptoms in patients with End-Stage Heart Failure Short Term Infusions = BAD! Side Effects: 1) Ventricular Arrhythmias |
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Digitalis (Digoxin)
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Cardiac Glycosides - Inhibits Na/K/ATPase (Inotropic)
Half Life = 40 Hours Does NOT show Desensitization (Unlike Catecholamines) K+ Competes with Digitalis for binding to Na/K/ATPase! Thus, Hypokalemia (e.g. Diuretics) INCREASES the effectiveness of Digitalis; a frequent cause of Digitalis Toxicity! Hypercalcemia Increases the activity of Digitalis! Improves Symptoms! NOT Survival! VERY LOW Therapeutic Index! Ca Channel/B Blockers can Potentiate Digitalis' Inhibitory effect on AV Node, Precipitating HEART BLOCKS, and BRADYCARDIAS Toxicity: 1) Generalized Malaise 2) Fatigue and Loss of Appetite (1st Signs) 3) GI Symptoms (Anorexia, Nausea, Diarrhea) from Increased Vagal and Direct Activation of CTZ 4) Arrhythmias (Most Frequent) 5) Bradycardia 6) Heart Blocks 7) Visual Aberrations, Color Distortions 8) Gynecomastia 7) Supraventricular and Ventricular Tacharrhythmias |
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Carvedilol
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Beta-Blocker
Has A1, B1, and B1 Antagonist Activity! Uses: 1) CHF Side Effects: 1) Hypotension 2) 1st Degree Heart Block 3) Bradycardia 4) Occasionally a Worsening of Heart Failure |
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Furosemide
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Loop Diuretic
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Diltiazem, Nifedipine
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Calcium Channel Blocker
Inhibit Coronary Vasospasm CardioSPARING - Some can decrease Contractility Used for Angina Side Effects: 1) Hypotension 2) Peripheral Edema 3) Constipation Contraindicated with: 1) CHF 2) SA Nodal Disease 3) AV Nodal Disease (Heart Block) 4) Wolf-Parkinson White Syndrome |
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Nitroglycerin, Nitroprusside, Isosorbide Dinitrate
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Nitrates
Vasodilate Peripheral Vessels Decrease both Preload and Afterload Epidural Vessels In diseased heart, they redistribute blood flow to ischemic areas! |
