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27 Cards in this Set
- Front
- Back
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Congestive heart failure - physiological problem?
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low contractility
high venous BP |
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Congestive heart failure - treatment strategy?
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greater volume output
less work & venous congestion |
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Congestive heart failure - algorithm?
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Diuretics
ACE inhibitors Digoxin Beta-blockers (DAD_Bradstreet) |
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Loop Diuretics for CCF - action?
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reduces preload
reduces oedema |
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Furosemide - MOA?
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diuretic effect
increasd salt & water excretion |
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Furosemide - target organ?
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kidney
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Furosemide - advantages over thiazides?
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- potent diuretic
- swift action |
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Furosemide - downsides?
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- hypotension
- hypovolemia - hyperuricemia |
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Furosemide + NSAIDs can cause...?
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fluid accumulation & heart failure
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Furosemide + lithium can cause...?
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toxicity
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ACE inhibitors - effect on CCF?
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arterial vasodilatation
reduced peripheral resistance |
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name 2 ACE inhibitors
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Ramipril
Lisinopril |
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Ramipril - MOA?
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ACE inhibitor
inhibits Angiotensin II & Aldosterone formation Arterial Vasodilatation less salt & water reabsorbed |
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Ramipril - effect on CCF?
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Reduce Afterload
Reduced Preload |
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Beta-blockers - effect on CCF?
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slow heart
lowers BP |
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Beta-blockers - MOA?
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block B1 adrenoceptors
reduce sympathetic activity reduces renin |
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name two cardio-selective beta-blockers
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Atenolol & Metoprolol
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Beta-blocker contradindications?
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heart failure
hypotension asthma |
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Beta-blocker - adverse effects?
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Bradycardia
Bronchospasm Blood sugar rises |
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Digoxin - class?
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cardiac glycoside
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Digoxin - action?
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positive inotrope without increasing oxygen demand
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Digoxin - MOA?
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Slows, Steadies, Strengthens
1) increases parasympathetic vagal activity 2) reduces conduction speed 3) inhibits Na+/K+ pump causing increased contractility |
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Digoxin - effect on CCF?
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slows, steadies & strengthens
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Digoxin - also used for..?
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atrial fibrillation
heart spasm |
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Digoxin - contraindications?
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heart block
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Digoxin - side effects?
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- Narrow Therapeutic Window
- TDM required - Arrhythmias/heart block |
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State Dioxin's therapeutic index
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0.8 - 2.0 micromoles per litre plasma volume
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