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31 Cards in this Set
- Front
- Back
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Combined alpha and beta blockers that may have use in CHF
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Labetalol and carvedilol
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Use of these agents may lead to bradycardia, AV block and acute exacerbation of CHF
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beta blockers
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Cardiac glyocoside used in CHF. MOA?
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Digoxin:
Shuts down Na/K+ ATPase and prevents the escape of Ca2+ from the cell |
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Calcium channel blocker contraindicated in CHF
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verapamil:
Inhibits Ca2+ influx, thus reducing cardiac contraction. However, also slows AV nodal conduction. |
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Digoxin toxicity may be precipitated by?
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Hypokalemia
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Major signs of digitalis toxicity
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Arrythmias, N/V, and diarrhea
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Digitalis arrhythmias may be precipitated by?
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Hypokalemia
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Chronic intoxication with digitalis is caused by?
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Excessive Ca2+ accumulation within cardiac cells
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Digoxin is used in?
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AFIB and CHF
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Peptide drug used to treat CHF
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Nesiritide:
Increases Na excretion and reduces arterial and venous tone |
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Diuretics work in CHF by
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decreasing preload
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SE of nesiritide
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Hypotension and kidney failure
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Agent used in acutely decompensated CHF that resembles BNP
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Nesiritide
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Agent used in CHF that is a selective alpha and non-selective beta blocker
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Carvedilol
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Side effect of amrinone
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Thrmobcytopenia
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Beta 1 agonists used in acute CHF
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Dopamine and dobutamine:
B1 receptors increase HR and contractility |
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Beta blockers are used in CHF for?
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Reducing chronic progression of CHF, however, they are never used in acute CHF
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Along with diuretics, this class is used as first line txmt for CHF
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ACE inhibitors:
Captopril Causes decreased renin secretion and ultimately decreases blood volume |
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Phosphodiesterase inhibitors that increase mortality in CHF and have no beneficial effects
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Amrinone and milrinone:
Increase cAMP and thus, increase intracellular Ca2+ levels. |
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1st line txmt for CHF
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Diuretics:
Furosemide Hydrochlorothiazide Spironolactone |
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Used int the txmt of digoxin toxicity
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Digoxin antibodies:
Digibind |
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Used for the immediate reduction of the pulmonary congestion seen in acute heart failure
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Furosemide
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Does digitalis prolong life in those with chf?
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No; improves functional status.
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Why is digitalis used in AFib?
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Has parasympathomimetic effects that increase AV node refractory time and decrease conduction velocity.
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Digitalis induced automaticity causes what?
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Increased automaticity due to calcium overload leads to delayed afterdepolarizations, which are recognized as PVC's with a 1:1 ratio called Bigeminy.
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EKG changes with digitalis use
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Early: Increased PR interval, due to decrease in AV conduction, and T wave flattening
Late: Shortened QT, T wave inversion, and ST depression. |
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Mechanical effects of digitalis
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Increased ventricular ejection, CO, and renal perfusion. These allow for a decrease in the sympathetic tone, reducing HR, preload, and afterload.
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Digitalis effects on atrial muscle
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Decrease refractory period and increased conduction velocity.
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Half life of digoxin
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30-40 hrs, thus it may build up to toxic levels.
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Atropine is often used to counteract what effect of digoxin
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Decreased PR interval
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Drug that reduces the clearance of digitalis and thus may increase its toxicity
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quinidine
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