Card: Heart Fail, Inotropes And Pressors Pharm

Front 1

ACE adverse effects

Monitor?

Back 1

hyperK+, hypotension, angioneurotic edema, dry couge, renal insuff.

K+. creatinine

Front 2

Primary diuretic for HF?

Back 2

Loop

Front 3

Major problem with Loops in HF?

Back 3

Renal fail; monitor ins/outs

Front 4

AEs with spironolactone/epleremone?

Back 4

Increased K+, increased SrCr

Front 5

adverse effects of dig?

Back 5

bradycard, heart block, GI, CNS, arrhythmia

MOnitor: signs of tox, K+

Front 6

How are Betablockers effective in heart fail?

Back 6

increase density of beta1, inhibit cardio tox of catecholamines, decrease neurohormonal activation (the bad effects... it does lead to increased mortality after all)

Front 7

which beta blocks to use and how to titrate?

Back 7

use carvedilol, metoprolol XL
titrate up slowly

Front 8

when to use nitrate and hydralazine?

Back 8

in place of ACE if bad kidneys

Front 9

a problem with nitrates?

Back 9

tolerance can develop

Front 10

what does dobutamine do?

Back 10

agonist: beta1 (contract heart)
agonist: beta 2 (decrease BP)

Front 11

when do you use dobutamine?

Back 11

acute, decompensated heart failure

Front 12

adverse effect dobutamine?

Back 12

tachycard, vent tachyarrhythmia, angina, dyspnea

Front 13

milrinone, mech?

Back 13

increases force w/o stim beta 1's
increase Ca++

Front 14

when to use miltinone?

Back 14

heart fail, septic shock

Front 15

adverse effect miltinone?

Back 15

tachycard, angina, vent tachy (all same as dobutamine)
also, hypotension, thrombocytopenia

Front 16

cyanide is bad for the ___ and thiocyanate is bad for the ____
(breakdown products of Na nitroprusside)

Back 16

liver, kidney

Front 17

Dopamine: low dose... stimulates and does what?

Back 17

dopamine receptors.
renal, cerebral and mesenteric vessel dilation

Front 18

dopamine: med dose... stim and does what?

Back 18

dopmine and beta
See beta 1 effects: increased contractility and HR

Front 19

dopamine: high dose... stim and does what?

Back 19

dopamin, beta, and alpha
see alpha effect: contract (increase SVR), increased afterload, increased BP

Front 20

what does epinephrine do?

Back 20

increased CO and SV

Front 21

what does norepi do?

Back 21

increases SVR (no beta2 stim)

Front 22

when to use pressors?

Back 22

systolic BP <90, w/o hypovolemia (septic, card shock)

Front 23

caution in pressors...

Back 23

increased heart rate, myocardial O2 demand, monitor for signs of myocard ischemia