Heart Failure Drugs - Mechanism Of Action, Clinical Use, Side Effects

Front 1

MOA - Digoxin in heart failure (decrease afterload, increase contractility, decrease preload, decrease mortality?)

Back 1

increases contractility

Front 2

MOA - Digoxin in myocytes

Back 2

inhibits Na-K ATPase

Front 3

A patient is on digoxin. They are nauseous and seeing halos. What drug most likely precipitated this? metoprolol, captopril, spironolactione, furosemide, nifedipine

Back 3

furosemide

Hint 3

think of how K and Ca interacts with digoxin

Front 4

A person has heart failure and develops atrial fibrillation. How can digoxin help with their Afib?

Back 4

blocks AV node to slow ventricular rate

Front 5

Side effects - nausea, vomiting, visual problems, arrthythmias

Back 5

Digoxin

Front 6

MOA - ACE inhibitors in heart failure (effect on preload, afterload, contractility, mortality)

Back 6

reduces afterload
reduces mortality

Front 7

What is the most likely reason why ACE inhibitors reduce mortality in heart failure?

Back 7

reduces cardiac remodeling

Front 8

What drugs decrease mortality in heart failure

Back 8

ACE inhibitors, ARBs, beta blockers, aldosterone antagonists, combo-hyralazine and isosorbide dinitrate

Front 9

What is the most likely reason why beta blockers reduce mortality in heart failure?

Back 9

reduce cardiac remodeling

Front 10

Patient presents in the ER with pulmonary edema from their heart failure. When should you start them on a beta blocker?

Back 10

When they are stabilized (ie pulmonary edema is resolved)

Front 11

Patient presents in ER with pulmonary edema. They have history of heart failure being treated with furosemide. What drug should you use in this situation?
loop diuretic, thiazide diuretic, digoxin, beta blocker, ACE inhibitor

Back 11

loop diuretic

Front 12

What is the main drug that controls edema in a patient with heart failure?
loop diuretic, aldosterone antagonist, digoxin, beta blocker, ACE inhibitor

Back 12

loop diuretic

Front 13

What effect does loop diuretics have on preload, afterload, contractility and cardiac output in patient with heart failure?

Back 13

preload - reduced
afterload - no effect
contractility - no effect
cardiac output - little effect

Front 14

A patient presents in ER with pulmonary edema. How does nitroglycrin help?

Back 14

Dilates veins and reduces preload

Front 15

MOA - spironolactone in heart failure

Back 15

prevents cardiac remodeling

Front 16

A person presents in the ER with an arrhythmia. They have heart failure and are on several drugs. Tests reveal hyperkalemia. What most likely caused their problem?
Digoxin, loop diuretic, thiazide diuretic, aldoserone antagonist, nitrate, beta blocker

Back 16

aldosterone antagonist

Front 17

MOA - hydralazine in treating heart failure

Back 17

decreases afterload
in combination with isosorbide dinitrate decreases mortality

Front 18

MOA - dobutamine in treating heart failure

Back 18

activates beta1 on the heart to increase contractility and cardiac output

Front 19

When do you use dopamine in treating heart failure?

Back 19

Severe acutely decompensated heart failure when other drugs have failed

Front 20

Is nesiritide used for chronic stable heart failure or acute decompensated heart failure

Back 20

acute decompensated heart failure

Front 21

What effect does nitroprusside have on hemodynamics in a patient with heart failure?

Back 21

dilates arteries - reduces afterload
dilates veins - reduces preload

Front 22

What effect does reducing preload have on cardiac output (healthy heart and heart failure heart)?

Back 22

Healthy heart - reduced CO
HF heart - little effect

Front 23

MOA - milrinone

Back 23

Phosphodiesterase inhibitor - keeps cAMP around longer - positive inotropic effect

Front 24

Is digoxin used for chronic stable heart failure or acute decompensated heart failure

Back 24

chronic stable heart failure