Tx Of Heart Failure

Front 1

Dobutamine

Back 1

Selective B-1 Adrenergic Receptor Agonist
*Increases CO

Front 2

Signs & Symptoms of Heart Failure

Back 2

-Pedal Edema
-Anxiety/Restlessness
-Increased HR
-Rapid Breathing
-Persistent Cough
-Cyanotic and clammy skin
-Upright posture/leaning forward

Front 3

Goals of CHF treatment

Back 3

-Improve myocardial contractility w/o increasing heart rate
-Reduce afterload
-Reduce preload
**Increasing HR is NOT beneficial

Front 4

Drugs used in CHF Tx

Back 4

Diuretics (@ first signs of pulmonary edema)
--Hydochlorothiazide, Furosemide
ACE Inhibitors
--Captopril
Cardiac (Digitalis) Glycosides
--Digoxin
Vasodilators
Beta Blockers

Front 5

Therapeutic Effects of ACE Inhibitors

Back 5

Relaxation of arterial smooth muscle
Reduced aldosterone release
Dilate veins (with chronic admin)
Reduce trophic changes in myocardium

Front 6

Cardiac (Digitalis) Glycosides

Back 6

Digoxin & Digitoxin
Reduced congestive symptoms and improved exercise tolerance
Reduce lethality from progressive damage but increases sudden death
Margin of safety is very low
(Risk of Cardiac Arrhythmias)
Tx overdose with Digitalis Antibodies
**Once you begin tx with glycosides you can't switch w/o severe deterioration

Front 7

Mechanism of action for Cardiac Glycosides

Back 7

Reduce action of Na+/K+ ATPase-->less Na+ going out-->more in the cell-->reduced action of Na+/Ca2+ pump.-->More Ca2+ in cell-->Increased contractility

Front 8

Effects of Potassium levels on Cardiac Glycosides

Back 8

High systemic K+ levels(K+ sparing diuretics)-->less glycoside effects
Low systemic K+ (Diuretics)-->more glycoside effects