pharm heart failure

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Author:
shmvii
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253280
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pharm heart failure
Updated:
2013-12-19 12:27:45
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pharm
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  1. heart failure = (real simple def)
    CO is insufficient to adequately perfuse the tissues
  2. congestive heart failure = ?
    combined R and L failure --> pulm congestion & periph edema
  3. symptoms of congestive heart failure
    • fatigue
    • edema 
    • SOB
  4. 2 common causes of heart failure
    • HTN
    • coronary heart disease
  5. heart failure -->decreased renal blood flow --> ?
    renin secretion, increased plasma angiotensin & aldosterone levels --> increased sodium and water retention --> increased blood volume --> increased preload
  6. 3 types of drugs used for heart failure
    • diuretics
    • vasodilators
    • inotropics
  7. diuretics fight heart failure how?
    increase secretion of sodium and water --> decreased blood volume --> decreased preload and edema
  8. vasodilators fight heart failure how?
    reduce load on the heart by reducing resistance heart must pump against
  9. inotropic drugs fight heart failure how?
    increase force of cardiac muscle contraction
  10. 4 diuretic classes of drugs
    • thazides
    • loop diuretics
    • potassium sparing diuretics
    • carbonic anhydrase inhibitors
  11. thazides  - what kind of drug? treat what?
    • diuretic
    • treat: mild heart failure and hypertension
  12. side effect of thazides
    hypokalemia -- so give them K+ supplements
  13. loop diuretics - used for what?
    reduce periph and pulm edema in mod/sever heart failure
  14. loop diuretics vs thazides regarding diminished renal function
    loop diuretics are effective in these pts, and thazides are not
  15. which diuretics inhibit NaCL reabsorption / increase its secretion?
    • thazides
    • loop diuretics
  16. loop diuretic side effect
    hypokalemia -- so, give K+ supplements
  17. postassium sparing diuretics - main action
    reduec Na+ reabsorption
  18. 3 potassium-sparing diuretics - and their basic mechanisms
    potassium sparing diuretics reduce Na+ reabsorption. They do it by...

    spironalactone - antagonizing aldosterone

    amiloride & triamterene - blocking Na+ channels
  19. spironolactone - what type of drug? does what?
    • potassium sparing diuretic
    • reduce Na+ reabsorption by antagonizing aldosterone

    it's a weak diuretic
  20. when would we use spironalactone?
    only in liver disease with ascites (bc it's a weak diuretic)
  21. amiloride - what kind of drug? does what?
    • potassium sparing diuretic
    • reduce Na+ reabsorption by blocking Na+ channels in distal nephron

    similar drug: triamterene
  22. triamterene- what kind of drug? does what?
    • potassium sparing diuretic
    • reduce Na+ reabsorption by blocking Na+ channels in distal nephron

    similar drug: amiloride
  23. carbonic anhydrase inhibitors - type of drug? name one?
    • diuretic (weak)
    • acetazolamide
  24. acetazolamide - type of drug? mechanism?
    • carbonic anhydrase inhibitor
    • a weak diuretic
    • depress bicarbonate reabsorption
  25. acetazolamide is used to treat what?
    • glaucoma
    • it reduces intraocular pressure
  26. the diuretics
    • thazides
    • loop diuretics
    • potassium sparing diuretics - spironolactone & amiloride, triamterene
    • corbonic anhydrase inhibitors - acetazolamide
  27. most appropriate type of drug for mild-to-severe heart failure
    vasodilators
  28. basic mechanism of vasodilator drugs?
    • prevent formation of vasoconstrictor agent -- angiotensin II
    • cause venous and arteriole dilation to reduce pre/after load
  29. 2 vasodilator drugs and their basic mechanism
    • captopril
    • enalapril


    inhibit angiotensin-converting-enzyme (blocking angiotensin II, whichi is a vasoconstricting agent)
  30. captopril & enalapril are wht kind of drug? do what?
    • vasodilators
    • ACE-inhibitors
    • they inhibit angiotensin converting enzyme --> less angiotensin II
  31. 3 types of inotropic drugs
    • cardiotonic glycosides / cardiac glycosides
    • sympathomimetic agents
    • posphodiesterase inhibitors
  32. cardiotonic glycosides / cardiac glycosides - type of drug? does what?
    • inotropic
    • fights heart failure by increasing the force of cardiac muscle contractions
  33. sympathomimetic agents - type of drug? does what?
    • inotropic
    • fights heart failure by increasing the force of cardiac muscle contractions
  34. phosphodiesterase inhibitors - type of drug? does what?
    • inotropic
    • fights heart failure by increasing the force of cardiac muscle contractions
  35. name a cardiac glycoside
    digoxin
  36. digoxin - type of drug? mechanism
    • inotropic -- cardiac glycoside
    • increases force of contraction
    • increases vagal activity / slows HR
    • reduces heart's O2 consumption
    • increases vagal activity -- slows heart and slows atrioventricular conductance
  37. sympathomimetic agents - name one, drug type, mechanism
    • dobutamine
    • inotropic
    • stimulate influx of Ca++ to increase force of contraction and increase heart rate
  38. dobutamine - drug type? administration method?
    • inotropic sympathomimetic
    • iv infusion for acute severe heart failure

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