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Whats heart failure?
heart's inability to pump sufficient blood to meet the body's needs
HF has how many functional classes?
Class 1-4 (involves pt. ability to carry out physical activity)
What are the most common causes of HF?
CAD and HTN
What are some drugs that should be avoided in pt. with HF?
NSAIDS, and nondihydropiridines CCB
All pt. with stage C(structural heart disease with prior or current symptorms of HF) HF with left ventricular dysfunction should be on what medications?
diuretic, ACEI, and BB
T/F: only pt. with signs or symptoms of volume overlaod will need diuretic (loop)
T/F: Pt. allergic to sulfa containing drugs also may be allergic to loops
What loops should be taken on empty stomach? (due to its bioavailability)
furosemide and bumetanide
How are ACEI beneficial in treating HF?
- reduce hospitalizations and improve symptoms
- Reduce mortality and slow progression of HFex. of drugs pg184
What ARBs are confirmed for the tx. of HF?
When are they used?
- candesartan(Atacand) and valsartan(Diovan)
- Used when pt. can't take ACEI (usually due to cough or angioedema)
What BB have shown to provide survival benefits (Reduce mortality)?
- metoprolol succinate ER (Toprol XL)
- bisoprolol (Zebeta)
- carvedilol (Coreg,CR)
T/F: BB may cause fluid retention and worsen HF
What drugs improve survival in pt. with moderate to severe heart failure?
- spironolactone (Aldactone)(SE:gynecomastia)
T/F: Digoxin(Lanoxin) does not improve mortality but does have symptomatic benefits
What are some drugs that increase digoxin conc?
quinidine, verapamil, amiodarone, macrolides(erythromycin and clarithromycin), itraconazole and ketoconazole, spironolactone, cyclosporine
Whats the goal plasma conc. of digoxin?
- (Also digoxin is eliminated by the kidneys and needs to be adjusted in renal insufficient pt.)
Whats the drug of choice in pt. that can't tolerate ACEI or ARBS?
Look at pg 189 for drug tx. for acute decompensated HF
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