Term
What is the mechanism of Digitalis?
What are the adverse effects?
What is the half life? |
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Definition
Mechanism
Block Na/K-ATPase-> decrease Ca/Na-> increasing cellular Ca-> Increased Inotropy
Vagomimetic
Adverse
AV block/ Arrhythmias
Color Vision Loss
Gynecomastia
Toxic with non-sparing Diuretics
Half Life
Digoxin: 40 hours
Digitalis: 170 hours |
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Term
| What is the relative therapeudic index of digitalis and what is the half life? |
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Definition
Low therapeudic index
Half life- 40hrs(Digoxin), 170hrs(Digitoxin) |
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Term
| What are drugs that interact with digitalis |
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Definition
Quinidine
Non-K-sparing diuretics |
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Term
Phosphodiesterase Inhibitors used in CHF?
When are they used?
What is wrong with them?
What is their mechanism? |
|
Definition
Amrinone: Short IV tx because it induces hepatoxicity and nausea
Milrinone: Acute HF because it has a Higher mortality than digitalis
Mech: PDE 3 inhibition blocking cAMP degration |
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Term
When is Dopamine used in HF?
What is its mechanism |
|
Definition
Acute HF
Mech: Peripheral Dialation, Increase Norepi at heart |
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Term
What are the diuretics used in CHF
What is the mechanism of the one that decreases mortality in heart failure? |
|
Definition
Hydrochlorothiazide
Furosemide
Spironolactone
Mechanism of spironolactone:
Increase NO
Decrease fibrosis
Decrease vasoconstriction
K-sparing diuresis |
|
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Term
What are the vasodialators used in CHF?
Which reduces CHF mortality?
When would the other be used? |
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Definition
Nitrates: Pulm Congestion
Hydralazine: Low Ventricular output
BiDil(Isosorbide Dinitrate and Hydralazine) decreases mortality in African Americans |
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Term
| What is the mechanism of Nesirtide and why is it not used? |
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Definition
B-type natriuetic Peptide-> increases cGMP
Not used bc Increased short-term mortality |
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Term
| How do Ace-inhibitors or ARB effectively treat CHF |
|
Definition
Decrease Sympathetics
Decrease Vasoconstriction (Afterload)
Decrease Aldosterone(Preload)
Decrease Remodeling
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|
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Term
| What is the most effective B-Block in treating CHF, what is the proposed mechanism? |
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Definition
Carvedilol because there is alpha block as well
Decrease Sympathetic overload |
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Term
| What is the Step-wise approach to treat CHF |
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Definition
I. Weight Reduction
II. Decrease Salt
III. Spironolactone
IV. Ace Inhibitor
V. B-blocker
VI. Digitalis
VII. Vasodialators |
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Term
| What drugs used to treat CHF will decrease mortality |
|
Definition
Ace-inhibitors
B-blockers
Spironolactone
BiDil |
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