Term
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Definition
| inability to pump blood out to meet bodies needs of nutrients, oxygen and energy |
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Term
| Two major causes of Heart Failure |
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Definition
Coronary Artery disease
Hypertension |
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Term
| 2 Physiological adaption by the body after Heart Failure? |
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Definition
involves cardiac remodeling due to sympathetic stimuli and the renin angiotensin aldosterone system.
(Ventricles dilate, in an attempt to compensate for decreased oxygen) |
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Term
| Explain treatment of heart failure? |
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Definition
| Some treatment counteracts these compensatory mechanisms because over time they become counterproductive. therapy is used in order to decrease symptoms by counteracting increased sympathetic stimulation and counteract renin angiotensin system which will improve symptoms. |
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Term
| 4 Kinds of drugs used for heart failure? |
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Definition
Diuretics
ACE inhibitors
Beta Blockers
Inotropic Agents |
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Term
| three most commonly used diuretics |
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Definition
Thiazide
Thiazide like
Loop Agents |
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Term
| Three things that diuretics do to stop symptoms of heart failure? |
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Definition
Reduce blood volume (decrease preload)
Decrease venous pressure (decrease preload)
Decrease Arterial Pressure (decreases afterload) |
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Term
| Three manifestations that are improved when using diuretics |
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Definition
Decreased peripheral edema
Decreased pulmonary edema
stops cardiac dilation |
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Term
| Why do you use loop diuretics with heart failure? |
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Definition
| Use with sudden onset of pulmonary edema, because get rid of lots of fluid quickly |
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Term
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Definition
This diuretic drug is valuable because it opposes remodeling replacement of heart cells with fibrous tissue slows this process. Aldosterone contributes to change in heart structure, increases rate of remodeling, which causes less functional contractile myocardial cells - spironolactone decreases aldosterone effects to remodel.
DECREASES RATE OF WORSENING OF HEART FAILURE |
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Term
| Three reasons why are ACEI'S used? |
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Definition
-block production of angiotensin II
-dilate arterioles and veins
-decrease release of aldosterone |
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Term
| Mechanism of Beta Blockers to improve symptoms of heart failure? |
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Definition
| decrease sympathetic outflow |
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Term
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Definition
Carvedilol
Bisoprolol
Metoprolol |
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Term
| What do Inotropic Agents do? |
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Definition
| increase the force of contraction or efficiency of pumping more blood pumped out. |
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Term
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Definition
| Major inotropic agent we use. |
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Term
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Definition
| increases functional contraction efficiency- pump out more blood to the tissues, this indirectly decreases sympathetic release by virtue of the fact that it allows heart to pump blood in a better way. This works via the pump system. |
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Term
| What is digoxin pump system |
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Definition
| When your heart pumps, in each myocardial cell, once depolarization occurs, calcium enters the cell ( you must have calcium in the cell for the muscles to contract) digoxin works by increasing the duration of time that there is a high intracellular calcium concentration. Calcium enters during depolarization so sodium comes in with it and we must pump a lot of potassium out, even when it leaves there is more potassium in cell than outside of cell, so to restore membrane quickly so that this process can happen again and the heart can contract again, the repolarization process requires an energy pump to pump potassium against gradient from low conc. to high conc. which requires a energy requiring pump. Thats what the Na/K ATPase pump does - digoxin poisons pump and prevents re polarization to keep calcium in the cell. so basically, it slows re polarization keep calcium in cell longer so contractile mech. can continue to work for longer with makes heart pumping more efficient so that it pumps out more blood with each pump. |
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Term
| overview of digoxin pump. |
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Definition
| poisoning ATPase pump in myocardial cells, which results in maintain of high intracellular concentration to facilitate actin myosin binding and contraction. |
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Term
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Definition
Injection is better than any oral form which gives you highest concentration of the drug.
Injecting >oral form> oral liquid filled tablets |
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Term
| Digoxin and brain tissue? |
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Definition
| passes blood brain barrier? |
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Term
| Digoxin in relation to Hypokalemia |
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Definition
| most important digoxin caution- potassium and digoxin compete for na/k atpase- when patient is hypokalemia this works better, but only to an extent if patient become too hypokalemic this is bad, causes too much contraction and can lead to s/e |
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Term
| Digoxin in relation to cardiac side effects and what to look for? |
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Definition
Any dysrhythmia can be caused by digoxin
What to look for? pulse less than 55-60 per minute, and any different rhythm so known patients baseline rhythm |
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Term
| Drugs that cause decreased potassium (predisposed to digoxin toxicity) |
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Definition
| any drugs that cause low potassium, makes patient more likely to cause side effects. |
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Term
| 2 Non cardiac Digoxin S/E |
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Definition
-GI side effects- (ANV) anorexia, nausea, vomiting, (do not predict or preceed cardiac side effects)
-CNS side effects- faigue, HA,
-Visual distrubances |
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Term
| Do GI side effects in a digoxin patient show that there may be more future cardiac side effects? |
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Definition
| No, products today are too pure. |
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Term
| Important Digoxin interaction? |
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Definition
| decreases level of potassium |
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Term
| What drugs increase potassium |
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Definition
| ACEI and diuretics ( if these drugs are given with digoxin, they may inhibit digoxins interaction with digoxin) |
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