Term
|
Definition
| The inability of the heart to maintain adequate CO to meet the metabolit demands of the body. |
|
|
Term
| usually asymptomatic with low CO, and possible exercise intolerance |
|
Definition
| symptoms associated with early stages of heart failure are: |
|
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Term
|
Definition
| what is the main symptom of decompensated heart failure |
|
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Term
|
Definition
| When the body senses a decrease in CO and BP it tries to maintain homeostasis by using the ______ to raise BP. |
|
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Term
|
Definition
| The baroreceptor does what to the blood vessels? |
|
|
Term
| vasoconstrict; increases afterload |
|
Definition
| What does renin do to blood vessels?? and what does this do to the heart? |
|
|
Term
| increased water retention and edema |
|
Definition
| What does alodosterone from the RAS cause in heart failure pts? |
|
|
Term
|
Definition
| these have recently been discovered to be cardiac growth factors. |
|
|
Term
decrease cardiac work, o2 consumption, decrease preload and afterload, increase CO
control Na and water |
|
Definition
| What are the overall goals of heart failure treatment? |
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Term
|
Definition
| these diuretics inhibit the active exchange of Cl/Na in the distal convoluted tubule |
|
|
Term
| in the distal convoluted tuble, and cortical collecting ducts |
|
Definition
| where do K sparing diuretics work? |
|
|
Term
|
Definition
| where do the loop diuretics work? |
|
|
Term
|
Definition
| these are the primary therapy for the majority of heart failure patients with pulmonary congestion |
|
|
Term
|
Definition
| These diuretics are used to reduce vascular volume, edema, pulmonary congestion. They are administered IV for decompensated HF |
|
|
Term
|
Definition
furosemde
bumetanide
torsemide |
|
|
Term
Thiazide diuretics
(hydrochlodothiazide) |
|
Definition
| these are used when pts are resistant to loop diuretics, or they may be combined with loops to produce synergistic natriuresis |
|
|
Term
| K sparing (spironolactone) |
|
Definition
| these diuretics are actually shown to decrease the amount of cardiac remodeling, and in combination with ACE (-) increase survival. |
|
|
Term
|
Definition
| Treatment goal of vasodilators in heart failure |
|
|
Term
|
Definition
| what is the drug of choice to treat heart failure? |
|
|
Term
|
Definition
| What do AT1 receptors cause? |
|
|
Term
|
Definition
| side effect of ACE inhibitors |
|
|
Term
|
Definition
captopril
enalapril,
lisinopril |
|
|
Term
| ↓ peripheral resistance → ↓afterload and preload → ↑CO↓ aldosterone release ↓ Na and H2O absorption;↓ cardiac hypertrophy and remodeling |
|
Definition
| Mechanism of action for ACE inhibitors |
|
|
Term
block AT1 receptors, effects similar to ACE(-)
|
|
Definition
| what is the mechanism of action for type I angiotensin II receptor antagonists? |
|
|
Term
| Angiotensin II Receptor antagonists |
|
Definition
| Potential Advantages of __________ ↓ side effects -bradykinin metabolism unaffected receptors not blocked |
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|
Term
|
Definition
| This drug is for i.v administration only. its converted to NO and is a preload and afterload reducer |
|
|
Term
|
Definition
| This drug is thought primarily to be a venodilator, it's converted to NO |
|
|
Term
| nitroglycerin (vasodilator) side effects |
|
Definition
|
Term
| Hydralazine and Isosorbide dinitrite (vasodilators) |
|
Definition
| These two drugs were used in combination a lot before the advent of ACE inhibitor. They have to be taken every four to six hours and compliance is a huge issue |
|
|
Term
| unknown ↓ afterload dilating arteries almost exclusively |
|
Definition
| mechanism of action for the vasodilator hydralazine |
|
|
Term
|
Definition
| Mechanism of action for the vasodilator isosorbide dinitrite |
|
|
Term
|
Definition
| this vasodilator is a recombinant form of human brain natriuretic peptide, and can only be administered through i.v. for the acute treatment of dyspnea |
|
|
Term
|
Definition
| Mechanism of this vasodilator is to< ↑ cyclic GMP, diuretic and vasodilator responses (↓ preload and afterload) |
|
|
Term
| increase ventricular performance → ↑ CO |
|
Definition
| What is the treatment goal of positive inotropic drugs? |
|
|
Term
| Cardiac Glycosides (digoxin, digotoxin) |
|
Definition
| These drugs are also called digitalis drugs. They have oral absorption and renal excretion |
|
|
Term
|
Definition
| Digoxin has a half-life of ____ days, and is eliminated by the ______ |
|
|
Term
|
Definition
| digitoxin has a half life of ____ days and is eliminated by the _____ |
|
|
Term
major effect is to inhibit Na→
(digoxin, digitoxin) |
|
Definition
| Mechanism of action of the cardiac glycosides |
|
|
Term
Side effects:
very narrow therapeutic index. Side effects are ↑ by low K+.
GI effects, cardiac arrhythmia
|
|
Definition
| What are some side effects of Digoxin? |
|
|
Term
| Lidocaine, potassium , Beta blockers |
|
Definition
| What drugs are good treatments for the side effects of Digoxin? |
|
|
Term
| Fab fragments- and IGg antibody |
|
Definition
| what can be administered in an overdose of digoxin? |
|
|
Term
|
Definition
| _________ is used for pts in HF with atrial arrythmia, or if symptoms persist after ace inhibitor and beta blockers |
|
|
Term
| dopamine (D1, beta1, and alpha1 agonist) |
|
Definition
| This drug is a positive inotropic that is administered IV in er treatment for decompensated pts. It dilates the renal artery so that a diuretic may be administered |
|
|
Term
|
Definition
| This drug increases FC without increasing HR. it was often used in combo with low dose dopamine |
|
|
Term
|
Definition
| Side effects of dopamine and dobutamine |
|
|
Term
| Phosphodiesterase inhibitors: (inamrinone and milrinone) |
|
Definition
these were developed to replace digitalis. they work by increasing intracellular levels of cAMP by inhibiting its breakdown ↑cAMP → phosphorylation of Ca++ channels → ↑ intracellular Ca++ → ↑ FC and CO increases
|
|
|
Term
| phosphodiesterase inhibitors |
|
Definition
| inamrinone and milrinone are _______ |
|
|
Term
| short term severe failure, or right-sided failure |
|
Definition
| Phosphodiesterase inhibitors should only be given in what circumstances |
|
|
Term
carvedilol
metroolol
bisprolol |
|
Definition
| Name the beta blockers used to treat heart failure |
|
|
Term
|
Definition
_________ decrease SNA to heart decrease HR + O2 consumption decrease deleterious effects of catecholamines (decrease hypertrophy and remodeling ↑ ventricular function (↑ EF)
|
|
|
Term
| ace inhibitor/ beta blocker/ diuretic |
|
Definition
| what combo of drugs increases the survival rate of heart failure pts the most? |
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