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Drugs Used in HF

Quiz 6

QuestionAnswer
Group of drugs composed of digitalis, a substance which occurs naturally in the foxglove plant. Have narrow therapeutic range. Widespread use for 200 years. Cardiac Glycosides
Cardiac Glycosides are also known as Inotropes
Digoxin is what type of drug? Cardiac Glycosides (Inotropes)
Absorption of this drug varies widely between manufacturers. Once absorbed or given IV, takes 8 hr to reach tissue binding sites. Have long half-lives; several days for therapeutic effect. May receive loading dose. Cardiac Glycosides (Inotropes) = DIGOXIN
Positive inotropic, and negative inotropic and dromotropic effects. Stimulates PNS, slows heart rate, and slows conduction through AV node. Cardiac Glycosides (Inotropes) = DIGOXIN
Used to treat CHF, A-fib, atrial flutter, and paroxysmal atrial tachycardia. May improve cardiac hemodynamics when used with diuretics and vasodilators in mild to moderate HF. Cardiac Glycosides (Inotropes) = DIGOXIN
`Will increase myocardial O2 demand, so benefits must outweigh risk before prescribing in post MI for supraventricular arrhythmias. Cardiac Glycosides (Inotropes) = DIGOXIN
Quinidine may double serum levels by reducing this drug's rate of elimination. Verapamil enhances effects of this drug. Cardiac Glycosides (Inotropes) = DIGOXIN
Antacids decrease absorption of this drug if taken at the same time, so doses should be staggered. Cardiac Glycosides (Inotropes) = DIGOXIN
Therapeutic range of Digoxin is _______ng/dL 0.5-2.0
Hypokalemia may predispose patients to toxicity. Signs include N/V, diarrhea, restlessness, irritability, cardiac arrhythmias (bradycardia, atrial, and ventricular). Cardiac Glycosides (Inotropes) = Digoxon
Cariotonic-inotropic agents used in the short-term management of HF not controlled by digoxin, diuretics, and vasodilators. Phosphodiesterase Inhibitors
Drugs relax vascular smooth muscle to produce vasodilation, decrease preload and afterload. Given by continuous IV infusion. Phosphodiesterase Inhibitors
What type of drug is Amrinone? Phosphodiesterase Inhibitors
What type of drug is Milrinone? Phosphodiesterase Inhibitors
Group of drugs that may be used in severe HF to provide circulatory support. Strengthen myocardial contraction. Adrenergic Agents
Use of minimal effective dose of this group of drugs is recommended, because tachycardia and HTN can cause increased cardiac workload and increased myocardial O2 consumption. Adrenergic Agents
Dopamine is what type of drug? Adrenergic Agents
Dobutamine is what type of drug? Adrenergic Agents
Drugs of 1st choice in treating all four NY Heart Association classifications. Act to block the conversion of Angiotensin I to Angiotensin II, thus producing dilation of both veins and arteries, and decreased retention of Na and H2O. Angiotensin-converting Enzyme (ACE) Inhibitors
This group of drugs results in decreased preload and afterload, decreases cardiac workload, and increases perfusion of body organs and tissues. Can be given with or without digoxin. Angiotensin-converting Enzyme (ACE) Inhibitors
What type of drug is Captopril? Angiotensin-converting Enzyme (ACE) Inhibitors
What type of drug is Lisinopril? Angiotensin-converting Enzyme (ACE) Inhibitors
What type of drug is Quinapril? Angiotensin-converting Enzyme (ACE) Inhibitors
What type of drug is Enalapril? Angiotensin-converting Enzyme (ACE) Inhibitors
Used in treatment of chronic HF to suppress activation of SNS and excessive catacholamine response that eventually damages myocardial cells. Beta-adrenergic Blocking Agents
Over time, use of this group of drugs results in the heart returning to normal shape and function (reverse remodeling), and cardiac output increases. Beta-adrenergic Blocking Agents
This group of drugs is not used in acute HF because of initial decrease in myocardial contractility. May be started once acute symptoms relieved. Beta-adrenergic Blocking Agents
This group of drugs usually starts in low doses, then dosage increased over 2 weeks. Used with ACE inhibitor. Beta-adrenergic Blocking Agents
What type of drug is Bisoprolol? Beta-adrenergic Blocking Agents
What type of drug is Carvedilol? Beta-adrenergic Blocking Agents
What type of drug is Metaprolol? Beta-adrenergic Blocking Agents
Group of drugs used to relieve edema by decreasing extracellular fluid volume and increasing excretion of Na and H2O, thus decreasing preload. Diuretics
This group of drugs may be given PO or IV. Initial treatment in acute failure. Relieved symptoms of HF but does not improve left ventricular function. Diuretics
Group of drugs includes ACE inhibitors, angiotensin receptor antagonists, nitrates (venous dilators), and arterial vasodilators (such as Hydralazoine). Vasodilators
Group of drugs acts to decrease preload and afterload depending on the agent used. May combine isosorbide (a nitrate) with hydralazine to decrease both preload and afterload. Vasodilators
Group of drugs may be taken PO for clients with chronic HF, or IV for those in severe HF. Vasodilators
This specific drug is a combination of hydralazine and isosorbide, which received approval in 2005 for treating HF, especially in African-Americans. BiDil
Group of drugs produced by recombinant DNA technology; it is identical to endogenous human BNP, which is secreted by the ventricles in response to fluid and pressure overload. Human B-Type Natriuretic Peptide (BNP)
Group of drugs compensates for deteriorating cardiac function by reducing preload and afterload, increases diuresis, and suppresses the renin-angiotensin-aldesterone mechanism. Human B-Type Natriuretic Peptide (BNP)
Nesteritide is the first drug in this class to be used in the treatment of HF Human B-Type Natriuretic Peptide (BNP)
What type of drug is Nesteritide? Human B-Type Natriuretic Peptide (BNP)
Group of drug relaxes blood vessels and improves blood flow by targeting the neurohormone endothelin-1 that is produced in excess in HF. Other drugs in this class are being studied (additional data beeded to support use in HF). Endothelin Receptor Antagonists
What type of drug is Bosentan? (Note additional info on answer side!) Endothelin Receptor Antagonists (Note: This drug is approved by the FDA for treatment of pulmonary HTN)
Upon evaluation of the patient with HF, what therapeutic effects may we see with use of HF drugs? Breath easier, decreased edema, improved activity tolerance
What should we assess the pt for with HF? Symptoms of HF, breath sounds, edema, dyspnea, HTN, confusion, fatigue
What considerations should be made in implementation of drug administration for HF? Assess baseline apical HR and rhythm prior to each dose, hold for apical rate <60 and call MD, monitor serum digoxin levels, monitor for signs of dig toxicity.
What should we teach client who is taking meds for HF? Take own pulse (call MD with pulse <60 and do not take med), take at same time every day and don't double missed doses, take same brand (DO NOT substitute), report s/s HF, report s/s dig toxicity.
Created by: mreedy