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Flashcards in Cardio - Treatment of HF Deck (98)
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1

What pathophysiological parameters can we alter pharmacologically to treat HF?

Increase inotropy, decrease preload, decrease afterload, optimize HR, blunt RAAS, blunt SNS

2

What are the top 3 drugs we can use to decrease preload?

Furosemide, Spironolactone, Hydrochlorothiazide

3

What is the trade name for furosemide?

Lasix or Salix

4

What is the trade name for Spironolactone?

Aldactone

5

What is the trade name for Pimobendan?

Vetmedin

6

What drugs are considered diuretics?

Furosemide, Spironolactone, Hydrochlorothiazide

7

What drug class are weak diuretics and why?

Carbonic anhydrase inhibitors - weak due to increased Na resorption distally (PCT)

(Not really used as diuretics)

8

Where do loop diuretics act?

Ascending Loop of Henle

9

What is the mechanism behind loop diuretics?

Act on the Na/K/2Cl co-transporter to block it, therefore allowing electrolytes to remain in the lumen and be excreted in the urine along with water

10

Where do thiazide diuretics act?

DCT

11

What is the mechanism behind thiazide diuretics?

They block resorption of the Na/Cl co-transporter, causing loss of Na and Cl into the lumen - they are excreted out

12

Where do K+ sparing diuretics act?

Distal tubule/Collecting duct

13

What is the mechanism behind K+ sparing diuretics?

They block aldosterone, so you get less of the Na/H antiporter; Na is excreted and K+ is kept ("spared") in the blood

14

What type of diuretic is furosemide?

It is a loop diuretic

15

What type of diuretic is hydrochlorothiazide?

thiazide diuretic

16

What type of diuretic is spironolactone?

K+ sparing diuretic

17

In what order would you choose a diuretic in the face of CHF?

Furosemide > Spironolactone > Hydrochlorothiazide

18

What are potential side effects of furosemide?

Activates RAAS (need ACEi), azotemia, hypokalemia, metabolic alkalosis, hypochloremia, hypomagnesemia

19

What are potential side effects of spironolactone?

Azotemia, hyperkalemia, facial dermatitis (cats)

20

What are the side effects of hydrochlorothiazide?

Azotemia, hypokalemia, hypercalcemia

21

What diuretic is the most effective at diuresis?

Furosemide

22

What diuretic activates RAAS and which one blocks RAAS?

Furosemide activates RAAS

Spironolactone blocks RAAS

23

What are the 5 drug options we have to decrease afterload?

Enalapril/Benazepril, nitroprusside, amlodipine, hydralazine, sildenafil

24

What is the general mechanism of drugs that decrease afterload?

They are vasodilators

25

What drug class are enalapril/benazepril in?

ACE inhibitors

26

What drug class is hydralazine in?

They increase cGMP

27

What drug class are nitroprusside and nitroglycerine in?

They are nitrates

28

What drug class is amlopidine in?

Ca channel blocker

29

What drug class is sildenafil in?

PDE-V inhibitor

30

What is the selectivity of vasodilation of enalapril/benazepril?

Balanced vasodilator (dilates arteries and veins to some degree)

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