Flashcards
Chronic heart failure
Cards in this deck (22)
- 1List 4 neurohormonal adaptations that occur in HF?Symp. NS activation
RAAS activation
Increase ADH
ANP - 2What prophylaxis medication would be prescribed in AF?Warfarin
OR
Aspirin - 3What should be monitored when using ACEIs for HF?Urea/creatinine
K+ - 4What common drug should be avoided when taking ACEIs for HF? Why?NSAIDs
Reduce effectiveness and increase risk of kidney damage - 5What class of diuretics are used in mild HF or HF in the elderly?Thiazides (bendroflumethiazide)
- 6What class of diuretics are used in HF if there is significant pulmonary oedema?Loop diuretic (furosidemide)
- 7What is the important side-effect of diuretics?Hypokalaemia
- 8What mechanisms lend beta-blockers to effective therapy for HF?Block maladaptive sympathetic activity (cardiac work reduction)
Decrease heart rate and O2 consumption, reduce myocyte dysfunction - 9In what co-morbid condition are beta-blockers particularly favoured in HF treatment?AF (anti-arrhythmic)
- 10What is an important counselling point prior to starting beta-blockers for HF?Symptoms may worsen at 1st (as reduced drive to heart) - tolerate over time
- 11How should both ACEIs and beta-blockers be prescribed for HF?ACEI first + titrate up. Once established dose, introduce beta-blocker
- 12What is the mechanism of spironolactone?Aldosterone receptor antagonist
- 13Why might low-dose spironolactone be used in HF?Reverses LV hypertrophy
Decrease aldosterone-related fibrosis of the heart - 14Describe the mechanisms of digoxin?+ve inotrope
Inhibits NA+/K+ ATPase on myocytes - Na+ accumulates there reduce function of NA+/Ca2+ exchanger, increased intracellular Ca2+
= increase contractility but decrease rate (impaired atrioventricular conduction) - 15In what associated condition is digoxin favoured in treatment of HF?AF
- 16What heart symptoms would contraindicate digoxin as treatment for HF?Bradycardia (pre-existing)
Heart block - 17In what condition would digoxin dosages need to be reduced?Renal impairment
- 18What feature may increase the toxicity of digoxin?Hypokalaemia
- 19What are some features of digoxin toxicity?Anorexia
Nausea
Visual disturbance
Diarrhoea - 20What is first line treatment of LV dysfunction seen in HF?ACEI + beta-blocker
(+diuretic if oedema) - 21What drugs might be used as 2nd line treatment in LV dysfunction seen in HF?Spironolactone
OR
AT1RA
OR
Hydralazine + nitrate - 22What drug is used 3rd line in HF?Digoxin
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- CP1 Flashcards on Chronic heart failure, created by Lou Clark on 12/06/2018.
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- Lou Clark
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