Pathophysiology
Results from any functional or structural cardiac disorder that impairs the ventricles ability to fill with or eject blood.
What is Heart Failure (HF)?
Releases NO by interaction with glutathione or sulfhydryl groups in erythrocytes and tissues. Thus not requiring enzyme activation.
Rosiglitazone and Pioglitazone belong to this class that can either worsen HF/ cause drug-induced disease.
What is Thiazolidinediones?
CI greater than or equal to 2.2
PCWP greater than or equal to 18
What is Warm and Wet? or
What is Congestion of either Pulmonary or Peripheral?
Captopril
What is the brand name for Captopril?
Cannot create enough force to eject adequate amount of blood from the left ventricle.
What is Systolic?
This drug is a PDE3 Inhibitor and is chemically incompatible with Lasix leading to precipitation.
What is Milrinone?
Daily Double!!!
This prodrug is a Neprilysin Inhibitor (NI) and becomes activated to LBQ657. Thus preventing the break down of ANP, BNP, and CNP.
What is Sacubitril?
Marker of Volume status: Increase in PCWP
What is fluid overload?
Diovan
What is the brand name for Valsartan?
It is the amount of blood in the ventricles at the end of diastole.
What is Preload?
The catecholamine structure of this drug increases the potential for air oxidation. Sodium bisulfite is added to the IV preparation for stabilization.
What is Dobutamine?
An HF patient should be aware of this particular drug that has an early toxicity of GI symptoms (N/V). Loss of appetite and bradycardia!
What is Digitalis Glycoside? or What is Digoxin?
First line treatment for "Wet" presentations of ADHF.
What is Diuretic Therapy? or What is Bumetanide? or What is Lasix?
Sacubitril - Valsartan
What is the generic combo for Entresto?
This type of compensatory mechanism can cause a fall in CO, which leads to activation of these three major players: Sympathetic nervous system, RAAS, and Antidiuretic hormone (vasopressin).
What is Neurohormonal Activation?
This prodrug is activated by CES1 enzyme in the liver.
What is Sacubitril?
This drug is thought to interfere with Ca+2 entry into VSMC. Site of action peripheral arteries leads to drop in PVR.
What is Hydralazine?
The heart can change its force of contraction (reflective of its SV) in response to changes in pressure with the LV (reflective of venous return). Therefore, CO is dependent on preload.
What is Frank-Starling Law?
DAILY DOUBLE!!!
Nebivolol
What is the generic name for Bystolic?
Dilated weak heart impairing its ability to pump blood to the rest of the body.
LVEF<40%
What is Systolic function? or What is HFrEF (heart failure with reduced ejection fraction?
This chemical reaction changes the formulation of Nitrates when exposed to Moisture.
What is Hydrolyze?
In heart: Attenuate remodeling/cardiac fibrosis resulting from cardiac extracellular matrix collagen deposition.
ADR: Gynecomastia
What is Aldosterone Antagonists? What is Aldactone (spironolactone? or What is Inspra (Eplerenone)?
Beneficial Effects: Helps decrease myocardial wall stress to increase CO and decrease myocardial O2 use.
Detrimental effects: Fibrosis (non-functional heart muscle)
What is compensatory response: Ventricular Hypertrophy and remodeling?
ISDN/Hydralazine
What is the generic name for Bidil?
DAILY DOUBLE!!
Cardiac disease resulting in slight limitation of physical activity (symptomatic with moderate exertion)
What is NYHA classification stage 2?
This drug blocks the "funny" current/channel from the sinoatrial node. Nearly complete oral absorption but may slow absorption and increase plasma exposure.
What is Ivabradine?
Within the SA node, this drug selectively blocks the HCN channel, inhibits the If current and lowers heart rate.
What is Corlanor (ivabradine)?
Target dosing in HF: 20-40mg po daily.
What is lisinopril (prinvil, zestril)?
Milrinone
What is the generic name for Primacor?