Pharma quiz 2 last page. HF

Study Notes

Oxygenated blood moves from lungs to body but fails to circulate effectively.
Causes pulmonary congestion leading to symptoms such as:
- Pale or cyanotic skin
- Shortness of breath with crackles on auscultation

Deoxygenated blood from the body struggles to return to the lungs.
Results in systemic congestion characterized by:
- Cold, clammy, cyanotic skin
- Fluid accumulation
- Jugular venous distention (JVD)
- Symptoms often worsen with gravity

Classifies heart failure severity, with higher classes indicating worse conditions.

ACE inhibitors: First-line treatment for heart failure.
Angiotensin II receptor blockers: Effective with no cough side effect.
Certain B-blockers: Useful for managing heart rate.
Loop diuretics (e.g., furosemide): Promote diuresis; prevent fluid retention.
Aldosterone inhibitors (e.g., spironolactone, eplerenone): Prevent sodium retention and edema.
Digoxin: Last-resort medication, increases contractility, carries risk of toxicity.

Digoxin (Langxin): Initially recommended for heart failure management.
- Enhances contractility and slows electrical conduction.
- Risk of toxicity; monitor closely for adverse effects including visual disturbances like blurred vision and green/yellow halos.

Monitor for orthostatic hypotension, electrocardiogram (ECG) changes, and serum digoxin levels.
- Hold digoxin if heart rate is < 60 or > 100 bpm and notify a physician.
Be aware of potential hypokalemia complications.
Educate patients on the importance of avoiding fiber intake with digoxin.

Digibind and Digifab: Treatment options for digoxin overdose and life-threatening dysrhythmias.

Dobutamine: Increases contractility.
Hydralazine/Isosorbide Dinitrate: Recommended specifically for black patients.
Milrinone: A phosphodiesterase inhibitor used as an inotropic agent and for short-term management in ICU settings.
- Increases cyclic AMP (cAMP), improving contractility and dilation.
- Notable for having several adverse effects; only available in Canada.