NURS 3210 CH 24 PPT

Reducing the effects of the renin-angiotensin-aldosterone system and the sympathetic nervous system; ACE inhibitors, ARBs, and certain beta blockers.

To reduce symptoms of heart failure secondary to fluid overload; typically used in conjunction with other medications.

As the heart failure progresses.

<p>To improve symptoms and reduce hospitalizations; added after other medications have been used.</p> Signup and view all the answers

<p>Class IV.</p> Signup and view all the answers

<p>Increase the force of myocardial contraction.</p> Signup and view all the answers

<p>To reduce the effects of the sympathetic nervous system; cardioselective beta blockers, such as metoprolol, are commonly used.</p> Signup and view all the answers

<p>To reduce the effects of the renin-angiotensin-aldosterone system.</p> Signup and view all the answers

<p>Inhibiting the enzyme phosphodiesterase, resulting in an increase in intracellular cAMP, positive inotropic response, vasodilation, and increased calcium for myocardial muscle contraction.</p> Signup and view all the answers

<p>Blacks</p> Signup and view all the answers

<p>Dopamine</p> Signup and view all the answers

<p>Milrinone</p> Signup and view all the answers

<p>Short-term management of heart failure in patients in the intensive care unit</p> Signup and view all the answers

<p>Blocking aldosterone at its receptors in the kidney, heart, blood vessels, and brain</p> Signup and view all the answers

<p>Potassium-sparing</p> Signup and view all the answers

<p>Phosphodiesterase inhibitors</p> Signup and view all the answers

<p>Inhibiting angiotensin-converting enzyme, preventing sodium and water resorption by inhibiting aldosterone secretion, which leads to diuresis and decreases preload and the work of the heart.</p> Signup and view all the answers

<p>It was approved specifically for use in Blacks, making it the first drug approved for a specific ethnic group.</p> Signup and view all the answers

<p>Dry cough</p> Signup and view all the answers

<p>Decreasing systemic vascular resistance (afterload)</p> Signup and view all the answers

<p>The mechanism of action of ARBs does not affect potassium levels, unlike ACE inhibitors which can increase potassium levels.</p> Signup and view all the answers

<p>Hypertension, HF, and acute MI</p> Signup and view all the answers

<p>ARBs are less likely to cause hyperkalemia, while ACE inhibitors can increase potassium levels.</p> Signup and view all the answers

<p>ARBs are less likely to cause dry cough and hyperkalemia.</p> Signup and view all the answers

<p>Heart failure is a complex clinical syndrome resulting from any functional or structural impairment to the heart, specifically ejection of blood or ventricular filling. Symptoms depend on the cardiac area affected, including dyspnea, fatigue, fluid retention, and/or pulmonary edema.</p> Signup and view all the answers

<p>Common causes of heart failure include myocardial infarction, coronary artery disease, cardiomyopathy, valvular insufficiency, atrial fibrillation, infection, tamponade, and ischemia.</p> Signup and view all the answers

<p>The stages of heart failure are: Stage A (high risk for heart failure but no symptoms or structural heart disease), Stage B (structural heart disease but no symptoms), Stage C (structural heart disease with symptoms), and Stage D (refractory HF requiring interventions).</p> Signup and view all the answers

<p>The stages are: Class I (no limitations of physical activity), Class II (slight limitations), Class III (marked limitations), and Class IV (unable to perform any physical activity).</p> Signup and view all the answers

<p>The primary goal is to manage symptoms, improve quality of life, and reduce morbidity and mortality.</p> Signup and view all the answers

<p>The therapeutic range for digoxin is 0.8-2 ng/mL.</p> Signup and view all the answers

<p>Common adverse effects include nausea, vomiting, anorexia, fatigue, and arrhythmias.</p> Signup and view all the answers

<p>The primary treatment for digoxin toxicity is digoxin immune Fab, which binds to digoxin and enhances its elimination.</p> Signup and view all the answers

<p>Valsartan/Sacubitril is a combination of ARB and neprilysin inhibitor, and its primary indication is for the management of heart failure with reduced ejection fraction.</p> Signup and view all the answers

<p>ARNI blocks the degradation of vasoactive peptides by inhibiting the neprilysin enzyme.</p> Signup and view all the answers

<p>The cardioprotective quality of beta blockers is to prevent catecholamine-mediated actions on the heart by reducing or blocking sympathetic nervous system stimulation to the heart and the heart's conduction system.</p> Signup and view all the answers

<p>Aldosterone antagonists work by activating the renin-angiotensin-aldosterone system, which decreases the levels of aldosterone, leading to reduced retention of sodium and water and thereby reducing edema that can worsen heart failure.</p> Signup and view all the answers

<p>One common adverse effect of Valsartan/Sacubitril is hyperkalemia, which is related to its mechanism of action as an ARB and neprilysin inhibitor.</p> Signup and view all the answers

<p>Beta blockers are used in heart failure to reduce the sympathetic nervous system stimulation to the heart, and metoprolol and carvedilol (Coreg) are commonly used medications.</p> Signup and view all the answers

<p>The primary effect of beta blockers on the heart is to reduce heart rate, delay AV node conduction, reduce myocardial contractility, and decrease myocardial automaticity, which is related to their mechanism of action as blockers of the sympathetic nervous system stimulation.</p> Signup and view all the answers

<p>The primary concern for using Valsartan/Sacubitril is that it is not recommended for use in pregnancy, and this is essential to consider due to the potential risks to the fetus.</p> Signup and view all the answers