Pharmacologic Management of Heart Failure
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Questions and Answers

What is one of the treatment goals for heart failure in terms of reducing morbidity?

  • Increasing afterload
  • Relief of symptoms (correct)
  • Decreasing blood volume
  • Reducing preload

What is NOT the treatment goals for heart failure in terms of reducing morbidity?

  • Maintaining optimal blood glucose levels (correct)
  • Relief of symptoms
  • Avoid hospital admission
  • Treat underlying or aggravating cause

Which class of drugs DO NOT reduces both preload and afterload in the treatment of heart failure?

  • ACE inhibitors/ARBs
  • Aldosterone antagonists
  • Diuretics (correct)
  • β-blockers

Which class of drugs improves cardiac contractility in the treatment of heart failure?

<p>Inotropic agents (D)</p> Signup and view all the answers

Which class of drugs DO NOT acts as arterial dilators in the treatment of heart failure?

<p>Inotropic agents (B)</p> Signup and view all the answers

Which class of drugs reduces preload by reducing circulatory volume in the treatment of heart failure?

<p>Diuretics (B)</p> Signup and view all the answers

Which class of drugs reduces afterload by preventing A II formation or blocking the effects of A II in the treatment of heart failure?

<p>ACE inhibitors/Angiotensin receptor blockers (C)</p> Signup and view all the answers

Which class of drugs increases myocardial contractility in the treatment of heart failure?

<p>Inotropic Agents (B)</p> Signup and view all the answers

Which enzyme does Digoxin inhibit to increase intracellular Ca2+?

<p>Na+/K+ ATPase enzyme (D)</p> Signup and view all the answers

What is the main clinical use of Digoxin?

<p>Chronic heart failure (D)</p> Signup and view all the answers

What is the half-life of Digoxin?

<p>36 hours (B)</p> Signup and view all the answers

What are the cardiac adverse effects of Digoxin?

<p>Heart block, arrhythmias (A)</p> Signup and view all the answers

What is the recommended monitoring for Digoxin therapy?

<p>Plasma digoxin monitoring (B)</p> Signup and view all the answers

What are the possible reasons to monitor plasma concentrations of Digoxin?

<p>To detect toxicity or lack of efficacy (A)</p> Signup and view all the answers

Which electrolyte imbalance increases the risk of digitalis-induced arrhythmia?

<p>Hypercalcemia (C)</p> Signup and view all the answers

Which condition can lead to decreased elimination of Digoxin?

<p>Hypothyroidism (D)</p> Signup and view all the answers

What is the recommended treatment for ventricular arrhythmias associated with Digoxin toxicity?

<p>Phenytoin (C)</p> Signup and view all the answers

Which enzyme do bipyridines inhibit to increase cAMP levels?

<p>Phosphodiesterase isozyme 3 (PDE-3) (C)</p> Signup and view all the answers

What is the main route of excretion for bipyridines?

<p>Renal excretion (D)</p> Signup and view all the answers

What are the common adverse effects of bipyridines?

<p>Nausea/vomiting, arrhythmia, thrombocytopenia, liver enzyme changes (B)</p> Signup and view all the answers

Which one of these drugs is NOT a β1 agonist?

<p>Epinephrine (B)</p> Signup and view all the answers

Which one of these is NOT a clinical use of β1 agonists?

<p>To treat hypertension (B)</p> Signup and view all the answers

Which one of these adverse effects is NOT associated with β1 agonists?

<p>Hypotension (C)</p> Signup and view all the answers

Which one of these is the primary mechanism of action (MOA) of beta-1 agonists?

<p>Stimulate cardiac beta-1 receptors (C)</p> Signup and view all the answers

Which diuretic is recommended for mild edema?

<p>Thiazide (A)</p> Signup and view all the answers

Which diuretic is recommended for moderate and severe edema?

<p>Furosemide (D)</p> Signup and view all the answers

Which diuretic is reported to reduce morbidity and mortality when taken with ACE inhibitors and other agents?

<p>Spironolactone (A)</p> Signup and view all the answers

Which of the following best describes the mechanism of action of diuretics?

<p>Promote diuresis and reduce circulating blood volume (C)</p> Signup and view all the answers

Which of the following is a common reason for diuretic resistance in heart failure management?

<p>Compensatory increase in renal tubular Na+ reabsorption (C)</p> Signup and view all the answers

How do diuretics reduce peripheral and pulmonary edema in heart failure?

<p>By decreasing salt and water retention (A)</p> Signup and view all the answers

Which part of the nephron do thiazide diuretics primarily act on?

<p>Distal convoluted tubule (C)</p> Signup and view all the answers

Which type of diuretic inhibits the sodium channels involved in sodium reabsorption in the cortical collecting duct?

<p>Potassium-sparing diuretics (C)</p> Signup and view all the answers

Where do loop diuretics primarily act in the nephron?

<p>Thick ascending Loop of Henle (C)</p> Signup and view all the answers

Which of the following is NOT an example of a loop diuretic?

<p>Hydrochlorothiazide (A)</p> Signup and view all the answers

What is the main route of administration for loop diuretics?

<p>Oral (B)</p> Signup and view all the answers

What is the main clinical use of loop diuretics?

<p>Heart failure (C)</p> Signup and view all the answers

Which transporter do loop diuretics inhibit in the thick ascending limb of the loop of Henle?

<p>NKCC2 transporter (C)</p> Signup and view all the answers

Which of the following is the primary route of administration for thiazide diuretics?

<p>Oral (A)</p> Signup and view all the answers

What is the peak effect duration of thiazide diuretics?

<p>4-6 hours (B)</p> Signup and view all the answers

Which of the following is NOT a mechanism of action of thiazide diuretics?

<p>Inhibit aldosterone secretion (D)</p> Signup and view all the answers

Which of the following is the primary indication for thiazide diuretics?

<p>Hypertension (A)</p> Signup and view all the answers

Which electrolyte imbalance is associated with an increased risk of digoxin toxicity due to thiazide use?

<p>Hypokalemia (C)</p> Signup and view all the answers

Which of the following adverse effects is mostly associated with loop diuretics?

<p>Hypovolaemia (C)</p> Signup and view all the answers

Which of the following adverse effects is mostly associated with thiazide diuretics?

<p>Hyperglycemia (C)</p> Signup and view all the answers

Which of the following adverse effect is for either loop diuretics or thiazide diuretics?

<p>Hyperuricemia (C)</p> Signup and view all the answers

Which of the following adverse effects is NOT associated with K+ sparing diuretics?

<p>Hypokalaemia (D)</p> Signup and view all the answers

Which of the following adverse effects is associated with EnaC blockers?

<p>Hyponatraemia (B)</p> Signup and view all the answers

Which organ is primarily responsible for the metabolism of K+ sparing diuretics?

<p>Liver (A)</p> Signup and view all the answers

Which electrolyte imbalance is a concern when using K+ sparing diuretics in patients taking ACE inhibitors?

<p>Hyperkalaemia (C)</p> Signup and view all the answers

Which type of K+ sparing diuretic inhibits the aldosterone-induced production of sodium transport proteins (Aldosterone-dependent antagonists) at collecting tubules?

<p>Spirinolactone (D)</p> Signup and view all the answers

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