18 - Cardiotonic Drugs

Cardiotonic Drugs are used for ____.

Heart Failure

Heart Failure

When the Heart cannot produce enough CO to deliver O2 to the Organs of the body

Acute Heart Failure

Sudden onset and life-threatening

Chronic Heart Failure

Long-term with adapted responses that ultimately lead to worsening health

Systolic Heart Failure

Ventricles are enlarged, thin, and pump less than 40-50% of EDV into circulation

Diastolic Heart Failure

Ventricles are stiff and cannot fill as needed

EDV is decreased so less Blood makes it into circulation

Left-Sided Heart Failure

Characterized by Pulmonary Congestion/Edema

Fluid builds up in the Lungs

Left-Sided Heart Failure Symptoms

- Dyspnea (Shortness of Breath)

- Decreased Exercise Tolerance

- Cough

Right-Sided Heart Failure

Characterized by Systemic Congestion/Edema

Fluid builds up in the Body

Right-Sided Heart Failure Symptoms

- Edema

- Decreased Exercise Tolerance

- Ascites (Fluid accumulation in Abdomen)

Low Ejection Fraction Heart Failure is the same as ____.

Systolic Heart Failure

Normal Ejection Fraction Heart Failure is the same as ____.

Diastolic Heart Failure

A decreased Baroreceptor Reflex decreases SNS stimulation (T/F)

False; Increases

BP has dropped, so the SNS is used to vasoconstrict and increase CO

What are the 5 classes of Cardiotonic Drugs?

- Diuretics

- Cardiotonic Agents

- ACE Inhibitors

- Angiotensin Receptor Blockers (ARBs)

- β-Blockers

Diuretics

Increase urine output by inhibiting Na+ and water reabsorption; Reducing...

- Blood Volume

- BP

What are the 3 types of Diuretics?

- Thiazides (Hydrochlorothiazide)

- Loop (Furosemide)

- K+ Sparing (Spironolactone)

Loop Diuretics (Furosemide)

Inhibits Na+, Cl-, K+ transport in the Ascending Loop of Henle, increasing Na+, Cl-, and water excretion

K+ Sparing Diuretics (Spironolactone)

Aldosterone Receptor antagonist, reducing Na+ and water reabsorption

AEs of Diuretics

- Hypovolemia/Hypotension

- Hyperuricemia

What are the 3 Cardiotonic Agents?

- Digoxin

- Milrinone

- Dobutamine

Digoxin

Inhibit Na+/K+ Pumps, leading to increased intracellular Na+ and decreased Ca2+ export via Na+/Ca2+ Pump; Ultimately increases intracellular Ca2+ and vagal tone...

- Increasing Contractility (via intracellular Ca2+)

- Decreasing HR (via decreased RMP)

Milrinone

PDE3 Inhibitor that increases cAMP levels, therefore, increasing Ca2+ influx; Increasing...

- Contractility

- Vasodilation

Dobutamine

β1-Agonist that enhances cAMP-mediated Ca2+ influx; Increasing...

- Contractility

- Vasodilation

What are the 2 ACE Inhibitors?

- Lisinopril

- Enalepril

What are the 2 Angiotensin Receptor Blockers (ARBs)?

- Losartan

- Valsartan

What are the 4 β-Blockers?

- Propranolol

- Atenolol

- Metoprolol

- Carvedilol

What Antihypertensive interacts with Epinephrine?

Atenolol