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Drugs Used in Heart Failure - Coggle Diagram
Drugs Used in Heart Failure
Positive Ionotropes
improve contractility of the heart
increase SV and CO
Drugs that increase myocyte cAMP
Beta Agonists (Sympathomimetics)
Dobutamine
use limited to acute treatment of severe heart failure due to systolic dysfunction
must be given by CRI in hospital settling
tachycardia and arrhythmias are a concern
Dopamine
also used for short term treatment in acute systolic heart failure (preferred drug bc it is less likely to cause arrhythmias)
also used in the management of acute oliguric renal failure in the dog
high dose = increase vasoconstriction
medium dose = increased inotropy (contractility)
low dose = renal vasodilation
Na+/K+ ATPase Blockers
Digoxin
derivative of the purple foxglove plant
inhibits sodium potassium ATPase pumps on myocytes -> caused buildup of intracellular calcium -> action potential sees greater calcium released and enhanced actin-myosin interaction = increased ionotropy (contractility)
used primarily in the HORSE
Calcium sensitizers
Pimobendan
first line drug to enhance contractility for dogs
good for valvular insufficiency and dilated cardiomyopathy
works FAST and very safe (often combined with diuretics and aceinhibitors
Drugs that decrease preload
Diuretics
Furosemide, Hydrochlorothiazide, Spironolactone
furosemide causes acute renal dilation -> aids acute relief of edema
disadvantage is their activation of the RAAS system
hypokalemia (RAAS activation will cause retention of sodium and expelling of K+) and digoxin toxicity
Venodilators
Nitroglycerin
indicated in acute treatment of CHF
usually used in conjunction with furosemide
Drugs that decrease afterload
Arteriodilators
Calcium channel blockers (CCB)
Amlodipine
calcium channel blocker that's an arteriodilator
Hydralazine
Mixed Vasodilators
decrease preload and afterload
Ace Inhibitors
angiotensin converting enzyme inhibitor
used as first line therapy in heart failure
decrease preload and afterload
Benazapril
Angiotensin receptor b;lockers
Telmisartan
Nitroprusside
Sildenafil
(viagara)
Drugs that treat reduced distensibility
Negative Inotropes/chronotropes
decrease inotropy and chronotropy but increase myocyte rate of relaxation
used to treat HCM and aortic and pulmonic stenosis
Calcium channel blockers
Diltiazem
Beta Adrenergic blockers
Atenolol
Propranolol
Carvedilol
Additional drugs used in heart failure
Spironolactone