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Drugs used for Congestive Heart Failure

Drugs used for Congestive Heart Failure. Drug List. Vasodilators: Nitrates that act to directly relax vascular muscle tone and cause decrease in blood pressure with pooling of blood in the veins. The preload and afterload will be decreased

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Drugs used for Congestive Heart Failure

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  1. Drugs used for Congestive Heart Failure

  2. Drug List

  3. Vasodilators: Nitrates that act to directly relax vascular muscle tone and cause decrease in blood pressure with pooling of blood in the veins. The preload and afterload will be decreased • ACE inhibitors: are agents that block the conversion of angiotensin 1 to angiotensin 2. These drugs causes vasodilatation and decreased blood volume. The afterload will be decreased. • Diuretics: are employed to decrease the blood volume, which decreased the venous return and blood pressure. The results are decreased preload and decreased afterload.

  4. Beta agonists: will stimulate the beta receptors in the heart, increasing the myocardial contraction – called positive inotropic effect • Cardio-tonic drugs: These agents effect the intracellular Ca++ levels in the heart muscle cells leading to increased contractility. The result is increased cardiac output, increased renal blood flow, increased perfusion and increased urine formation. Cardiotonic drugs are: • Cardiac Glycosides • Phosphodiesterase inhibitors

  5. Cardiac glycosides - Digoxin • They increase the level of calcium inside the cardiac myocyte by inhibiting the Na+/K+ pump. • More Ca++ accumulates in the cytoplasm during depolarization and the myocardium will contract forcefully. This is known as positive inotropic effect • Increased cardiac output • Increased blood flow to the body organs like the kidney and liver

  6. Effects of Cardiac Glycosides • Negative chronotropic effect: The heart rate is slowed due to decreased rate of cellular repolarization • Decreased conduction velocity through AV node

  7. Contraindications and Precautions • Allergy • Ventricular dysrhythmias • Heart block • Sick sinus syndrome • Acute myocardial infarction • Aortic stenosis • Electrolyte imbalances: Hypokalemia, Hypomagnesemia, hypercalcemia • Renal failure may cause accumulation of drug

  8. Adverse effects of digoxin • Headache, weakness, seizures and drowsiness • Arrhythmias • Signs of digitalis toxicity: anorexia, nausea and vomiting, visual changes – yellow halo around objects, palpitations or slow heart rate

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