MN553 Unit 7 Quiz|215
Questions with Verified
answers 2024
What is the drug of choice for stage A heart failure - -ACEs
- What medication is considered in Stage A heart failure but is more
expensive than ACEs - -ARBs
- What drugs will you see in most stage B heart failure patients - -Beta
blockers
- What medications will you see in all stage b heart failure patients - -ACEs
- What drugs will you see in Stage B heart failure patients who cannot
tolerate ACEs - -ARBs
- What medications will you see in all stage c heart failure patients (5) - -
ACESs
BBs
Diuretics
Digoxin
Spironolactone
- What medications will you see in stage D heart failure (5) - -Sacubitril
Valsartan (Entresto)
ACEs
ARBs
Inotropes: dobutamine
Ventricular assisting devices
Transplantation
,Hospice
- Pharmacodynamics of ACEs - -Inhibit angiotensin-converting enzyme
(ACE) which results in decreased production of both angiotensin II and
aldosterone
- What are the special characteristics of ACEs - -Can lower vascular
resistance without decreasing cardiac output (CO) or glomerular filtration
rate (GFR)
Does not produce reflex tachycardia
- Uses for ACEs - -Strong evidence for CV and cerebrovascular risk
reduction, heart failure, and slowing renal disease
- Outcomes of ACEs on the heart - -Improves oxygenation to heart muscle,
decreases inappropriate remodeling of heart muscle after MI or with HF,
reduces effects of diabetes on the kidneys
- Outcomes of ACEs on insulin - -Improves insulin sensitivity, does not affect
glucose metabolism or raise serum lipid levels
- Outcomes of ACEs in patients with angina - -Prevents formation of AT II
and decreases pulmonary vascular resistance by decreasing retention of
sodium and water and reducing extracellular fluid and preload
- Outcomes of ACEs in patients with diabetes - -Prevents slow nephropathy
- Outcomes of ACEs in patients after an MI and HF - -Promotes ventricular
remodeling
- True or false
ACEs are equally effective in all races - -False
Not as effective in African Americans
- How do you increase the effects of ACEs in the African American population
- -Combine with a diuretic
- What is the biggest risk with ACEs in AA and Asian populations - -3-4 times
greater risk of angioedema
- ACE ADRs - -Dry cough (bradykinin mediated)
Hypotension
, Loss of taste
Angioedema
Blood dycrasias
Teratogenicity
Hyperkalemia
Acute renal failure
Cholestatic jaundice
Pancreatitis
Rash
- ACE monitoring - -Possible orthostasis within 1 hour of administration
when starting and with each dosage change
- ACE patient education - -Do not double dose if one is missed
Hypotension
Cough is common with the older generation
- Angiotensin II Receptor blocker MOA - -Prevent the binding of AT II to
receptors in the kidneys, brain, heart, and arterial walls
Inhibit the renin-angiotension aldosterone system (RAAS) and cause fall in
peripheral resistance
- Can you use AT II receptor blockers in kidney disease and HF - -Yes until
late stage, but not all forms are renal protective like ACEs
- What are the benefits of AT II receptor blockers - -No bradykinin-mediated
cough like ACEs
- What are considered alternatives for patients who cannot tolerate ACEs or
become resistant - -ARBs
- What medication will you see ARBs combined with - -Hydrochlorothiazide
- ARB ADRs - -Similar to ACEs without the cough (typically)
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