19: Heart Failure Drugs
- Page ID
- 90333
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)- 19.0: Introduction
- This page covers heart failure as a syndrome characterized by inadequate cardiac output, primarily due to left ventricular dysfunction. It highlights chronic hypertension and acute myocardial infarction as potential causes. The chapter aims to provide a comprehensive overview of heart failure, examining its causes along with pharmacologic and nonpharmacologic treatment approaches.
- 19.1: Heart Failure
- This page discusses heart failure, detailing its pathophysiology, symptoms, causes, and treatment options. It outlines stages of heart failure and highlights the importance of cardiac output, self-monitoring, and patient education for effective management. Non-pharmacologic treatments like dietary changes and exercise are emphasized alongside a pharmacologic overview.
- 19.2: Drugs Affecting the Renin-Angiotensin-Aldosterone System
- This page covers key pharmacological treatments for heart failure and hypertension, focusing on ACE inhibitors, ARBs, and MRAs. It outlines the actions, benefits, and side effects of these drug classes, including hyperkalemia and hypotension. The importance of careful monitoring and patient education on dietary restrictions and potential side effects is emphasized, particularly for vulnerable populations like older adults and pregnant individuals.
- 19.3: Beta-Adrenergic Blockers
- This page covers beta-adrenergic blockers for heart failure, highlighting their benefits, adverse effects, and nursing responsibilities. It explains how these medications improve cardiac function by reducing heart rate and blood pressure and mentions specific drugs like metoprolol and bisoprolol that lower mortality rates. Clients are advised to monitor for symptoms of low blood pressure and to avoid combining beta blockers with other medications without consulting a provider.
- 19.4: Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2Is)
- This page details sodium-glucose cotransporter 2 inhibitors (SGLT2Is), focusing on their role in treating heart failure, originally developed for type 2 diabetes. These medications reduce heart failure mortality through diuresis and improved cardiac function. Key adverse effects include ketoacidosis and urinary tract infections. It emphasizes the need for nurses to monitor dehydration and renal health, as well as the importance of client education on side effects and when to seek medical help.
- 19.5: Diuretics
- This page discusses the use of diuretics in heart failure treatment, specifically loop and thiazide diuretics, highlighting their characteristics, risks, and the necessity of monitoring electrolytes. It emphasizes patient education and clinical assessments. A case study illustrates a patient with elevated blood pressure and fluid retention, leading to the consideration of furosemide for management, alongside guidance on enalapril use and potassium intake.
- 19.6: Adjunct Medications Used in Heart Failure
- This page covers adjunct medications for heart failure, specifically hydralazine and isosorbide dinitrate (BiDil), effective for Black clients with low ejection fractions. It addresses nursing implications such as blood pressure monitoring and patient education. Additionally, it discusses digoxin's toxicity risks and ivabradine's role in improving heart rate and oxygenation, along with related nursing considerations.
- 19.7: Chapter Summary
- This page covers heart failure, emphasizing a decline in cardiac output and its essential factors: heart rate and stroke volume. It explains the renin-angiotensin-aldosterone system's impact on cardiac function and categorizes heart failure medications, including ACE inhibitors, ARBs, and diuretics. Additionally, it discusses adjunctive treatments like hydralazine/isosorbide dinitrate and ivabradine, offering a thorough overview of pharmacological management strategies for heart failure.
- 19.8: Key Terms
- This page covers key cardiovascular terms like afterload, preload, cardiac output, and contractility, which are essential for understanding heart function. It discusses various drug classifications, such as ARBs, ACE inhibitors, and diuretics, that manage blood pressure and heart failure. The differences between heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) are clarified, highlighting their distinct manifestations.
- 19.9: Review Questions
- This page provides exercises on cardiac medications and patient education, covering cardiac output components, mechanisms of heart failure drugs like lisinopril and dapagliflozin, and dosing calculations. It stresses the importance of monitoring electrolytes, understanding demographic factors in heart failure treatment, and the necessity of proper education and assessment before medication administration.