Naplex Quiz On Heart Failure! Exam

Before initiating a beta blocker, it is important for a patient to be stable in terms of fluid overload and volume retention. This is because beta blockers can potentially worsen these conditions. By ensuring that the patient is stable, the risk of exacerbating fluid overload or volume retention can be minimized, making it safer to initiate a beta blocker treatment. Therefore, the statement is true.

About 70% of pts are assigned to the warm and wet classification.

When quinidine, verapamil, or amiodarone are added to a drug regimen with digoxin, these medications can inhibit the clearance of digoxin from the body, leading to increased levels of digoxin. This can result in digoxin toxicity. To prevent this, the dose of digoxin should be decreased by 50% when these medications are added to the regimen.

Inspra is the brand name. Spironolactone's brand name is Aldactone.

Coreg - carvedilol. Toprol - metoprolol.

This pt has slight limitations of physical activity. Class I has no limitations; class III has marked limitations (minimal exertion will lead to symptoms).

The correct answer is "Pulmonary (upper respiratory tract infections, cough)". This option is not included because it does not represent a major adverse event associated with digoxin. Digoxin primarily affects the cardiovascular system, causing cardiac arrhythmias, bradycardia, and heart block. It also affects the gastrointestinal system, leading to symptoms such as anorexia, abdominal pain, and nausea/vomiting. Additionally, digoxin can have neurological effects, including visual disturbances, disorientation, confusion, and fatigue. However, it does not typically cause upper respiratory tract infections or cough.

Extended release metoprolol, bisoprolol, and carvedilol have all been shown to reduce mortality and should be used in all stable patients with current/prior heart failure symptoms and reduced left ventricular ejection fraction, unless there are contraindications. These beta-blockers have demonstrated efficacy in improving symptoms, reducing hospitalizations, and prolonging survival in patients with heart failure.

Stage A includes pts at high risk of developing heart failure, but without presence of sx that are strongly associated with heart failure. According to this classifcation, neither pts in Stage A or B actually have heart failure.

Demadex is a brand name for Torsemide. Torsemide is a loop diuretic medication that is used to treat edema (fluid retention) caused by conditions such as congestive heart failure, kidney disease, or liver disease. It works by increasing urine production and reducing the amount of excess fluid in the body. Torsemide is commonly prescribed to help reduce swelling and fluid buildup in patients with these conditions.

All of the counseling points mentioned for a patient taking beta-blockers for heart failure are true. Carvedilol should be taken with food to enhance its absorption. Beta blockers may initially cause worsening of heart failure and fluid retention, so regular weighing can help assess for fluid overload. Fatigue or weakness may occur initially but should resolve within a few weeks. Beta blockers can mask the signs of hypoglycemia except sweating. It is important to take the medication as directed because beta blockers can decrease the risk of death and hospitalization associated with heart failure.

The given statement is true. Candesartan's brand name is indeed Micardis.

Bisoprolol is eliminated 50% by the kidneys, while metoprolol and carvedilol are metabolized by the liver.

When paroxetine/fluoxetine are used with metoprolol/carvedilol, there is a potential for increased plasma concentrations of the beta blocker. This means that the levels of the beta blocker in the blood may be higher than usual, leading to an increased effect of the medication. This interaction could potentially result in an intensified therapeutic response or increased side effects of the beta blocker. It is important to monitor patients closely for any signs of toxicity or adverse effects when these medications are used together.

Additional potassium should be used cautiously (not encouraged). ACEIs are pregnancy category C during the 1st trimester and pregnancy category D during the second and third trimesters.

Captopril's brand name is Capoten (often given TID). Lisinopril's brand name is Zestril or Prinivil.

Digoxin - 0.5 - 1

Pts with ADHF often require POSITIVE inotropes (dopamine, dobutamine, milrinone)

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Spironolactone can increase digoxin plasma concentrations because it inhibits the renal excretion of digoxin, leading to increased levels of digoxin in the blood. Eplerenone undergoes hepatic metabolism via P450 enzymes, which means that it is metabolized in the liver by these enzymes. Serum creatinine should be

Loop diuretics are known to cause hypokalemia and hypomagnesemia, which means that they can lead to low levels of potassium and magnesium in the body. Additionally, the diuretic effect of loop diuretics can be diminished by NSAIDs. Food intake can also decrease the bioavailability of furosemide and bumetanide, making the medication less effective. Some patients who are allergic to sulfa-containing medications may also be allergic to loop diuretics. Lastly, loop diuretics can make the skin more sensitive to sunlight, so patients may need to wear sunscreen while taking the medication.