PHPY 304 Lecture Notes - Lecture 11: Spironolactone, Furosemide, Afterload

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Objectives: define heart failure (hf) & quote its prevalence, quote the effects on stroke volume (sv) due to changes in preload (vr), afterload (tpr) and cardiac. List drug classes which change these 3 parameters: quote their mechanisms of action, efficacy and major adverse effects of agents used in the management of chf. Redu(cid:272)ed (cid:272)ardia(cid:272) output for the (cid:271)ody"s need. Dyspnea, fatigue edema, reduced ef on echo, heart looks large on x-ray. Increased work load: hypertension, valve issues, pregnancy, hyperthyroid, diabetes. Stroke volume levels are lower in heart failure. Increase in preload (incomplete emptying), and afterload (elevated sns and raas) and tpr with a decrease in sv and co. To counteract this the heart stretches, however it fails. Compensatory mechanisms in heart are sns and frank sterling law both increase contactile force. Goals: drugs to decrease pre-load and after load. Furosemide: used for chf mainly, effects. Add spironolactone: k+ sparing, reduces hyperkaliemia, blocks aldo action on heart remodeling and cardia fibrosis.

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