Week 7 Quiz.docx - Week 7 Quiz Chapters 16 20 34 47 25 38 CVS and Renal Treatments for Heart Failure Stage A ACEIs are drug of choice ARBs are

Week 7 Quiz.docx - Week 7 Quiz Chapters 16 20 34 47 25 38...

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Week 7 Quiz Chapters: 16, 20, 34, 47, 25, 38 CVS and Renal Treatments for Heart Failure Stage A : ACEIs are drug of choice; ARBs are considered but more expensive Stage B : ACEI in all patients, ARB for those who cannot tolerate an ACEI, BBs in most Stage C : ACEI and BBs (nonselective) in all patients, Diuretics, digoxin, Spironolactone Stage D : Stage C treatment, Inotropes: dobutamine, Ventricular assist device, transplantation, hospice ACEIs- Can lower vascular resistance without decreasing cardiac output or glomerular filtration rate -Strong evidence for CV and cerebrovascular risk reduction, HF, and slowing renal disease -Improves oxygenation to heart muscle, decreases innapropriate remodeling of heart muscle after MI or with heart failure, reduces affects of diabetes on the kidneys -Improves insulin sensitivity, does not affect glucose metabolism or raise serum lipid levels -Use with young causcasian patients, patients w/ angina, diabetic patients (prevents or slows nephropathy), HF patients -African American and Asians have 4 to 4 times greater risk of developing angioedema Common ACE inhibitors: Benanzopril Captopril Enalapril Fosinopril Lisinopril Moexipril Angiotensin II Receptor Blockers -Prevent binding of AT II to receptors in kidney, brain, heart, and arterial walls -Inhibit the renin-angiotensin-aldosterone system and cause fall in peripheral resistance -Evidence supports use in kidney disease until late stage and heart failure, but not renal protective like ACEI -No bradykinin-mediated cough like ACEI -Cost of generic ACE inhibitors provides significant advantage over branded ARBs (generics now
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