Drugs Mechanism of action Clinical Applications Toxicities

LOOP DIURETICS Reduces preload and afterload Acute and Chronic HF esp. acute Hypovolemia
pulmonary edema Ototoxicity
Hypokalemia
Furosemide
Spironolactone Reduces preload and afterload Chronic HF Hyperkalemia
Eplerenone- lacks gynecomastia Antagonist of aldosterone Gynecomastia
ACE Inhibitor and ARBs Blocks angiotensin-converting-enzyme Heart failure Cough
Reduces preload and afterload and Hypertension Nephrotoxic
remodelling Diabetes Hyperkalemia
Captopril
CI in Pregnant women
POSITIVE INOTROPIC Inhibits Na/K/ATPase Chronic Heart Failure Arrhythmogenic
Increase Na—Decrease Ca expulsion Atrial fibrillation (nodal arrhythmias) Interaction with Quinidine
DRUGS Increase contractility --

Digoxin
Dobutamine Beta 1 agonist Acute Heart Failure Arrhythmias
Increase contractile force
BETA BLOCKERS Reduces afterload and remodelling Chronic heart failure Cardiac depression

Carvedilol
Bisoprolol
Metoprolol
VASODILATORS Reduces preload and afterload Acute severe decompensated failure Excessive hypotension
Thiocyanate and cyanide poisoning
Nitroprusside
Hydralazine+ Isosorbide dinitrate Chronic failure in African Americans Headache
Tachycardia
Nesiritide Natriuretic peptide vasodilator Acute severe decompensated failure Nephrotoxic
Reduces preload and afterload
PDE5 INHIBITORS Increase cAMP—increase Ca Acute heart failure Vasodilation
Increase contractility
Milrinone