Inquire through: | Professional | Confidential Support
Pharm Final - Module 12 (HF, Angina,
Arrhythmia, Obesity, Smoking Cessation,
Anemia) Verified and Updated Questions
and Answers (100% Correct Answers)
Spironolactone (Aldactone)
Answer: · MRA
· Potassium-sparing diuretics (can cause hyperkalemia and renal impairment)
· Lower cost than eplerenone
· Can cause endocrine side effects (androgen blocker)
· Avoid in pregnancy
· Need to check labs 1-2 weeks after starting
Eplerenone (Inspra)
Answer: · MRA
· Potassium-sparing diuretics (can cause hyperkalemia and renal impairment)
· Avoid in pregnancy
· Need to check labs 1-2 weeks after starting
· More expensive than spironolactone, but it doesn't cause the androgen side effects
(usually try spironolactone first)
Sacubitril/valsartan (Entresto)
Answer: · ARNI
· DO NOT combine with ACE or ARB or direct renin inhibitor (need to be off an ACE
for 36 hrs before you can start an ARNI)
· Expensive
, Inquire through: | Professional | Confidential Support
· Avoid in pregnancy/lactation, and Hx angioedema
Digoxin (HF)
Answer: · Inotropic effects, used in arrhythmias
· Can be an add on to other HF therapies, not so great on its own
· Narrow therapeutic window --> monitor for toxicity and renal function
What drugs can be helpful with Heart Failure?
Answer: • HFrEF Primary Therapy: Need a diuretic, a beta blocker, and either an
ACE, an ARB, or an ARNI
• HFrEF Secondary therapy: Certain SGLT2s, MRA, Ivabradine, digoxin, hydralazine +
nitrate (patients may be on some or none of these)
Which drugs for Heart Failure can cause hypokalemia or hyperkalemia?
Answer: • Hypokalemia: Loop diruetics
• Hyperkalemia: Sacubitril/valsartan (Entresto), eplerenone
What are some examples of loop diuretics?
Answer: • Furosemide, bumetanide, torsemide
What are some considerations for beta blocker therapy in Heart Failure?
Answer: • 3 beta blockers with established clinical benefits in HFrEF: carvedilol
(immediate release or extended release), extended release metoprolol succinate, or
bisoprolol
• Initiated soon after patient starts ACE, ARNI, or ARB
• Start at low doses and titrate up based on symptoms to reach optimal dose
• Monitor weight
What are some pharmacotherapeutic considerations for prescribing an aldosterone
antagonist for a patient with heart failure?
Answer: • Spironolactone is the cheaper of the two MRAs, but it has androgen-
blocking endocrine effects
• Should switch to eplerenone if there are androgen effects
Pharm Final - Module 12 (HF, Angina,
Arrhythmia, Obesity, Smoking Cessation,
Anemia) Verified and Updated Questions
and Answers (100% Correct Answers)
Spironolactone (Aldactone)
Answer: · MRA
· Potassium-sparing diuretics (can cause hyperkalemia and renal impairment)
· Lower cost than eplerenone
· Can cause endocrine side effects (androgen blocker)
· Avoid in pregnancy
· Need to check labs 1-2 weeks after starting
Eplerenone (Inspra)
Answer: · MRA
· Potassium-sparing diuretics (can cause hyperkalemia and renal impairment)
· Avoid in pregnancy
· Need to check labs 1-2 weeks after starting
· More expensive than spironolactone, but it doesn't cause the androgen side effects
(usually try spironolactone first)
Sacubitril/valsartan (Entresto)
Answer: · ARNI
· DO NOT combine with ACE or ARB or direct renin inhibitor (need to be off an ACE
for 36 hrs before you can start an ARNI)
· Expensive
, Inquire through: | Professional | Confidential Support
· Avoid in pregnancy/lactation, and Hx angioedema
Digoxin (HF)
Answer: · Inotropic effects, used in arrhythmias
· Can be an add on to other HF therapies, not so great on its own
· Narrow therapeutic window --> monitor for toxicity and renal function
What drugs can be helpful with Heart Failure?
Answer: • HFrEF Primary Therapy: Need a diuretic, a beta blocker, and either an
ACE, an ARB, or an ARNI
• HFrEF Secondary therapy: Certain SGLT2s, MRA, Ivabradine, digoxin, hydralazine +
nitrate (patients may be on some or none of these)
Which drugs for Heart Failure can cause hypokalemia or hyperkalemia?
Answer: • Hypokalemia: Loop diruetics
• Hyperkalemia: Sacubitril/valsartan (Entresto), eplerenone
What are some examples of loop diuretics?
Answer: • Furosemide, bumetanide, torsemide
What are some considerations for beta blocker therapy in Heart Failure?
Answer: • 3 beta blockers with established clinical benefits in HFrEF: carvedilol
(immediate release or extended release), extended release metoprolol succinate, or
bisoprolol
• Initiated soon after patient starts ACE, ARNI, or ARB
• Start at low doses and titrate up based on symptoms to reach optimal dose
• Monitor weight
What are some pharmacotherapeutic considerations for prescribing an aldosterone
antagonist for a patient with heart failure?
Answer: • Spironolactone is the cheaper of the two MRAs, but it has androgen-
blocking endocrine effects
• Should switch to eplerenone if there are androgen effects
