Anesthesia Pharmacology Practice Questions: Congestive Heart Failure

Which one(s) of the following approaches best characterizes the current approach to the management of heart failure with decreased ejection fraction?
1. Approaches centered on diuretic use
2. Approaches utilizing digoxin and inotropic pharmacological interventions
3. Approaches utilizing angiotensin-converting enzyme inhibitors
4. Approaches utilizing ß-adrenergic receptor antagonists
5. A & B
6. C & D
Use of angiotensin-converting enzyme inhibitors and ß-adrenergic receptor antagonists, forming the basis of contemporary pharmacotherapy of CHF with reduced ejection fraction have been associated with which one(s) of the following?
1. Improved cardiac structure and function
2. Reduced symptoms
3. Improved quality of life
4. Decreased frequency of hospitalization
5. Reduced mortality from both cardiac arrhythmias and myocardial pump failure
6. A & B
7. A & C
8. B & D
9. A, B, C, D & E
Pharmacological treatment of congestive heart failure with reduced ejection fraction utilizing angiotensin-converting enzyme inhibitors is associated with about a 20% decrease in mortality at about a 35% decrease in the combined endpoint of mortality and heart failure-related hospitalizations.
1. True
2. False
In patients receiving angiotensin-converting enzyme (ACE) inhibitors for treating congestive heart failure with decreased ejection fraction, the addition of ß-adrenergic receptor antagonist drugs confer limited or no decrease in mortality on top of that noted with ACE inhibitors alone.
1. True
2. False
Choose the correct statement(s) concerning ACE inhibitors and ß-adrenergic receptor blockers in treating congestive heart failure with decreased ejection fraction.
1. ACE inhibitor administration benefit is best described as a "class" effect.
2. Clinically helpful effects of ß-adrenergic receptor antagonists appear limited to particular drugs-therefore not a "class" effect.
3. Both
4. Neither
Administration of which one(s) of the following ß-adrenergic blockers have been shown to improve survival, as assessed in clinical trials?
1. Bisoprolol
2. Metoprolol succinate
3. Carvedilol
4. A & C
5. B & C
6. A, B & C
Antagonism of aldosterone effects is associated with worsening mortality in congestive heart failure.
1. True
2. False
Administration of which one(s) of the following mineralocorticoid antagonists decrease both mortality and hospitalization for congestive heart failure?
1. Eplerenone
2. Spirolactone
3. Both
4. Neither
In heart failure patients with reduced ejection fraction and who are being treated by ACE inhibitors:
1. Even following long-term angiotensin-converting enzyme inhibitor treatment(heart failure patients with reduced ejection fraction), circulating levels of angiotensin II remain indefinitely suppressed.
2. In heart failure patients with reduced ejection fraction being treated with ACE inhibitors and ß-receptor antagonists, the addition of Valsartin (an angiotensin receptor blocker) improves outcome.
3. Both
4. Neither
The pharmacological combination of nitrates along with hydralazine appears to enhance survival in congestive heart failure patients exhibiting decreased ejection fraction.
1. True
2. False