QuestionSBA
QuestionChoice
Adrenaline is mainly used in resuscitation after a cardiac arrest or more commonly in patients suffering from anaphylaxis. Adrenaline may be dangerous when used in heart failure patients due to the excess strain placed on the cardiac muscle, but it is positively inotropic making this incorrect.
10006929
d
Adrenaline
QuestionChoice
Bisoprolol is used in the treatment of heart failure. Beta-blockers are negatively inotropic, but their effects are not as powerful as verapamil, and it is usually safe in heart failure patients. Its' effects help to reduce the oxygen demand of the heart. They are also commonly used to manage angina and atrial fibrillation.
10006927
b
Bisoprolol
QuestionChoice
Digoxin is a powerful positive inotrope. This means that it causes the heart muscle to contract with greater force, increasing cardiac output. Digoxin may be used in heart failure and atrial fibrillation.
10006928
c
Digoxin
QuestionChoice
Furosemide is a loop diuretic. It acts by increasing sodium and water excretion in the kidneys. It is used to treat symptomatic heart failure by reducing oedema/fluid overload. It is not ionotropic as it does not directly affect the force of contraction, but can reduce overall heart strain by reducing fluid.
10006930
e
Furosemide
QuestionChoice
Verapamil is a highly negatively inotropic calcium channel blocker. A negative inotrope reduces the force of contraction by the heart, thereby reducing cardiac output. Verapamil is typically used for arrhythmias, angina and hypertension, where its negatively inotropic effects are beneficial. In heart failure, patients already have a reduced cardiac output, and therefore verapamil can exacerbate this and be dangerous.
10006926
a
Verapamil
Concept
Chapter
2693
4195
Class IV anti-arrythmics: Calcium-channel blockers
Topic
169
Cardiovascular pharmacology
13932
A 65-year-old man attends the cardiology clinic following a recent diagnosis of heart failure. The patient asks if needs to stop taking any of his current medications given this diagnosis.

Which of the following medications may worsen the patient's heart failure due to it's negatively inotropic effects?
a