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Hf Med List

In: Other Topics

Submitted By smsokol83
Words 460
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|Action |Starting Dose |Target dose |Indications, Contraindications, Averse Effects | |
|ACE Inhibitors |Block RAAS system, decrease |Lisinopril: 2.5-5 mg qd |Lisinopril: 20-40 mg qd |Initiate at low doses |
|Lisinopril |symptoms and mortality |Enalapril: 2.5-5 mg bid |Enalapril: 10-20 mg bid |May cause angioedema, hyperkalemia, increased creatinine, symptomatic |
|Enalapril |Block conversion of Angiotensin I |Captopril: 6.25-12.5 mg tid |Captopril: 50 mg tid |hypotension, cough (tickle in throat) |
|Captopril |to angiotensin II | | |Takes days, weeks to months to see improvement |
| |Afterload reduction | | | |
|Hydralazine |Pure vasodilator |10-25 mg q6-8 hrs |75 mg q6 hrs or 100 mg q8 hrs |May cause tachycardia |
| |Afterload reduction | | |Used for intolerance of ACE inhibitors, for additional BP control, or |
| | | | |for afterload reduction in severe mitral regurgitation or atrial |
| | | | |insufficiency |
|Nitrates |Decrease preload |Isosorbide dinitrate: 10 mg q6 |Isosorbide dinitrate: up to 40 |Dose limited by symptoms (headache or hypotension) |
|Isosorbide |Relieve angina |hrs (hold midnight dose) |mg q6hrs (hold midnight dose) |Use lowest dose that relieves symptoms |
|dinitrate |Decrease orthopnea |Isosorbide mononitrate: 30 mg |Isosorbide mononitrate: up to | |
|Isosorbide | |qd |120 mg qd | |
|mononitrate | | | | |
|Digoxin |Oral inotrope |0.125-0.25 mg qd |Same |Not first choice, but may be added if diuretic, beta blocker, and ACEI |
| |Blocks neurohormonal effects of | | |not working |
| |heart | | |Limited by renal excretion |
| | | | |Smaller doses used when creatinine > 1.3 mg/dL |
| | | | |Dose decreased 50% in patients receiving amiodarone |
|Diuretics |Control fluid volume |Furosemide: 20-40 mg (in |Furosemide: Up to 320 mg bid |Diuretic dosage requirements are higher during aggressive diuresis than|
|Furosemide | |patient who has never been on |Metolazone: 10 mg qd if |during maintenance |
|Metolazone | |diuretics) |necessary in addition to |Combination of furosemide and metolazone is very powerful, and loss of |
| | |Metolazone: 2.5-5 mg qd |furosemide |potassium, magnesium, and calcium can be dramatic increasing the risk |
| | | | |of arrhythmias |
|Spironolactone |Blocks effects of aldosterone and |25 mg qd |25 mg qd |May cause hyperkalemia |
| |protects potassium | | |May cause gynecomastia in men |
|Beta blockers |Improve symptoms, increase |Metoprolol SR: 12.5 mg qd |Metoprolol SR: 100-200 mg qd |May precipitate exacerbation during initiation and titration |
|Metoprolol |exercise tolerance, decrease |Carvedilol: 3.125 mg bid |Carvedilol: 24-50 mg bid |Monitor weight and heart rate carefully – do not stop drugs suddenly |
|SR |hospitalizations and mortality |Bisoprolol: 1.25 mg qd |Bisoprolol: 10 mg qd |Benefit is long term and may not be evident for up to 3 months |
|Carvedilol |Reverse remodeling with | | | |
|Bisoprolol |improvement in cardiac performance| | | |
|Angiotensin II receptor |Blocks effects of aldosterone |Candesartan: |Candesartan: |Dizziness, renal failure, angioedema |
|Candesartan | |4 mg qd |8-32 mg qd | |
|Valsartan | |Valsartan: |Valsartan: | |
| | |40 mg bid |80-160 mg bid | |

Oral Medications Used in the Treatment of Heart Failure. 2006…...

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