RX PREP CHRONIC HEART FAILURE

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created 3 months ago by vodaosu88
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1

Lab value represents systolic dysfunction (HFrEF)

  • EF <40%
2

Lab value represents diastolic dysfunction (HFrEF)

  • EF >40%
3

What are some drug-induced Heart Failure?

  • Drug Information NATION

Drug Information NATION

    • DPP-4 inhibitors
    • Immunosuppressants
    • Non-DHP CCBs
    • Antiarrhythmics
    • Thiazolidinediones
    • Itraconazole
    • Oncology agents (anthracyclines)
    • NSAIDs
4

What drugs used in HF show

  • Mortality benefit
  1. beta-blockers
  2. ACEI/ARBs,
  3. sacubitril
5

What drugs used in HF show

  • decreases hospitalization
  • Digoxin
6

What drugs used in HF show

  • decrease symptoms
  • Loop diuretics
7

What's the use of Loop diuretics in HF?

  • Loop diuretics → for fluid overload
  • Do not decrease mortality
8

If patient has sulfa allergy, what drug to use in place of loop diuretics?

  • Choose ethacrynic acid
9

What's the AEs of loop diuretics?

  • Ototoxicity
10

Know the dosing for some loop diuretics?

  • Furosemide 40 mg = torsemide 20 mg = bumetanide 1 mg
11

What's the conversion of Furosemide IV:PO ?

  • 1:2
12

What's the treatment for HF

  • ACEI/ARBS
  • Class effect; start low and titrate to target doses
13

What's the treatment for HF

  • ARNI
  • alsartan/sacubitril; can use 1st line in place of ACEI/ARB
14

What's the treatment for HF

  • Beta-blockers
  • NOT a class effect; start low and titrate to target doses
15

What's the treatment for HF

  • ARAs
  • DO NOT use if K>5 or CrCL <30 mL/min
16

What's the treatment for HF

  • BiDil
  • black patients; drug interactions with nitrates
17

What's the treatment for HF

  • Digoxin
  • for symptoms/morbidity
  • Does not decrease mortality
18

What's the theraeutic range for digoxin in HF?

In A.fib?

  • 0.5-0.9 ng/mL
  • Higher in AFib: 0.8-2 ng/mL
19

What are some AEs of digoxin?

  • N/V, decreased appetite, decreased HR, yellow-green vision, arrhythmias
20

What's the antidote for digoxin overdose?

      • DigiFab
21

What's the treatment for HF

  • IVABRADINE
  • Decreases hospitalizations.
  • Good for those unable to tolerate beta-blocker or need further treatment
22

Specific criteria for use of Ivabradine in HF?

  • normal NSR at baseline, at least 70 bpm