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Drugs for CHF - Coggle Diagram
Drugs for CHF
VASODILATORS
ACE inhibitors - Enalapril, Ramipril
ARBs - Losartan, Telmesartan
- Action in CHF: ↓mortality by 20%, ↓symptoms, ↑exercise tolerance
- ADRs: Dry persistent cough (20%), angioedema (1%), rash, hyperkalemia, hypotension
- C/I: Absolute - Bilateral renal Artery stenosis, pregnancy
- Use in CHF: 1st line drug for CHF
For both symptomatic & asymptomatic LV dysfunction
ACEIs are more efficacious for CHF - ARB only if ACEI is not tolerated
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IV – nitrates, Sodium Nitroprusside
- ADR - Nitrates - tolerance
- Use in CHF: For acute decompensated HF, esp when accompanied by MI or HT
Rapid onset, short duration, easily titrated effect
Nesiritide (BNP), Carperitide (ANP), Ularitide
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BETA BLOCKERS - Carvedilol, Nebivolol, Metoprolol, Bisoprolol
- Action in CHF: Catecholamines have excess mitogenic activity - beta blockers ↓ remodelling, ↓apoptosis - ↓LV size
↓ HR, prevent tachyarrhythmias
Over time, ↑EF & contractility
25 mg BD Carvedilol ↓all cause mortality by 65%
- Use in CHF: For all stable pts with CHF – must not have any recent volume overload
No benefit in asymptomatic LV dysfunction
- C/I: acute CHF
May cause worsening of CHF – start at low dose & ↑slowly