CHF medications

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Agent RA RCW SVR BP CO
Isordil 60 - - (-) - -/+
Hydralazine 100 ~ ~ - +/- ++
hy (MR/AI) - -- ++ -/+ +/-
ACEI - - - +/- +
Minoxidil ~ ~ -- +/- ++
  • Carvedilol: decreases mortality 67%
  • Digoxin: decrease syx/hospitaliz
  • Aldactone in Class IV decrease mortality
  • Isordil: cor. VD; +BP if ischemia
  • ISDN/HYDRA. decreased mortality in CHF
  • ACEI GREAT mortality benefit

Target Doses

  • Hydralazine: 100 TID start 25
  • Isordil: 60-80 TID
  • Captopril: 100 TID start 12.5
  • Lisinopril/enalapril: 10 bid class II/III
    • 20 bid class IV
  • Carvedilol 25 BID; 50 BID if >80kg
  • Digoxin: varies
  • Spironolactone 25-50 qd
  • Enalapril 1.25mg IV
  • Nitroglycerin (Initial dose 5-10ug/min, increased every 3-5 minute to dose range 10-200ug/min)
  • Nitroprusside (Initial dose 5-10ug/min, increased every 3-5 minute to dose range 5-400ug/min)

^Consider when need afterload reduction

See Also

Congestive Heart Failure (CHF)