CHF medications
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