Cardiovascular & Diuretics

Question 1

B-Blockers

Answer 1

Continue
Avoid withdrawal esp in CAD(angina) context
Initiation only if there is several weeks to optimise

Question 2

Alpha-1 blockers
Prazosin
terazosin
doxazosin

Answer 2

Continue

Opthalmology: check

Question 3

CCB

Answer 3

continue

Avoid nifedipine - associated with rapid BP decreases

Question 4

ACE-I

Answer 4

Stop AM of surgery
CHF and HTN - consider continuing if poorly controlled, check with IM
Resume within 48h post-op (inc. 30-d mortality without)
local anesth cases: Continue

Question 5

ARB
losartan
irbesartan
valsartan

Answer 5

STOP on AM of sx
Restart within 48h post-op

Local cases: continue

Question 6

Digoxin

Answer 6

Continue

Question 7

Nitrates
Patch
ISMN

Answer 7

Continue

Question 8

Diuretics:

furosemide

Answer 8

HTN: Hold on AM of sx
CHF, stable volume status : Hold on AM of sx
CHF, prone to overload: Continue
Attention: HypoK+

Question 9

Diuretic-antihypertensive combinations

Answer 9

Hold AM of sx

Question 10

Alpha-2 agonists

Clonidine

Answer 10

Continue: avoid withdrawal

Question 11

Entresto: sacubitril & valsartan

Answer 11

Stop at least 24h

Neprilysin is a neutral endopeptidase and its inhibition increases bioavailability of natriuretic peptides, bradykinin, and substance P, resulting in natriuretic, vasodilatatory, and anti-proliferative effects.