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Pharmacotherapy III > Dosing for Exam 2 (HF) > Flashcards

Dosing for Exam 2 (HF) Flashcards

1
Q

What is the initial dose for furosemide?

A

20-40mg daily (can be divided)

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2
Q

What is the initial dose for bumetanide?

A

0.5-1mg daily (can be divided)

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3
Q

What is the initial dose for torsemide?

A

10-20mg daily (can be divided)

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4
Q

What is the initial dose for ethacrynic acid?

A

25-50mg daily (can be divided)

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5
Q

What are the equivalent doses of the loop diuretics?

A

F 40mg = B 1mg = T 10-20mg = E 50mg

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6
Q

What is the max outpatient dose of the three loop diuretics for a patient with CrCl over 50 mL/min?

A

Furosemide 80-160mg
Bumetanide 1-2mg
Torsemide 20-40mg

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7
Q

What is the max outpatient dose of the three loop diuretics for a patient with CrCl 20-50 mL/min?

A

Furosemide 160mg
Bumetanide 2mg
Torsemide 40mg

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8
Q

What is the max outpatient dose of the three loop diuretics for a patient with CrCl under 20 mL/min?

A

Furosemide 400mg
Bumetanide 8-10mg
Torsemide 100-200mg

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9
Q

What is the initial dose for enalapril? Target dose?

A

Initial: 2.5-5mg BID
Target: 10mg BID

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10
Q

What is the initial dose for captopril? Target dose?

A

Initial: 6.25-12.5mg TID
Target: 50mg TID

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11
Q

What is the initial dose for lisinopril? Target dose?

A

Initial: 2.5-5mg daily
Target: 20-40mg daily

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12
Q

What is the initial dose for ramipril? Target dose?

A

Initial: 1.25-2.5mg daily
Target: 5mg BID - 10mg daily

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13
Q

What is the initial dose for losartan? Target dose?

A

Initial: 25-50mg daily
Target: 50-150mg daily

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14
Q

What is the initial dose for valsartan? Target dose?

A

Initial: 20-40mg daily
Target: 160mg BID

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15
Q

What is the initial dose for candesartan (Atacand)? Target dose?

A

Initial: 4-8mg daily
Target: 32mg daily

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16
Q

What is the initial dose for carvedilol? Target dose?

A

Initial: 3.125mg BID
Target: 25mg BID if under 85kg or 50mg BID if over 85kg

17
Q

What is the initial dose for Coreg CR? Target dose?

A

Initial: 10mg daily
Target: 80mg daily

18
Q

What is the initial dose for metoprolol XL? Target dose?

A

Initial: 12.5-25mg daily
Target: 200mg daily

19
Q

How quickly should you titrate beta blockers up in HF?

A

Double the dose every 2 weeks and monitor closely. Aim for target in 8-12 weeks.

20
Q

What is the initial dose for eplerenone based on CrCl? Target dose?

A

Initial: CrCl over 50 mL/min – 25mg daily
CrCl 30-49 mL/min – 25mg every other day
Target: CrCl over 50 mL/min – 50mg daily
CrCl 30-49 mL/min – 25mg daily

21
Q

What is the initial dose for spironolactone based on CrCl? Target dose?

A

Initial: CrCl over 50 – 12.5-25mg daily
Crcl 30-49 – 12.5mg daily or every other day
Target: CrCl over 50 – 25mg daily
CrCl 30-49 – 12.5-25mg daily

22
Q

What is the initial dose for hydralazine alone or in combination? Target dose? Max dose?

A

Initial: 10-25mg daily alone or 37.5mg TID combo
Target: 75mg TID alone or 75mg TID combo
MAX: 100mg TID

23
Q

What is the initial dose for ISDN alone or in combination? Target dose? Max dose?

A

Initial: 10mg TID alone or 20mg TID combo
Target: 40mg TID alone or in combo
MAX: 80mg TID

24
Q

What is a normal dose of digoxin?

A

0.125-0.25mg daily

25
Q

What three drugs require empiric dose reductions for digoxin?

A

Amiodarone, Itra/ketoconazole, Verapamil

26
Q

What is the initial dose of Entresto (sacubitril/valsartan)? Target dose?

A

Initial: 49/51mg BID (or 24/26mg BID if no/low dose ACE/ARB, eGFR under 30, or moderate hepatic impairment)
Target: 97/103mg BID

27
Q

What is the appropriate dose of ivabradine?

A

5mg BID, adjusted q2weeks to HR 50-60. MAX 7.5mg (2.5mg if bradycardia is concern)

28
Q

How is furosemide dosed IV in ADHF?

A

40-120mg IV bolus or 10mg/hr infusion
MAX 200mg bolus or 960mg/24 hours
Assess urine output over 2-4 hours before re-dosing

29
Q

How is nitroprusside dosed in ADHF?

A

0.25mcg/kg/min, titrated to response (max 3)

30
Q

How is nitroglycerin dosed in ADHF?

A

5mcg/min initially, increase by 5mcg/min every 5-10 minutes (max 200)

31
Q

How is nesiritide dosed in ADHF?

A

2mcg/kg IV bolus

0.01 mcg/kg/min infusion, increase by 0.005mcg/kg/min (max 0.03)

32
Q

How is dobutamine dosed in ADHF?

A

2.5-5mcg/kg/min titrated to response

MAX 20 mcg/kg/min

33
Q

How is milrinone dosed in ADHF?

A

50mcg/kg IV LD followed by 0.1-0.375mcg/kg/min infusion

MAX 0.75mcg/kg/min

34
Q

How is dopamine dosed for its various purposes?

A

Increase urine output: 0-3 mcg/kg/min
Increase contractility: 3-10 mcg/kg/min
Increase vasoconstriction: over 10 mcg/kg/min

Pharmacotherapy III (6 decks)

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