Heart Failure Class/Dose/AE/Monitoring

Question 1

Carvedilol

Answer 1

BB
i: 3.125 mg BID
T: 25 mg BID

AE: decreased HR or heart block, decreased BP, fluid retention, fatigue

Monitor: HR, BP (sympomatic hypotension), fluid balance, fatigue

Question 2

Carvedilol Phosphate

Answer 2

BB
i: 10 mg QD
T: 80 mg QD

AE: decreased HR or heart block, decreased BP, fluid retention, fatigue

Monitor: HR, BP (sympomatic hypotension), fluid balance, fatigue

Question 3

Metoprolol Succinate

Answer 3

BB
i: 12.5 - 25 mg QD
T: 200 mg QD

AE: decreased HR or heart block, decreased BP, fluid retention, fatigue

Monitor: HR, BP (sympomatic hypotension), fluid balance, fatigue

Question 4

Lisinopril

Answer 4

ACEi
i: 2.5 - 5 mg QD
T: 20 - 40 mg QD

AE: cough, angioedema, decreased BP, increased K+, functional renal insufficiency, rash, dysqeusia (taste distortion)

Monitor: BP, K+, renal function, volume status

Question 5

Enalapril

Answer 5

ACEi
i: 2.5 - 5 mg QD
T: 10 mg BID

AE: cough, angioedema, decreased BP, increased K+, functional renal insufficiency, rash, dysqeusia (taste distortion)

Monitor: BP, K+, renal function, volume status

Question 6

Captopril

Answer 6

ACEi
i: 6.25 - 12.5 mg TID
T: 50 mg TID

AE: cough, angioedema, decreased BP, increased K+, functional renal insufficiency, rash, dysqeusia (taste distortion)

Monitor: BP, K+, renal function, volume status

Question 7

Ramapril

Answer 7

ACEi
i: 1.25 - 2.5 mg QD
T: 5 mg BID or 10 mg QD

AE: cough, angioedema, decreased BP, increased K+, functional renal insufficiency, rash, dysqeusia (taste distortion)

Monitor: BP, K+, renal function, volume status

Question 8

Losartan

Answer 8

ARB
i: 25 - 50 mg QD
T: 50 - 150 mg QD

AE: decreased BP, increased K+, functional renal insufficiency

Monitor: BP, K+, renal function, volume status

Question 9

Valsartan

Answer 9

ARB
i: 20 - 40 mg QD
T: 160 mg BID

AE: decreased BP, increased K+, functional renal insufficiency

Monitor: BP, K+, renal function, volume status

Question 10

Furosemide

Answer 10

Loop Diuretic
i: 20 - 40 mg QD or BID
MAX: 
80 - 160mg (CrCl>50)
160mg (CrCl 20 -50)
400mg (CrCl

Question 11

Eplerenone

Answer 11

Aldosterone Receptor Antagonist

CrCl > 50 mL/min
i: 25 mg qd
Maintenance: 50 mg qd

CrCl 30 - 49 mL/min
i: 12.5 mg qad
Maintenance: 25 mg qd

Adverse effects:
increased K+ (especially if taken with ACEi or ARB)

Monitoring:
BP, SCr, K+, fluid balance

Question 12

Spironolactone

Answer 12

Aldosterone Receptor Antagonist

CrCl > 50 mL/min
i: 12.5 - 25 mg qd
Maintenance: 25 mg qd

CrCl 30 - 49 mL/min
i: 12.5 mg qad or daily
Maintenance: 12.5 - 25 mg qd

Adverse Effects:
gynecomastia, impotence, menstrual irregularities, increased K+

Monitoring:
BP, SCr, K+, fluid balance

Question 13

Digoxin

Answer 13

0.125 - 0.25 mg qd

Adverse effects:
anorexia, N/V, abdominal pain, CNS side effects, cardiac conduction disturbances

Monitoring:
Serum drug concentration, HR, SCr, electrolytes, s/s toxicity

Question 14

Dopamine IV

Answer 14

Low: 0-3 mcg/kg/min
Medium: 3-10 mcg/kg/min
High: > 10mcg/kg/min

Adverse effects:
arrhythmias, increased HR, ischemia, decreased K+, tolerance after 48 - 72 hours, skin necrosis upon infiltration

Monitoring:
BP, HR, ECG, glucose, renal function