HF

Question 1

What 2 drugs will you almost always see in pts with HF due to left ventricular systolic dysfunction?

Answer 1

High dose ACEi a betablocker (start at low dose and titrate very slowly)

Question 2

True or false. ACEi with an ARB are contraindicated together?

Answer 2

False, candesartan or valartan can be used as adjuncts to an ACEi, only under specialist supervision

Question 3

What beta blocker is licensed in pt with HF that are over 70?

Answer 3

Nebivolol

Question 4

What do you have to look out for when beta blockers are being initiated?

Answer 4

Symptoms may deteriorate initially

Question 5

What drug can be added on to ACEi +BB if pt remains symptomatic?

Answer 5

Sprionolactone or if CI eplenerone

Question 6

What moitoring will be required for a HF patient on ACEi, BB and spironolactone?

Answer 6

Creatinine, eGFR, potassium levels

Question 7

What can be given if an ACEi/ARB is CI or not tolerated?

Answer 7

Isosorbide dinitrate with hydralazine, poorly tolerated, can be given in addition to acei+bb

Question 8

What drug is reserved for worsening HF if the pt is already on acei, bb, aldosterone antagonist, arb, isosorbide DN, hydralazine?

Answer 8

Digoxin

Question 9

True or false. A loop diuretic can be used if eGFR<30ml/min/1.73m2?

Answer 9

True. Thiazides are ineffective if eGFR<30