HF MEDICATION: SGLP INHIBITORS + ENTRESTO

Question 1

What are SGLT-2 Inhibitors?

Answer 1

They reduce the amount of glucose in the urine without relying on insulin. They reduce the ability of the renal tubules to reabsorb glucose, allow increased insulin sensitivity, and decreased gluconeogenesis.

Question 2

What are the contraindications of SGLT-2 Inhibitors?

Answer 2

Type 1 DM, DKA, severe renal disease (GFR is < 30 mL/min), on hemodialysis.

Question 3

What are adverse effects of SGLT-2 Inhibitors?

Answer 3

Hypokalemia, mycotic infections, UTI, renal insufficiency, hypotension.

Question 4

What meds are SGLT-2 Inhibitors?

Answer 4

Empagliflozin (Jardiance), Canagliflozin (Invokana), and Dapagliflozin (Farxiga).

Question 5

How is Empagliflozin (Jardiance) dosed?

Answer 5

10 mg PO in the AM, titrate up to 25 mg. Discontinue if GFR persistently is < 45 mL/min.

Question 6

How is Canagliflozin (Invokana) dosed?

Answer 6

100 mg before the 1st meal, increase it to 300 mg for patients with normal renal function, discontinue if the patient’s GFR is > 60 mL/min.

Question 7

How is Dapagliflozin (Farxiga) dosed?

Answer 7

5 mg - 10 mg, discontinue if the GFR is < 60 mL/min.

Question 8

Who is Sacubitril/Valsartan (Entresto) indicated for?

Answer 8

Patients with Systolic HF, NYHA class 2-4.

Question 9

What are the side effects of Entresto?

Answer 9

Hypotension, dizziness, cough, hyperkalemia, and renal failure.

Question 10

What are the adverse effects of Entresto?

Answer 10

Hypersensitivity, angioedema, severe hypotension, renal failure.

Question 11

Why is Entresto a black box warning?

Answer 11

Can cause fetal toxicity.