HFrEF Medications Flashcards
What are the possible DDIs with ACE Inhibitors?
- Potassium Sparing
- NSAIDs = decrease antihypertensive effect
- Lithium = increase lithium
- Tizanidine = hypotension
What are the indications of ACE Inhibitors?
HFrEF, HTN, Diabetic Nephropathy, and Post ACS
What ACE drugs are approved for Diabetic Nephropathy?
Catopril
Off Label for others
What ACE drugs are approved for Post ACS?
Lisinopril
Ramipril
Catopril
Off Label: Enalapril
What are the AEs of ACE Inhibitors?
Dry Cough, Renal Dysfunction, Hyperkalemia, and Angioedema
What are the CIs of ACE Inhibitors?
- Previous Angioedema from ACE
- Pregnancy
What ACE is NOT hepatic ally metabolized and a good choice for liver disease?
Lisinopril
What is the HFrEF Target for Ramipril?
5 BID
What is the HFrEF Target for Captopril?
50 TID
What are the pearls of Captopril?
Shortest half life
AE = loss of taste
What is the HFrEF Target for Enalapril?
10-20 TID
What is the HFrEF Target for Lisinopril or Lisinopril/HCTZ?
40 QD
What are the indications for ARBs?
HTN, HFrEF, HFpEF, Diabetic Nephropathy, LV Dysfunction of Failure Post MI
What ARB drug is approved for HFrEF/HFpEF?
Candesartan and Valsartan
Losartan Off Label
What ARB drug is approved for Diabetic Nephropathy?
Irbesartan and Losartan
What ARB drug is approved for LV Post MI?
Valsartan
Losartan Off Label
What is the counseling point for Valsartan?
Take on an empty stomach, food will decrease absorption
What ARBs can metabolized via 2C9?
Candesartan, Losartan, Irbesartan, and Valsartan
What ARBs are metabolized via 3A4?
Losartan
What are the CIs of ARBs?
- Concomitant use with Aliskiren in patients with DM
- Pregnancy
What is the HFrEF target dose for Candesartan?
32 QD
What is the HFrEF target dose for Valsartan?
160 BID
What drugs may decrease the activation of Losartan?
Fluconazole
What patient population is most susceptible to angioedema?
African American Women
What is the indication and pharmacology of Aliskiren?
HTN, direct renin inhibitor
What can decrease the bioavailability of Aliskiren?
High fat meal
What is CI’d with Aliskiren use?
- ACE/ARBS in DM
- Pregnancy
What are the AEs of Alikskiren?
Hyperkalemia, Hypotension, Renal Effects
What is Entresto and its indication?
Sacubitril/Valsartan (neprilysin inhibitor/arb)
HFrEF
What is CI’d with Entresto?
- Angioedema with ACE/ARB
- Concomitant use within 36 hrs of ACEs
What are the AEs of Entresto?
Hypotension and Hyperkalemia
What drug needs a 36 hr washout period when switching from or to an ACE?
Entresto
