Medicines for CHF

Question 1

Beta-blockers that can be used in CHF

Answer 1

bisoprolol, carvedilol, metoprolol succinate

Question 2

Dose of candesartan for CHF

Answer 2

candesartan 4 to 32mg orally, daily

Question 3

Dose of spironolactone for CHF

Answer 3

spironolactone 12.5 to 50mg orally, daily

Question 4

Contraindications to ACE-I therapy

Answer 4

Absolute
  - Previous Hx of intolerance to ACE-I
  - Previous Hx of angioedema 
  - Bilateral renal artery stenosis
  - Unilateral renal artery stenosis of single functioning 
    kidney
Relative
  - Hypotension
  - Aortic or mitral stenosis 
  - Hyperkalaemia

Question 5

How common is cough due to ACE-I therapy

Answer 5

5-10% pts

Question 6

How common is angioedema due to ACE-I therapy

Answer 6

0.1 - 0.5% pts

Question 7

What percentage of pts with a history of angioedema due to ACE-I will also develop angioedema due to ARBs

Answer 7

10% pts

Question 8

By what % do ACE-I decrease mortality in CHF

Answer 8

20%

Question 9

By what % do B-blockers decrease mortality in CHF

Answer 9

B-blockers reduce mortality by a further 30% (not including that achieved by ACE-I)

Question 10

Do B-blockers improve symptoms in CHF

Answer 10

No

Question 11

Contraindications to B-blockers

Answer 11

• Reactive airways disease
• Severe 1st degree heart block without pacemaker
• Hypotension
• Severe bradycardia (