Prescribing in Heart Failure and Renal Failure Flashcards
Give examples of medications which may exacerbate heart failure
Thiazolidinediones
verapamil
NSAIDs/glucocorticoids
class I antiarrhythmics
e.g. flecainide
Why are thiazolidinediones contraindicated in heart failure?
causes fluid retention
Why is verapamil contraindicated in heart failure?
negative inotropic effect
Why are NSAIDs contraindicated in heart failure?
cause fluid retention
low-dose aspirin = exception
(benefits outweigh risks if coexistent cardiovascular disease)
Why are Class I antiarrhythmics (e.g. Flecainide) contraindicated in heart failure?
negative inotropic and proarrhythmic effect
negative inotropic and proarrhythmic effect
What drugs should be avoided in renal failure?
antibiotics: tetracycline, nitrofurantoin
NSAIDs
lithium
metformin
What drugs are likely to accumulate in chronic kidney disease (and therefore may need dose adjustment)
Antibiotics - penicillins, cephalosporins, vancomycin, gentamicin,
digoxin
atenolol
methotrexate
sulphonylureas
furosemide
opioids
What antibiotics can usually be given at normal dose even in chronic kidney disease?
erythromycin
rifampicin
