Loading....
Coupon Accepted Successfully!

Medicine

Open Flashcards

Cardiology

Question
12 out of 24
 

Drug not used in CHF. (AIIMS Nov 2009)



A NTG
B Spironolactone

C Nesiritide
D Trimetazidine

Ans. D

Trimetazidine

Recent Advances: Heart failure – management (Ref. Hari-18th ed., Pg – 1906)

Treatment: Heart Failure HF should be viewed as a continuum that is composed of four interrelated stages.

Stage A includes patients who are at high risk for developing HF but do not have structural heart disease or symptoms of HF (e.g., patients with diabetes mellitus or hypertension).

Stage B includes patients who have structural heart disease but do not have symptoms of HF (e.g., patients with a previous MI and asymptomatic LV dysfunction).

Stage C includes patients who have structural heart disease and have developed symptoms of HF (e.g., patients with a previous MI with dyspnea and fatigue).

Stage D includes patients with refractory HF requiring special interventions (e.g., patients with refractory HF who are awaiting cardiac transplantation).

Heart failure – management

Basic principle of drug therapy in CHF

1. Drugs to reduce preload = NO3, diuretic

2. Drug to in cause pumping of myocardium = digoxin

3. Drug to reduce after load = ACEI.

Drugs:the following drugs are used:

1. Diuretics: Loop diuretics routinely used to relieve symptoms eg furosemide.

SE Low:Hypokalemia, add K+ sparing diuretic (eg spironolactone) if K+ <3.2mmol/ predisposition to arrhythmias, concurrent digoxin therapy (Low K+ increases risk of digoxin toxicity),

If refractory oedema, add a thiazide eg metolazone

2. ACE-inhibitor: Consider in all patients with left ventricular systolic dysfunction; improves symptoms and prolongs life

3. Digoxin improves symptoms even in those with sinus rhythm

4. Vasodilators:Nitrate

5. Inotropic drugs – Milrinone, dopamine, Dobutamine.

6. Beta-blockers (eg carvedilol) β-blocker reduce mortality in heart failure Q

Doses of Dopamine:

Dose (μgm/kg/min):

Receptor

Effect

1 – 2

Dopaminergic

Increase renal blood flow

2 – 5

Beta

Increase heart rate

>5

Alpha

Increase peripheral resistance

Cardiology Flashcard List

24 flashcards
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
21)
22)
23)
24)