CHF medications

Agent	RA	RCW	SVR	BP	CO
Isordil60	-	-	(-)	-	-/+
hydral100	~	~	-	+/-	++
hy (MR/AI)	-	--	++	-/+	+/-
ACEI	-	-	-	+/-	+
Minoxidil	~	~	--	+/-	++

• Carvedilol: decreases mortality 67%
• Digoxin: decrease syx/hospitaliz
• Aldactone in Class IV dec mortality
• Isordil: cor. VD; +BP if ischemia
• ISDN/HYDRA. decreased mortality in CHF
• ACEI GREAT mortality benefit

Target Doses

• Hydralazine: 100 TID start 25
• Isordil: 60-80 TID
• Captopril: 100 TID start 12.5
• Lisinopril/enalapril: 10 bid class II/III
  • 20 bid class IV
• Carvedilol 25 BID; 50 BID if >80kg
• Digoxin: varies
• Spironolactone 25-50 qd
• Enalapril 1.25mg IV
• Nitroglycerin (Initial dose 5-10ug/min, increased every 3-5 minute to dose range 10-200ug/min)
• Nitroprusside (Initial dose 5-10ug/min, increased every 3-5 minute to dose range 5-400ug/min)

^Consider when need afterload reduction

See Also

Congestive Heart Failure (CHF)