Loop Diuretics
Strategies to manage DIURETIC resistance
As a critical care pharmacist, you will hear debate about the best approach for managing "diuretic resistance" in acute decompensated heart failure . Continue to start IV furosemide at 1 to 2.5 times the TOTAL DAILY oral home dose. For example, if the home oral furosemide dose is 40 mg daily, multiply this by 1 to 2.5 for an …
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Loop Diuretics
Loop diuretic use in heart failure
ROLE OF LOOP DIURETICS IN TREATMENT OF HEART FAILURE ã…¡ Loop diuretics are recommended for all volume overloaded patients with NYHA class II to IV heart failure to improve symptoms, exercise tolerance, and efficacy of other heart failure medications (e.g., beta-blockers). Thiazide could be used instead of a loop for patients with mild fluid retention and hyperten…
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HFrEF Treatment
Heart failure patients who may need an aldosterone antagonist
Less than half of eligible heart failure patients take an aldosterone antagonist (spironolactone, eplerenone). Help close the gap for patients with systolic heart failure. Now called heart failure with reduced ejection fraction (HFrEF). Think of an angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) , beta-blocker (BB), and aldoste…
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Loop Diuretics
Overview of HEART FAILURE treatment
Overview ã…¡ Heart failure typically classified by New York Heart Association (NYHA) I-IV functional classification or American College of Cardiology Foundation/American Heart Association (ACCF/AHA) A-D staging ( see table 1 ) . Heart failure with reduced ejection fraction (HFrEF) or systolic heart failure results in decreased heart pump function (left ventricular ejec…
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Loop Diuretics
Steps to manage LOOP diuretics
As a pharmacist, you'll see cases where you can optimize oral loop diuretics (furosemide, etc) for volume overload or edema in heart failure. First, ensure that patients are on target doses of medications that improve heart failure outcomes. ACEIs or ARBs, beta-blockers, etc. Keep in mind, loops only treat symptoms. And evaluate other possible causes of fluid re…
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Skin Cancer
Skin cancer risk with hydrochlorothiazide
Hydrochlorothiazide adverse reactions and warnings (July 2018)!ã…¡ Hydrochlorothiazide use is associated with a substantially increased risk of nonmelanoma skin cancer (NMSC), especially squamous cell carcinoma (SCC). Previous studies found modest increases in risk for cutaneous squamous cell carcinoma (SCC) among patients using photosensitizing medications, and i…
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