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 …
Read moreROLE 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…
Read moreOverview 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…
Read moreAs 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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