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Sacubitril/valsartan (ARNI) is getting more attention in the guidelines with regards to its use in heart failure (specifically HFrEF). Many patients are already on an ACE and making the transition from an ACE inhibitor to an ARNI is likely something you will come across. In clinical practice, there is a significant risk for angioedema when […]
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Digoxin is one of those medications that has a lot of unique clinical quirks. Here are a few clinical pearls you must remember when using digoxin in CHF. When using digoxin in CHF (more specifically (HFrEF) you must remember to check electrolytes. Alterations in electrolytes may increase the risk of arrhythmias. When a patient has […]
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Loop diuretics are the mainstay in removing fluid off the body in patients with heart failure. They are very common in clinical practice. What should you think about when monitoring loop diuretics? Monitoring Loop Diuretics – Benefit? One of the challenges with polypharmacy in our geriatric patient population is to continually assess the benefit of […]
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A 72-year-old male has a past history of heart failure with reduced ejection fraction, chronic kidney disease, hypertension, diabetes, intermittent claudication, and osteoarthritis. His current medication regimen includes: Aspirin 81 mg daily Cilostazol 100 mg twice daily Furosemide 40 mg twice daily Amlodipine 10 mg daily Lisinopril 10 mg daily Carvedilol 6.25 mg twice daily […]
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I have seen the prescribing cascade happen in clinical practice far too many times! One of those classic examples is heart failure. A patient is placed on a new medication that contributes to edema and heart failure. With a period of days to weeks, that patient is then placed on diuretics or doses have had […]
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