HF

Question 1

ACE inhibitors

Answer 1

Captopril 3.125-6.25 3x day
Enalapril 2.5mg 2x day
Lisinopril 2.5-5mg daily
….

Question 2

ARB

Answer 2

Losartan 25-50mg daily

Valsartan 20-40mg bid

Question 3

Indications for ARNI

Answer 3

symptomatic HFrEF,

substitute for ACE-I or ARBs but not given with ACEi (36hr washout period)

Question 4

how often to titrate ARNI?

Answer 4

up titrate every 2-4 wks

Question 5

contraindications to ARNI?

Answer 5

angioedema,

may cause hypotension and renal insufficiency

Question 6

When to use hydralazine & nitrate (isosorbide)?

Answer 6

when pt can’t take ARB/ACE.
For NYHA III, IV HF as an adjunctive therapy
best on black population

Question 7

When is MRA or Aldosterone antagonists recommended?

Answer 7

persistent symptoms with NYHA class II-IV heart failure and EF<35%, 
helps in hypokalemic patients

Question 8

Aldosterone antagonists

Answer 8

Potassium sparing diuretics:
Amiloride 5mg daily
Eplerenone 25mg daily
Spironolactone 12.5-25mg daily
Triamterene 50-75mg BID

Question 9

Beta blockers

Answer 9

Carvedilol (coreg): 3.125mg bid
Metoprolol tartrate (short acting) 12.5-25mg BID
Carvedilol CR: 10mg daily
Metoprolol ER: 12.5-25 daily

Question 10

Ivabradine indications: inhibits SA node –> decrease HR

Answer 10

symptomatic (NYHA class II-III) stable chronic HFrEF 
can be given with beta blockers but must be on maximal dose before HR assessment (>70 at rest, SR)

Question 11

Ivabradine dose

Answer 11

5- 7 BID

if conduction issues give2.5g BID

Question 12

benefits of SGLT2 Inhibitor

Answer 12

reduces mortality, hospitalization, slows the decline of GFR. Safe in non diabetic patients

Question 13

SGLT2-I side effects

Answer 13

UTI, DKA, hypoglycemia

Question 14

Does SGLT2-I need renal adjustment

Answer 14

yes or GFR <45

Question 15

Ex of SGLT2 drugs

Answer 15

Empagliflozin

Dapagliflozin

Question 16

Loop diuretics

Answer 16

Bumetanide (bumex) 0.5-1mg daily or BID(1=40lasix)
Furosemide 20-40mg daily or BID
Torsemide 20mg daily

Question 17

Thiazide diuretic

Answer 17

Chlorothiazide: 250-500mg daily or BID
Hydrochlorothiazide: 12.5-25mg daily or BID
Indapamide: 2.5mg daily
Metolazone (Zaroxylyn): 2.5 daily

Question 18

sequential nephron blockade

Answer 18

Metolazone (Zaroxylyn): 2.5-10mg daily +loop diuretic
Hydrochlorothiazide: 25-100mg daily or BID + loop diuretics
Chlorothiazide (Diuril): 500-1000mg daily + loop

Question 19

Antiarrhythmic meds on pts with HF

Answer 19

Amiodarone & Dofetilide (Tykosin)

Question 20

What to do when starting Amio?

Answer 20

Monitor TSH, LFTs

side effects pulmonary fibrosis, liver dysfunctions, and thyroid toxicity

Question 21

What medications should not be given to HF pts?

Answer 21

CCB, NSAIDs, Cox-2 inhibitors

Thiazolidinediones (glitazones:DM tx)

Question 22

Therapy for CAD

Answer 22

Anti-platelet
Statins
Revasculation

Question 23

Therapy for prevention of SCD

Answer 23

ICD, betablocker, aldosterone antagonist