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What diuretics should you use in DHF and at what doses?
- Furosemide 20-40 mg/day
- HCTZ 12.5-25 mg/day
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What is the difference between SHF and DHF treatment with diuretics?
DHF = don’t want to decrease preload anymore, so need to be very cautious with diuretics and start low
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What would be a normal Lisinopril dose for DHF?
2.5 mg/day
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What would be a normal Enalapril dose for DHF?
2.5 mg/day
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Are ACEIs first line therapies in ACEI?
Yes
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Are Diuretics first line treatments in DHF?
Yes
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What dose of Candesartan would be used in DHF?
4 mg/day
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What dose of Irbesartan would be used in DHF?
150 mg/day
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Are ARBs first line in DHF?
No, used if ACEI intolerance
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What is a normal dose of Metoprolol tartate for DHF?
25 mg BID
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What BBs can be used for DHF?
Any, not specific like with SHF
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What situation should you use caution in with a BB?
Excessive Bradycardia
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What are the initial goals for BB use in DHF?
- Resting HR = 60 bpm
- Exercise-induced HR <110 bpm
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Are BBs 1st line in DHF?
Yes
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What aspects of DHF are controlled by BBs?
HR, MI and BP
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Can non-DHP CCBs be used in DHF?
Yes
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Are Non-DHP CCBs 1st line drugs in DHF?
No, 2nd line
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What aspects of DHF are controlled by Non-DHP CCBs?
HR, BP and MI
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What is a normal DHF dose of Verapamil?
120-240 mg
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Can you use Non-DHP CCBs in SHF?
No
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What is a normal dose of Diltiazem in DHF?
90-120 mg
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What situation warrents cauton of aldosteron eantagonists in DHF?
Hyperkalemia
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What is a normal dose of Spirolactone in DHF?
12.5mg-25 mg/day
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What is a normal dose of Eplerenone in DHF?
25 mg/day
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Are Aldoseterone antagonist 1st line therapies in DHF?
No, add on therapy if patient is still symptom
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Are Nitrates a 1st line drug in DHF?
No, used to control MI
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What are Nitrates used for in DHF?
MI control
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What type of Nitrates are used in DHF?
Long acting nitrates like Imdur
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What is a normal Imdur dose for DHF?
30 mg/day
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When should you exercise caution in Nitrate treatment of DHF?
Excessive preload reduction due to vasoldilitory properties
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DHF pharamcotherapies target what symptoms?
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What is the first line DHF therapy for BP control?
ACEI
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What is the first line DHF therapy for HR control?
BB
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What is the first line DHF therapy for alleviating fluid retention?
Duretics: HCTZ or low dose furosemide
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What is the first line DHF therapy for alleviating MI?
BBs
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