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In continuation of part 1 article
Treatment include :
Diuretics make them pee remove fluid
Demadex torsemide
Lasix furosemide
Bumex bumetanide
Indapamine indapamide
Hydrachlorothiazide Diuretics (HCL) wring fluid out of your system the old fashioned way: they make you pee. The less fluid in your system, the less blood your heart has to pump, the less congestion in your lungs, and the easier you breathe. There are 2 types of diuretics: loop and thiazide. Loop diuretics are more powerful. One mg of Bumex = 10mg of Demadex = 40mg of Lasix.
Loop diuretics cause potassium, magnesium, thiamine, and calcium loss but since ACE inhibitors slow potassium loss, they may offset each other. A very small dose (2.5 mg) of Zaroxolyn taken 30 minutes before your Lasix can really turbocharge the draining effect. Be sure they take Lasix 1 or 2 hours before or after eating (not with food) - with Demadex it doesn't matter.
Please note that Demadex may be better for CHFers than Lasix. .. Magnesium, potassium, calcium, and vitamin B1 supplements are recommended. Watch for gout and avoid licorice!
Cardiac
Digoxin
Lanoxin
digoxin Digoxin/Lanoxin is a "cardiac glycoside." Such therapies have been used for weak hearts for centuries. Digoxin is still useful, especially in severe CHF. It helps the heart beat stronger and reduces CHF symptoms. Watch for confusion, nausea or visual disturbances. Also watch for swollen breasts (man or woman) and breast tenderness with long-term use
Beta-blockers
Beta-blockers
carvedilol
Zebeta
bisoprolol
Toprol XL
metoprolol Beta-blockers prevent the body from telling the damaged heart to speed way up. An accelerated heart rate would wear the heart out way too fast. Coreg is the most widely used but others may work as well - or not. Beta-blockers make us live longer and many CHFers - but not all - feel better taking them. Coreg is an alpha and beta-blocker with several other actions as well. Watch for hypotension, bradcardia, lightheadednesss, weight gain, or depression. Should be taken food! If they are diabetic and take a beta-blocker, check their blood sugars very closely!
Coumadin
Coumadin
warfarin Although commonly used in CHFers to prevent blood clots (and thus strokes), there is little evidence that this is necessary unless they have a-fib (atrial fibrillation)( irregular heart firing of the top part of the heart). If they have a-fib, they will need a blood thinner. Coumadin is questionable for CHFers in normal (sinus) rhythm, unless they have a history of clots or stroke. Watch for a tendency to bleed easily. Bruising is common. They will need to have your blood tested regularly if on Coumadin. PT/PTT/INR to check blood thickness, and clotting time
Aspirin
aspirin: Once commonly used in CHFers who were not taking Coumadin, there is no evidence that all CHFers should take aspirin every day.
Aldosterone-blockers
Aldactone
spironolactone
Inspra
eplerenone Long approved as a diuretic, the RALES trial showed a new use for this old drug. Taken at low doses - 25mg daily - it does not act as a diuretic but it does makethem less likely to die. It affects potassium, like most diuretics, so a blood test should be done when the drug is started, at the very least. Watch for growing breasts - 1 in 10 men will suffer this or impotence. The swollen breasts in men will not disappear if you stop taking the drug.
A new drug called eplerenone may give the same benefits without all the side effects
Vasodilators
Apresoline
hydralazine
Isordil/Sorbitrate
isosorbide dinitrate
Many brand names of
nitroglycerin
Imdur
isosorbide mononitrate
Vasodilators expand the blood vessels, lowering the resistance against which the heart must pump. This is called reducing afterload. These can be powerful drugs, so use with care. Watch for headaches and dizziness. Alpha blockers are vasodilators and expand blood vessels, and Coreg has this effect to some extent.
In the pre-hospital phase : Morphine, Nitrates (nitroglycerin) Oxygen, Lasix or some other dieuretics
Morphine dilates veins - called reducing preload - and decreases anxiety
Nitroglycerin also dilates coronary arteries as well & dilates vessels
IV Drugs
Primacor IV
milrinone
Inocor IV
amrinone lactate
dobutamine
dopamine
Natrecor
nesiritide Usually given intravenously, inotropes and certain other IV drugs make the heart pump more strongly (inoropic effect). They are usually used only in severe CHF and are fairly short acting. Since they speed up the wearing out of the heart (myocardium), they are not used unless really necessary. They do really help quality of life in severe or end-stage heart failure, though. They are used in hospitals or at home, with therapy started by a visiting nurse (home health) Natrecor is a new drug that has many of an inotrope's benefits without many of the side effects
Statins
Zocor simvastatin
Mevacor lovastatin
Pravachol pravastatin
Lescol fluvastatin
Lipitor Atorvastatin For those CHFers who have CAD, cholesterol control is crucial. Because less physical activity raises LDL, most CHFers are put on drugs to maintain healthier cholesterol levels. Watch for constipation, stomach upset, or muscle cramps. Many cholesterol lowering drugs lower the CoQ10 level. The price of different cholesterol lowering drugs may differ & costs drastically. If they suffer muscle weakness or soreness a lot after starting a statin drug, they should see their doctor immediately since a rare side effect causing this can be dangerous. Actually ruptruring muscles.
Understanding CHF is the key factor for the EMT or Paramedic..
R/r 911
Treatment include :
Diuretics make them pee remove fluid
Demadex torsemide
Lasix furosemide
Bumex bumetanide
Indapamine indapamide
Hydrachlorothiazide Diuretics (HCL) wring fluid out of your system the old fashioned way: they make you pee. The less fluid in your system, the less blood your heart has to pump, the less congestion in your lungs, and the easier you breathe. There are 2 types of diuretics: loop and thiazide. Loop diuretics are more powerful. One mg of Bumex = 10mg of Demadex = 40mg of Lasix.
Loop diuretics cause potassium, magnesium, thiamine, and calcium loss but since ACE inhibitors slow potassium loss, they may offset each other. A very small dose (2.5 mg) of Zaroxolyn taken 30 minutes before your Lasix can really turbocharge the draining effect. Be sure they take Lasix 1 or 2 hours before or after eating (not with food) - with Demadex it doesn't matter.
Please note that Demadex may be better for CHFers than Lasix. .. Magnesium, potassium, calcium, and vitamin B1 supplements are recommended. Watch for gout and avoid licorice!
Cardiac
Digoxin
Lanoxin
digoxin Digoxin/Lanoxin is a "cardiac glycoside." Such therapies have been used for weak hearts for centuries. Digoxin is still useful, especially in severe CHF. It helps the heart beat stronger and reduces CHF symptoms. Watch for confusion, nausea or visual disturbances. Also watch for swollen breasts (man or woman) and breast tenderness with long-term use
Beta-blockers
Beta-blockers
carvedilol
Zebeta
bisoprolol
Toprol XL
metoprolol Beta-blockers prevent the body from telling the damaged heart to speed way up. An accelerated heart rate would wear the heart out way too fast. Coreg is the most widely used but others may work as well - or not. Beta-blockers make us live longer and many CHFers - but not all - feel better taking them. Coreg is an alpha and beta-blocker with several other actions as well. Watch for hypotension, bradcardia, lightheadednesss, weight gain, or depression. Should be taken food! If they are diabetic and take a beta-blocker, check their blood sugars very closely!
Coumadin
Coumadin
warfarin Although commonly used in CHFers to prevent blood clots (and thus strokes), there is little evidence that this is necessary unless they have a-fib (atrial fibrillation)( irregular heart firing of the top part of the heart). If they have a-fib, they will need a blood thinner. Coumadin is questionable for CHFers in normal (sinus) rhythm, unless they have a history of clots or stroke. Watch for a tendency to bleed easily. Bruising is common. They will need to have your blood tested regularly if on Coumadin. PT/PTT/INR to check blood thickness, and clotting time
Aspirin
aspirin: Once commonly used in CHFers who were not taking Coumadin, there is no evidence that all CHFers should take aspirin every day.
Aldosterone-blockers
Aldactone
spironolactone
Inspra
eplerenone Long approved as a diuretic, the RALES trial showed a new use for this old drug. Taken at low doses - 25mg daily - it does not act as a diuretic but it does makethem less likely to die. It affects potassium, like most diuretics, so a blood test should be done when the drug is started, at the very least. Watch for growing breasts - 1 in 10 men will suffer this or impotence. The swollen breasts in men will not disappear if you stop taking the drug.
A new drug called eplerenone may give the same benefits without all the side effects
Vasodilators
Apresoline
hydralazine
Isordil/Sorbitrate
isosorbide dinitrate
Many brand names of
nitroglycerin
Imdur
isosorbide mononitrate
Vasodilators expand the blood vessels, lowering the resistance against which the heart must pump. This is called reducing afterload. These can be powerful drugs, so use with care. Watch for headaches and dizziness. Alpha blockers are vasodilators and expand blood vessels, and Coreg has this effect to some extent.
In the pre-hospital phase : Morphine, Nitrates (nitroglycerin) Oxygen, Lasix or some other dieuretics
Morphine dilates veins - called reducing preload - and decreases anxiety
Nitroglycerin also dilates coronary arteries as well & dilates vessels
IV Drugs
Primacor IV
milrinone
Inocor IV
amrinone lactate
dobutamine
dopamine
Natrecor
nesiritide Usually given intravenously, inotropes and certain other IV drugs make the heart pump more strongly (inoropic effect). They are usually used only in severe CHF and are fairly short acting. Since they speed up the wearing out of the heart (myocardium), they are not used unless really necessary. They do really help quality of life in severe or end-stage heart failure, though. They are used in hospitals or at home, with therapy started by a visiting nurse (home health) Natrecor is a new drug that has many of an inotrope's benefits without many of the side effects
Statins
Zocor simvastatin
Mevacor lovastatin
Pravachol pravastatin
Lescol fluvastatin
Lipitor Atorvastatin For those CHFers who have CAD, cholesterol control is crucial. Because less physical activity raises LDL, most CHFers are put on drugs to maintain healthier cholesterol levels. Watch for constipation, stomach upset, or muscle cramps. Many cholesterol lowering drugs lower the CoQ10 level. The price of different cholesterol lowering drugs may differ & costs drastically. If they suffer muscle weakness or soreness a lot after starting a statin drug, they should see their doctor immediately since a rare side effect causing this can be dangerous. Actually ruptruring muscles.
Understanding CHF is the key factor for the EMT or Paramedic..
R/r 911