Congestive heart failure drug interactions: Difference between revisions
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==Overview== | ==Overview== | ||
Polypharmacy is common in the management of the patient with congestive heart failure. Efforts should be made to assure that there are few if any adverse drug interactions. It should be noted that the volume of drug distribution and the clearance of drugs in heart failure is often altered due to impaired renal function, poor drug absorption due to gut edema, and impaired drug metabolism due to hepatic insufficiency. | Polypharmacy is common in the management of the patient with congestive heart failure. Efforts should be made to assure that there are few if any adverse drug interactions. It should be noted that the volume of drug distribution and the clearance of drugs in heart failure is often altered due to impaired renal function, poor drug absorption due to gut edema, and impaired drug metabolism due to hepatic insufficiency. | ||
==Drug Interactions== | |||
==Digoxin== | ===Digoxin=== | ||
The [[volume of distribution]] of [[digoxin]] is reduced in [[congestive heart failure]] as is the [[renal clearance]] and the dose should be adjusted accordingly. [[Verapamil]] and [[amiodarone]] can increase serum digoxin levels. [[Hypokalemia]] can exacerbate [[digoxin]] toxicity. | The [[volume of distribution]] of [[digoxin]] is reduced in [[congestive heart failure]] as is the [[renal clearance]] and the dose should be adjusted accordingly. [[Verapamil]] and [[amiodarone]] can increase serum digoxin levels. [[Hypokalemia]] can exacerbate [[digoxin]] toxicity. | ||
==Triple therapy with in Angiotensin-converting enzyme inhibitor, an Angiotensin Receptor Blocker, and Spironolactone== | ===Triple therapy with in Angiotensin-converting enzyme inhibitor, an Angiotensin Receptor Blocker, and Spironolactone=== | ||
The combination of these three agents can lead to severe [[hyperkalemia]] and the use of all three agents together is not recommended. | The combination of these three agents can lead to severe [[hyperkalemia]] and the use of all three agents together is not recommended. | ||
==Amiodarone== | ===Amiodarone=== | ||
== Warfarin== | ===Warfarin=== | ||
The dose of [[warfarin]] that is required in patients with congestive heart failure is often lower than usual. | The dose of [[warfarin]] that is required in patients with congestive heart failure is often lower than usual. | ||
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Revision as of 15:03, 7 May 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Polypharmacy is common in the management of the patient with congestive heart failure. Efforts should be made to assure that there are few if any adverse drug interactions. It should be noted that the volume of drug distribution and the clearance of drugs in heart failure is often altered due to impaired renal function, poor drug absorption due to gut edema, and impaired drug metabolism due to hepatic insufficiency.
Drug Interactions
Digoxin
The volume of distribution of digoxin is reduced in congestive heart failure as is the renal clearance and the dose should be adjusted accordingly. Verapamil and amiodarone can increase serum digoxin levels. Hypokalemia can exacerbate digoxin toxicity.
Triple therapy with in Angiotensin-converting enzyme inhibitor, an Angiotensin Receptor Blocker, and Spironolactone
The combination of these three agents can lead to severe hyperkalemia and the use of all three agents together is not recommended.
Amiodarone
Warfarin
The dose of warfarin that is required in patients with congestive heart failure is often lower than usual.