Congestive heart failure drug interactions: Difference between revisions
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| [[ | | [[Congestive heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] | ||
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| [[File:Critical_Pathways.gif|88px|link= Congestive heart failure critical pathways]]|| <br> || <br> | |||
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{{CMG}} | {{CMG}} | ||
==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== | ==Drug Interactions== | ||
===Digoxin=== | ===Digoxin=== | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Intensive care medicine]] | [[Category:Intensive care medicine]] | ||
[[Category:Medicine]] | |||
[[Category:Primary care]] | |||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category:Up-To-Date cardiology]] | [[Category:Up-To-Date cardiology]] | ||
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Revision as of 20:11, 11 August 2013
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Resident Survival Guide |
| File:Critical Pathways.gif |
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.
Warfarin
The dose of warfarin that is required in patients with congestive heart failure is often lower than usual.