Cardiovascular Essentials for Nurses-Handout: HF Medication Reference Sheet

Handout: HF Medication Reference Sheet

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This document provides a reference sheet for heart failure medications, including ARNI (Sacubitril/Valsartan), ACE inhibitors (Captopril, Enalapril, Lisinopril, Ramipril), ARBs (Losartan, Valsartan, Candesartan), aldosterone antagonists/MRAs (Eplerenone, Spironolactone), beta-blockers (Bisoprolol, Carvedilol, Metoprolol succinate), and SGLT2 inhibitors (Dapagliflozin, Empagliflozin). <br /><br />For each medication, the document lists the initial dose, titration increments, and target dose. It also provides monitoring parameters, major adverse reactions, contraindications, dosage and titration considerations, and miscellaneous information for each medication.<br /><br />The document emphasizes the importance of monitoring renal function and potassium levels for ARNI, ACE inhibitors, and ARBs. It also highlights adverse reactions such as hypotension, hyperkalemia, cough, dizziness, and renal failure for these medications.<br /><br />The document advises not to start ARNI if the patient is hypotensive, hyperkalemic, or has a history of angioedema. It also recommends stopping ACE inhibitors 36 hours prior to starting ARNI. The combination of ARNI with ACE inhibitors can increase the risk of angioedema.<br /><br />For aldosterone antagonists/MRAs, the document recommends monitoring serum potassium and renal function after initiation and any medication increase. It also mentions possible adverse reactions such as hyperkalemia, worsening renal function, and gynecomastia/breast tenderness in males.<br /><br />The document provides specific dosing considerations for severe renal impairment and moderate hepatitis impairment for ARNI, ACE inhibitors, and ARBs.<br /><br />For beta-blockers, the document highlights monitoring blood pressure, heart rate, and signs of congestion after starting and during titration. It advises against prescribing beta-blockers in individuals with a high decrease AV block, decompensated heart failure, or significant asthma or bronchoconstriction.<br /><br />Finally, for SGLT2 inhibitors, the document recommends monitoring blood pressure, heart rate, renal function, and volume status. It mentions possible adverse reactions such as hypoglycemia when administered with insulin and specific contraindications for certain patient populations.<br /><br />Overall, this reference sheet provides essential information about heart failure medications for healthcare professionals involved in cardiovascular nursing.

Keywords

heart failure medications

ARNI

ACE inhibitors

ARBs

aldosterone antagonists

beta-blockers

SGLT2 inhibitors

monitoring parameters

renal function

adverse reactions