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diagnosis management differential cardiology algorithm nephrology hfref hyperkalemia pharmacology gdmt treatment chf potassium rheumatology guideline high pathophysiology table aldosterone arb
Guidelines Directed medical therapy for Heart Failure Satyendra Dhar, MD, @DharSaty #HFrEF #GDMT #sodium-glucosecotransporter-2inhibitors #SGLT2i #reninangiotensinaldosteronesysteminhibitors
AngiotensinReceptorNeprilysinInhibitor #ACEi ... angiotensinreceptorblockers #ARB #ARNI ... MineralocorticoidReceptorAntagonist #LoopDiuretic
HFrEF: Guideline Directed Medical Therapy "Must Be On" • ACEI, ARB, or ARNI AND select Beta Blockers
Must Be On" • ACEI ... , ARB, or ARNI AND ... before increasing ACEI ... Reducing: • ACEI ... or ARB • ARNI
Heart Failure with Reduced Ejection Fraction (HFrEF) - Guideline Directed Medical Therapy - Initiation Strategies •
Stepwise Approach: ACE ... , ARB, ARNI → Beta-Blocker ... -2 Inhibitor → ARNI
Heart Failure with Reduced Ejection Fraction (HFrEF) - Guideline Directed Medical Therapy • Beta-blocker • ACE,
Beta-blocker • ACE ... , ARB, ARNI •
NSAID vs ACEI/ARB effects on the Kidneys Remember that NSAIDs and ACEI/ARB therapy have opposing effects on
NSAID vs ACEI/ARB ... that NSAIDs and ACEI ... NSAIDs cause vasoconstriction ... use shouldn't cause ... ACEI/ARB's are often
Target Doses in Congestive Heart Failure • Beta Blockers: Bisoprolol, Carvedilol, Metoprolol succinate, ARNI, Sacubitril/valsartan •
Metoprolol succinate, ARNI ... Sacubitril/valsartan • ACEI
The Diagnostic Approach to Hyperkalemia Drugs - Amiloride - Spironolactone - Triamterene - Trimethoprim - Pentamidine -
inhibitors Other causes ... LMW heparin - ACE-I ... #differential #causes
Etiologies of Hypoaldosteronism Hyporeninemic Hypoaldosteronism (Low Renin, Low Aldosterone) - Diabetic Nephropathy - NSAIDs Non-Hyporeninemic Hypoaldosteronism (Normal
Aldosterone) - ACE ... Comparison #Table #Causes
Here’s a review of the Renin-Angiotensin-Aldosterone system (RAAS) This is a very common pathway that clinicians should
sodium, which causes ... inhibiting drug classes ... (Aliskiren, ACEI
Peripartum Cardiomyopathy - Summary 1. Definition • Towards the end of pregnancy to 5 months postpartum
exclude other causes ... • Avoid ARB/ACE-I ... /ARNI/MRA • Avoid ... GDMT meds (e.g., ACE
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