Severe CHF

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Severe CHF

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10 Posts

ruhighazi
Forum Senior

Topics: 23
Posts: 76

05/12/06 - 01:11 AM

Which of the following may help a patient with a severe exacerbation of CHF requiring hospital admission to the ICU secondary to borderline cardiogenic shock?

a)Metoprolol
b)Corticosteroids
c)Milrinone
d)Diltiazem
e)Lidocaine

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Ruhighazi

frontal
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Topics: 53
Posts: 421

05/12/06 - 03:43 AM

Metoprolol?

aml
Forum Senior

Topics: 5
Posts: 132

05/12/06 - 04:59 AM

MILRINONE
Short-term, intermittent, Intravenous (IV) inotropic agents are a mainstay in the treatment of cardiogenic shock and in patients with advanced heart failure who are awaiting cardiac transplant.
Inotropic therapy can include either phosphodiesterase inhibitors (PDE-I) such as milrinone or beta-adrenergic agonists such as dobutamine.

frontal
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05/12/06 - 05:54 AM

Metoprolol will make the condition worse (-ve ionotrope). I think aml is right.

yasmeen
Forum Guru

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Posts: 947

05/12/06 - 07:04 AM

metaprolol? bete blockersr given and benificial in ccf even though they r negative ionotropics

mesh
Forum Guru

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Posts: 401

05/12/06 - 07:18 AM

MILRINONE

achilles
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05/12/06 - 08:17 AM

metoprolol.

beta blockers have been proven to decrease mortality.

first line Mx for this patient would have been diuretics and a vasodilator and also a beta blocker. if these are ineffective then we should add an inotropic agent such as milrinone.

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frontal
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05/12/06 - 09:31 AM

yasmeen wrote:
metaprolol? bete blockersr given and benificial in ccf even though they r negative ionotropics

I thought so too, but this patient's condition has worsened acutely... A beta blocker trial is more apt for chronic heart failure and ?maybe risky in this case with a cardiogenic shock. A positive ionotrope maybe a better choice.

ruhighazi
Forum Senior

Topics: 23
Posts: 76

05/12/06 - 11:23 AM

answer is C ( aml is right)

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achilles
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05/12/06 - 02:39 PM

#10

thanks ruhighazi. good questions ! pls keep posting more whenever you can.

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