Download Heart Failure Matters

SUMMER 2016
A Special Publication from The Everett Clinic
Heart Failure Matters
Medications Commonly Used
to Treat Heart Failure
H
eart failure medications can help you feel better and live longer. The list below includes
some of the more common medications used to treat heart failure. Your provider will determine
the best medication plan for you. It is very important to take your medications on time, every single day.
If you have any questions or concerns about your medications, be sure to discuss them with your provider.
Remember: Do not take over-the-counter medications without your provider’s knowledge.
ACE Inhibitors
Beta Blockers
Such as: lisinopril, enalapril, ramipril,
benazepril
Such as: carvedilol, metoprolol succinate
ACE inhibitors (angiotensin converting
enzyme inhibitors) are the cornerstone
of heart failure drug therapy. They slow
the progression of heart failure. They are
a type of vasodilator. ACE inhibitors can
sometimes cause a dry cough, in which
case an ARB (angiotension II receptor
blocker) may be preferred. Some
examples of ARBs include losartan and
valsartan.
Diuretics
Such as: furosemide, bumetanide,
spironolactone, hydrochlorothiazide,
chlorthalidone
People with heart failure often develop
swelling (or edema) in the legs and fluid
in the lungs. A diuretic (also called a
water pill) helps the body get rid of the
excess fluid. This helps to relieve the
heart’s workload, since there is less fluid
to pump throughout the body.
Many people find it best to take diuretics
in the morning so trips to the bathroom
happen during the day. Taking diuretics
in the evening often results in interrupted
sleep.
The heart tries to compensate for its
weakened pumping action by beating
faster, which puts more strain on it. Beta
blockers reduce the heart’s tendency
to beat faster. This allows the heart to
maintain a slower rate and lowers blood
pressure.
Vasodilators
Such as: isosorbide dinitrate, hydralazine,
nitrates
Vasodilators relax and expand blood
vessels. This makes it easier for the
heart to pump blood throughout the
body. These medicines are sometimes
used in people who cannot take an
ACE inhibitor, to relieve symptoms and
improve their tolerance for exercise.
Nitroglycerin tablets are a type of
vasodilator prescribed to ease chest pain.
Digitalis Preparations
Such as: digoxin
Digoxin helps the heart pump with more
force. This can help reduce some of the
symptoms of heart failure, especially
when the patient isn’t responding to ACE
inhibitors and diuretics. It also slows a
type of irregular heartbeat (called atrial
fibrillation) that is
present in some people with heart
failure. For digoxin to be effective,
patients must take the right amount. This
means they will probably have regular
blood tests to check their digoxin level.
Potassium
Potassium helps control heart rhythm
and is essential for the normal work of
the nervous system and muscles. It’s
important to have just the right amount
of potassium in the body, especially
for the heart. The kidneys control the
amount of potassium in the bloodstream
and eliminate any excess through the
urine.
Since most diuretics remove potassium
from the body, heart failure patients who
use them are at risk of low potassium.
Some patients need to take potassium
supplements. Sometimes all they need
to do is eat foods high in potassium,
such as bananas. Spironolactone is
a type of diuretic that helps the body
retain potassium. If you are taking this
medication, you usually should not be
taking a potassium supplement.
Patients will need to have regular blood
tests to check potassium level and
kidney function.
Heart Failure Self-Management Tool
RN/MD Phone Number: _______________________________________
Green Zone: ALL CLEAR
■■ No shortness of breath
Green Zone Means:
■■ No swelling
■■ Your symptoms are under
control
■■ No weight gain
■■ No chest pain
■■ No decrease in your ability to
maintain your activity level
Your Morning Weight:
■■ Continue taking
medications as ordered
■■ Follow low salt diet
■■ Keep all physician
appointments
■■ Continue to monitor
weight daily
Yellow Zone: CAUTION
When to Call
Your Doctor
If you have any of the following signs or
symptoms:
Many problems with heart failure,
when addressed soon enough,
can be treated at home. Monitor
your symptoms, ability to engage
in activity and daily weight. Call
to report any changes to your
provider.
■■ Increased cough
Sometimes it can be hard to
know when to call. To help you
understand your symptoms and
what to do about them, we
are providing a Heart Failure
Self-Management Tool. Many
people find it helpful to keep
it in a visible spot (such as the
refrigerator) to refer to when
needed. Please discuss the best
plan for you with your provider.
■■ Chest pain
■■ Increased weight gain of 2-3 pounds
in a day or 5 pounds in a week.
■■ Increased swelling
■■ Decreased appetite or just feeling
generally poor
■■ Occasional shortness of breath at rest or
increased shortness of breath with activity
■■ Increase in the number of pillows needed
to sleep or you need to sleep in a chair
Red Zone: DANGER
■■ Your symptoms may
indicate that you need
an adjustment of your
medications
■■ Many of these problems
can be dealt with by your
nurse and physician. If you
ignore them and they go
untreated, they may cause
you to be admitted to the
hospital.
■■ Contact RN/MD regarding
weight or symptom
changes
■■ Unrelieved shortness of breath
Red Zone Means:
■■ Unrelieved chest pain
■■ You need to be evaluated
by a physician right away
■■ Wheezing or chest tightness at rest
You are receiving these materials as a part of your enrollment in The Everett Clinic’s
Heart Failure Disease Management program. Participation is limited to patients in
select health plans. The content is designed to reinforce, not replace, information or
instructions given to you by your healthcare provider. If you have questions about the
Heart Failure Disease Management Program, or prefer to opt out, call 425-317-4654.
3901 Hoyt Avenue ■ Everett, WA 98201
everettclinic.com
Yellow Zone Means:
■■ Dial 911