Vasodilator therapy

Direct vasodilators

I. Mixed vasodilators (Recommended - best long term) II. Venodilators (Tolerance develop - worsening HF) Ill. Arteriolar vasodilators (Not Recommended)

Other Therapies

  • Diuretics Best FIRST LINE Furo (acute) -/+ Thia (chronic) & Lactones
  • Beta-blockers; generally not advisable, unless pheochromocytoma, thyrotoxicosis, and increased sympathetic overactivity - prevention or partially reverse progressive left ventricular diltation
  • Nesiritide - Dyspnea at rest HF - Unstable
  • Anticoagulants - Afib - Thromboembolisms, Thrombus
  • Antiarrhythmics As amiodarone that has little negative inotropic effect can be used in ventricular arrhythmia

Positive inotropic drugs:

''''Not generally advisable to use long term - there are some exceptions ''''

  1. Cardiac Glycosides - Ca2+ Influx
  2. Dopamine and dobutamine (used for short term only ). - B1 Stimulation
  3. Phosphodiesterase Inhibitors (PDE): amrinone and milrinone.