PHRM3011 Lecture Notes - Lecture 14: Hypochromic Anemia, Titration, Nuclear Material
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Increase dose at least every 2 weeks get to max dose tolerated by pt. Se-s couch, hyperkalaemia, hypotension, headache, dizziness, nausea, renal impairment. Monitor blood pressure, renal function (serum creatinine), k. Ndsaids + diuretic = decreased renal function. K sparing diuretics or k supplements = increase k. Lithium = increased lithium levels slowing the heart as to give it more time to fill live long, decrease hospital admission, improve symptoms in long term. Evidence for all grades of heart failure. Benefit with bisoprolol, metoprolol (only controlled release), carvedilol, nebivolol. No others in class to be use in hf introduce when the pt is stable. Get to highest dose pt can tolerate measured by pulse and bp. Dreams related to lipid solubility (carvedilol> nevidolol> metoprolol> Hypotension sx. worsened by dose increase too quickly. Di"s amiodarong, digoxin - decrease pulse (both drugs that also decrease pulse) cause na retention. 12. 5mg d initially then to 25mg daily (max 50mg daily)
