QuestionSBA
QuestionChoice
Both of these drugs are diuretics so would reduce the patient's fluid overload. However, ACE-inhibitors and beta-blockers are used first-line, alongside loop diuretics only for symptom control. Aldosterone antagonists are then only used if symptoms are not controlled by these three drugs and there is a reduced ejection fraction.
10000618
c
Loop diuretic + Aldosterone antagonist
QuestionChoice
All of the above drugs act to interfere with the body's response to the low cardiac output in heart failure. ACE inhibitors (e.g. ramipril) decrease plasma fluid and cause vasodilation, both of which decrease venous pressure. Beta-blockers (e.g. bisoprolol) help protect the myocardium from overstimulation from the action of noradrenaline on beta-adrenoceptors. Additionally, diuretics (e.g. furosemide) also decrease pressure via removing fluid, which helps to relieve symptoms such as oedema and breathlessness. However, they are not necessary if the person is not having symptoms.
10000616
a
ACE inhibitor + Beta blocker
QuestionChoice
An ACE inhibitor and beta-blocker would be used first-line. However, an ARB would only be used in place of an ACE inhibitor, not as well as, and would only be used if ACE inhibitors were not tolerated. A loop diuretic e.g. furosemide would also be used to reduce fluid overload.
10000617
b
ACE-inhibitor + Beta-blocker + Angiotensin Receptor Blocker
QuestionChoice
Beta-blockers are used first-line in chronic heart disease, as they protect the myocardium from noradrenaline by blocking the beta-adrenoreceptors. They also cause some vasodilation which helps to reduce venous pressure. However, a beta-blocker alone is not enough to treat chronic heart failure. An ACE-inhibitor (e.g. ramipril) and possibly a loop diuretic (e.g. furosemide) are also needed to adequately treat a chronic heart failure patient.
10000619
d
Beta-blocker alone
QuestionChoice
ACE inhibitors, beta blockers and loop diuretics are the three drug classes typically used first-line in chronic heart failure. However, both ARBs and aldosterone antagonists are not used first-line. Aldosterone antagonists are used when symptoms are not controlled with ACE inhibitors and beta-blockers, and ARBs are used instead of ACE inhibitors if ACE inhibitors are not tolerated.
10000620
e
ACE inhibitor + Beta blocker + Loop diuretic + Aldosterone antagonist + Angiotensin Receptor Blocker (ARB)
Concept
Chapter
2693
3798
Heart Failure
Topic
134
Cardiology
12670
Which of the following combination of drugs is typically the first-line medical treatment used in chronic heart failure?
a