Cardiovascular
Heart Failure, Angina, Unstable Angina, MI and Pericarditis (Note Sheet)
Compact notes on drug choices in heart failure, angina, MI, cardiogenic shock and pericarditis. Partly illegible; verify before use.
- ICD-10
- —
- Source
- OPD handbook p.215 (middle band of a handwritten student sheet; some lines are cut off)
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
Treatment
Step 1 of 6
Heart failure
- Tab Moduretic (amiloride 5 mg + hydrochlorothiazide 50 mg), ½ tab in the morning
- Tab Capril 25 mg, ¼ to 1 tab in the morning
- Tab Lasoride, 1 tab in the morning
- Complete bed rest
- Inj Lasix (frusemide) 20 mg IV stat
- Inj Nipride IV infusion; Inj Isoket; dopamine + dobutamine infusion; Inj digoxin
Step 2 of 6
Angina pectoris
- Tab Angised 0.5 mg, 1 tab under the tongue
- Tab Aspirin 300 mg, ½ tab
- Tab Concor (bisoprolol) 5 mg OD; Tab Rovista (rosuvastatin) 10 mg OD
- If beta-blockers are contraindicated: Tab Herbesser (diltiazem) 30 mg TID
- If not controlled, add: Cap Adalat (nifedipine) 10 mg TID, or Tab Isordil (isosorbide dinitrate) 10 mg TID
Step 3 of 6
Unstable angina / acute coronary syndrome
- Inj morphine (or Nalbuphine) 10 mg + Inj Maxolon (metoclopramide) 10 mg slow IV over 3–5 minutes
- Inj SKA (streptokinase) 1.5 million IU over 60 minutes (STEMI)
- Inj heparin 5000 U SC (NSTEMI)
- Tab Disprin 300 mg; Tab Lowplat 75 mg; Tab Concor 5 mg; Inj Isoket at 2 mg/hr
Step 4 of 6
Complicated MI
- HF and normal BP: Inj Lasix (frusemide) 20 mg, 2–5 amp stat; Inj Isoket IV infusion; once improved: Tab Lasix 40 mg 2 tab morning with Tab Potassium chloride 500 mg 2 tab for each tab of Lasix, or Tab Lasoride; Tab Capril (captopril) 25 mg ¼ with tab BID
- HF and raised BP: Inj Lasix 20 mg, 2–5 amp stat; Nipride (sodium nitroprusside) infusion 0.5 µg/kg/min
- No HF but low BP: IV fluids; dopamine infusion 5 µg/kg/min; dobutamine infusion 2.5 µg/kg/min
- HF plus low BP: Inj Lasix 20 mg; dopamine infusion 5 µg/kg/min; dobutamine infusion 2.5 µg/kg/min
Step 5 of 6
Cardiogenic shock
- MI treatment plus dopamine and dobutamine infusion
Step 6 of 6
Pericarditis
- Tab Proxen (naproxen) 500 mg, 2 tab at bedtime, or Tab Diclofenac 50 mg, 1 tab BID