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If the hospital is unable to satisfy any concern about patient care and safety, a patient or family also has the right to file a complaint directly with:

The Facility Licensing Division of the Montana Department of Public Health & Human Services at 800-762-4618 or 2401 Colonial Dr., Second Floor, Helena MT 59620

The Joint Commission on Accreditation of Healthcare Organizations at 800-994-6610 or complaint@jcaho.org

The Commission on Accreditation of Rehabilitation Facilities, and/or the Mountain Pacific Quality Health Foundation (the Professional Review Organization) at 1-800-497-8232 or 3404 Cooney Dr. Helena, MT 59602

Medicaid/Medicare recipients: Mountain-Pacific Quality Health Foundation may be contacted at
1-800-497-8232 or
3404 Cooney Dr., Helena, MT 59602

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Medication for CHF

here are several aspects to treating Congestive Heart Failure (CHF). In this section, we will talk about many of the prescription drugs that are used to manage CHF. There is no cure for CHF, but good management of this disease can dramatically improve the quality of your life.

Before we begin talking about specific medications, let's cover some important points about your medications in general.

PATIENTS NOT TAKING THEIR MEDICATIONS AS PRESCRIBED IS THE LEADING REASON FOR READMISSION TO THE HOSPITAL:

  • Always take your medications exactly as your doctor ordered them.
  • Do not stop taking your medications unless asked to do so by your doctor.
  • Do not alter the dosage of your medication without checking with your doctor.
  • Take your medications at the same time every day.
  • Do not take outdated medications. Check with your pharmacist if you have any questions about the age of your medications.
  • Check with your doctor before taking any over-the-counter medications as they may interact with your prescription medications.
  • If you see more than one doctor, be certain that all of your care providers know all of the medications you are taking. Always keep a current medication chart with you.

SOME TIPS TO HELP KEEP YOUR COSTS DOWN:

  • Ask your doctor about generic forms of the medications you are taking. They are normally less expensive.
  • Shop around at your local pharmacies to find the lowest price. Most pharmacies will tell you the cost of a prescription over the phone. You will need to tell them the name of the drug, the dose and how many times per day you take the medication. Ask them to quote you a price for a 30-day supply.

DEVELOP A ROUTINE:

  • Take your medications at the same time every day to keep a constant amount of medicine in your system at all times.
  • Check to see if your medications need to be taken with food or if they are best taken on an empty stomach.
  • If you take a diuretic ("water pill"), try taking it in the morning to prevent frequent trips to the bathroom at night. If you are prescribed a second dose of diuretic daily, try taking this second dose in the afternoon rather than later in the evening.

OK … Now that we have talked about important points relating to medications in general, lets go on and learn about some of the specific types of medications that you are likely to be prescribed.

DIURETICS: Diuretics are also known as "water pills." They help to eliminate excess fluid and salt from the body. Diuretics cause the kidneys to make more urine but they will also increase the body's excretion of potassium. Since potassium levels in the body may drop dramatically during diuretic use, you will need to include foods high in potassium in your diet. Your doctor may also prescribe a potassium supplement if foods alone do not replace enough potassium in your system.

Diuretics are used to treat both pulmonary edema and peripheral edema. Since diuretics also dilate blood vessels (open the vessels wider), it is also used to treat hypertension (high blood pressure).

Side effects: dizziness, severe leg cramps, increasing weakness. Some diuretics may also increase blood sugars in diabetics. If you are diabetic and taking diuretics, it is important to closely monitor your blood sugar levels.

Examples:

  • Lasix (furosemide)
  • Bumex (bumetanide)
  • Hydrochlorothiazide (HCTZ)
  • Dyazide
  • Maxide
  • Zaroxolyn (metolazone)
  • Hygroton
  • Lozol
  • Aldactone (spironolactone)

ACE INHIBITORS: Angiotensin Converting Enzyme Inhibitors block the formation of Angiotensin II, a substance that causes constriction (narrowing) of the blood vessels. In doing this, ACE inhibitors allow the blood vessels to relax and make it easier for the heart to pump. This relaxation of blood vessels also results in lowered blood pressure, making ACE inhibitors a good choice for treating hypertension.

Side effects: cough, dizziness, fatigue, headache, vomiting, diarrhea, nausea. Contact your doctor immediately if you experience swelling of your face, mouth, hands or feet, or if you experience difficulty swallowing or breathing.

Examples:

  • Capoten (captopril)
  • Vasotec (enalapril)
  • Prinivil or Zestoril (lisinopril)
  • Monopril (fosinopril)
  • Lotensin (benazepril)
  • Accupril (quinapril)
  • Altace (ramipril)

VASODILATORS: Like ACE inhibitors, this group of drugs relaxes the blood vessels and makes it easier for the heart to pump. Vasodilators also lower blood pressure.

Side effects: low blood pressure (hypotension), dizziness, abnormally high heart rate (tachycardia), headache, and blurred vision.

Examples:

  • Hydralazine
  • Transderm Nitro
  • Nitrodur
  • Nitrostat
  • Isordil
  • Sorbitrate (isosorbide dinitrate)
  • Monoket
  • Ismo
  • Imdur (isosorbide mononitrate)
  • Apresoline (hydralazine)

BETA BLOCKERS: This group of drugs blocks the body's response to catecholamines (epinephrine, norepinephrine). These are the compounds released during the "flight or fright" response. They cause the heart to work harder, increase blood pressure and raise heart rate. By blocking these compounds, beta blockers reduce the energy needs of the heart, decreasing the strain and workload of the heart.

Side effects: slow heart rate, decreased function of the left ventricle of the heart, worsening of symptoms due to asthma, peripheral vascular disease, diabetes.

Examples:

  • Coreg (carvedilol)

DIGITALIS: Digitalis has its effect directly on the heart muscle. It increases the strength of the heart's pumping action (contraction) and regulates the rate of the heartbeat. A stronger, more regular heartbeat provides better circulation to the body and decreased swelling. Digitalis is also used to slow some types of abnormally fast heart rates, such as atrial fibrillation. Your doctor may want you to check your heart rate each day before taking your medication to ensure your heart rate does not become too slow.

Side effects: fatigue, headache, low blood pressure, nausea, a bad taste in your mouth, too slow a heart rate (bradycardia), yellow or blue-green vision.

Examples:

  • Lanoxin (digoxin)

ANTICOAGULANTS: This group of drugs, also called blood thinners, work to prevent the formation of blood clots in the chambers of the heart, veins or arteries. Blood clots in small arteries like the coronary arteries (that supply blood to the heart muscle itself) can lead to a myocardial infarction (heart attack).

Side effects: bleeding

Examples:

  • Coumadin
  • Heparin
  • Lovenox
  • Aspirin