Drug of choice for acute left ventricular failure: September 2006

Ans. D: I/V Furosemide Diuretics remain the mainstay of therapy and current standard of care for acute hea failure. Intravenous administration of a loop diuretic (furosemide, bumetanide, torsemide) is preferred initially due to potential poor absorption of the oral forms in the presence of bowel edema. Treatment of Symptomatic Left Ventricular Systolic Dysfunction First Line (Class I recommendation) Diuretics and fluid restriction in patients who have evidence of fluid retention. ACE inhibitor - all patients, unless contraindicated (eg. renal aery stenosis, unstable renal function, hypotension) Beta-adrenergic blockade in all stable patients, unless contraindicated (eg. no or minimal evidence of fluid retention, no recent inotropic agent, no bronchospasm) Digitalis for the treatment of symptoms of Hea Failure, unless contraindicated (eg. renal insufficiency) Withdrawal of drugs known to adversely affect the clinical status of patients (e.g., nonsteroidal anti-inflammatory drugs, most antiarrhythmic drugs, and most calcium channel blocking drugs)