Back to the same old age old question - Is it furosemide or nitrates (GTN) that you'd reach for in a patient with acute heart failure? Agreed that both these drugs have some role but which is the first drug of choice?
Furosemide is supposed to decrease preload with an immediate direct vascular action. Then has a delayed affect due to diuresis.
Takes seconds to break an ampoule and inject.
NTG is used to bridge the gap in between. Using well titrated infusion. But takes a few minutes to load onto infuser pumps.
Furosemide is first choice!
Would first consider NTG only if sublingual spray available.
Frusemide still.................I thought the world is moving on to new modailites.
Would not give frusemide as firstline to some who could be already dry as bone/??Vasculopath with knackered kidneys(I think most of the patients will have either of these two)
It is my personal choice though.
And the Jury is still out on which is the best(no difference in mortality i think)
