1. Diuretics are the most rapidly effective drugs for treating the symptoms of pulmonary congestion. They are no longer recommended as initial therapy for chronic heart failure because the resulting volume depletion may increase sympathetic stimulation. For long-term therapy, diuretics should be combined with ACE inhibitors or angiotensin II receptor antagonists (ARAs).

2. Patients with moderate-to-severe HF will usually require furosemide, 20160 mg, for adequate diuresis. The dosage may be increased and often doubled. In patients who respond poorly to high doses of furosemide, the addition of metolazone (Zaroxolyn) or HCTZ, 2.55.0 mg, 30-60 minutes before the morning dose of diuretic is often effective.

3. Torsemide (Demadex), 10-100 mg, is comparable to furosemide but with a longer duration of action.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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