Heart Failure — Uganda (General Adult population)
General Measures
Bed rest with head of bed elevated/sitting position. Reduce salt intake and limit fluid intake (1-1.5 L/ day).
Diuretics
Furosemide 20-40 mg oral or IV daily or every 12 hours, increasing as required to 80-160 mg. Child: 1 mg/kg oral or IV (max: 8 mg/kg daily).
ACE Inhibitors
Enalapril: start with 2.5 mg once daily, increase gradually over 2 weeks to 10-20 mg (max 40 mg). OR Lisinopril 5mg up to 40mg. Child: Enalapril 0.1-1 mg/kg daily in 1-2 doses OR Captopril 0.1-0.3 mg/kg daily.
Beta Blockers
When patient stable: Carvedilol 3.125 mg every 12 hours, increase gradually to max 25 mg 12 hourly. OR Bisoprolol 1.25mg once daily increase gradually to max 10mg. Child: Carvedilol 0.05 mg/kg every 12 hours.
Second/Third Line
Spironolactone 25-50 mg once a day (Child: 1.5-3 mg/kg daily). Digoxin 125-250 micrograms/daily (Child: 15 micrograms/kg daily).
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