Tetralogy of Fallot With Absent Pulmonary Valve Medication
- Author: Prema Ramaswamy, MD; Chief Editor: Howard S Weber, MD, FSCAI more...
No specific medications for tetralogy of Fallot (TOF) with absent pulmonary valve are indicated. Anticongestive therapy is of limited benefit in the treatment of heart failure.
Positive inotropic agents increase the force of contraction of the myocardium and are used to treat acute and chronic congestive heart failure (CHF). Some of these drugs may also increase or decrease the heart rate (ie, positive or negative chronotropic agents), provide vasodilatation, or improve myocardial relaxation. These additional properties influence the choice of drug for specific circumstances.
Digoxin is a cardiac glycoside with direct inotropic effects in addition to indirect effects on the cardiovascular system. This agent acts directly on cardiac muscle, increasing myocardial systolic contractions. Its indirect actions result in increased carotid sinus nerve activity and enhanced sympathetic withdrawal for any given increase in mean arterial pressure.
Diuretic agents promote excretion of water and electrolytes by the kidneys. These drugs are used to decrease pulmonary or systemic edema.
Furosemide increases excretion of water by interfering with the chloride-binding cotransport system which, in turn, inhibits sodium and chloride reabsorption in the ascending loop of Henle and distal renal tubule.
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