Double Outlet Right Ventricle With Transposition Medication

Updated: Jan 29, 2019
  • Author: M Silvana Horenstein, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Medication

Medication Summary

Medical therapy is aimed at alleviating congestive heart failure (CHF), when present, to prepare patients for surgery. Antibiotics for endocarditis prophylaxis are required before performing procedures that may cause bacteremia. For more information, see Antibiotic Prophylactic Regimens for Endocarditis.

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Loop Diuretics

Class Summary

Furosemide is used to decrease pulmonary congestion in patients with pulmonary overcirculation.

Furosemide (Lasix)

Inhibits absorption of sodium and chloride in proximal and distal tubules of the loop of Henle, thereby promoting excretion of salt and water.

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Potassium-sparing Diuretics

Class Summary

Potassium-sparing diuretics (eg, spironolactone) are weak diuretics usually prescribed with more potent loop diuretics to prevent potassium depletion with subsequent development of hypokalemic-hypochloremic metabolic alkalosis.

Spironolactone (Aldactone)

Inhibits aldosterone-dependent sodium-potassium exchanger in distal convoluted renal tubule, thereby retaining potassium and promoting excretion of sodium and water.

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Inotropic Agents

Class Summary

Positive inotropic agents increase the force of contraction of the myocardium and are used to treat acute and chronic CHF. Some 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. Those used predominantly for their inotropic effects include cardiac glycosides. Digitalis glycosides are used for their inotropic properties in the presence of left ventricular failure.

Digoxin (Lanoxin, Lanoxicaps)

Digitalis glycoside. Enhances myocardial contractility by inhibition of Na+/K+ ATPase, a cell membrane enzyme that extrudes Na and brings K into the myocyte. Resulting increase in intracellular Na stimulates Na-Ca exchanger in the cell membrane, which extrudes Na and brings in Ca, therefore increasing contractility of myocyte (ie, positive inotropic effect).

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