Question

If a patient presents with acute decompensated HF and hasa SBP > 90 and HR b/t 50 - 100 but is renally impaired (SCr > 1.2) which IV vasodilator can they not get

a) Nitroglycerin
b) Nesiritide
c) Enalapril
d) Hydralazine

Answer 1

In a patient with acute decompensated HF and renal impairment, Enalapril should not be used as an IV vasodilator.

Step-by-step explanation:

In a patient with acute decompensated heart failure (HF) who is renally impaired, the IV vasodilator they cannot receive is Enalapril (option c).

Enalapril is an angiotensin-converting enzyme (ACE) inhibitor, which works by blocking the conversion of angiotensin I to angiotensin II. This helps to reduce vasoconstriction and lower blood pressure.

However, in a patient with renal impairment, Enalapril may not be as effective, as the kidneys are responsible for clearing the drug from the body. Therefore, the patient may not receive the full beneficial effects of Enalapril in this situation.