CEA Nursing Practice Exam

For a patient with heart failure and a low ejection fraction, which agent should be avoided during optimal medical therapy?

1. Amlodipine (Norvasc)

2. Entresto (Sacubitril/Valsartan)

3. Furosemide (Lasix)

4. Carvedilol (Coreg)

The correct answer is: Amlodipine (Norvasc)

Amlodipine (Norvasc) is a calcium channel blocker that is typically used to treat hypertension and angina. In patients with heart failure, particularly those with reduced ejection fraction, the use of calcium channel blockers like amlodipine can be detrimental. This is because these medications can lead to fluid retention and potentially worsen heart failure symptoms. In optimal medical therapy for heart failure with a low ejection fraction, the goal is to improve heart function, decrease fluid overload, and enhance symptomatic control. Amlodipine does not provide these benefits and can interfere with the effectiveness of other heart failure treatments. Instead, agents such as Entresto, furosemide, and carvedilol play crucial roles in managing heart failure. Entresto is used to reduce the risk of cardiovascular death and hospitalization for heart failure, furosemide is a loop diuretic that helps manage fluid retention, and carvedilol is a beta-blocker that can improve heart function and reduce mortality in heart failure patients. Therefore, while amlodipine may be effective for treating hypertension, its potential to exacerbate heart failure symptoms makes it a medication to avoid in patients receiving optimal medical therapy for heart failure with low ejection fraction.