Chlorothiazide is also known by its brand name Diuril.
Chlorothiazide
Thiazide diuretics include such commonly used diuretics as hydrochlorothiazide (HydroDIURIL, Esidrix), chlorothiazide (Diuril), and chlorthalidone (Hygroton)
category B (chlorothiazide, chlorthalidone, hydrochlorothiazide, indapamide, metolazone) or category C (bendroflumethiazide, benzthiazide, hydroflumethiazide, methyclothiazide, trichlormethiazide).
http://gustavus.edu/orgs/saab/ncaabanned.php a) Stimulants: amiphenazole methylenedioxymethamphetamine amphetamine (MDMA, ecstasy) bemigride methylphenidate benzphetamine nikethamide bromantan pemoline caffeine1 (guarana) pentetrazol chlorphentermine phendimetrazine cocaine phenmetrazine cropropamide phentermine crothetamide diethylpropion phenylpropanolamine (ppa) dimethylamphetamine picrotoxine doxapram pipradol ephedrine prolintane (ephedra, ma huang) strychnine ethamivan synephrine ethylamphetamine (citrus aurantium, zhi shi, bitter fencamfamine orange) meclofenoxate and related compounds methamphetamine (b) Anabolic Agents: anabolic steroids androstenediol methyltestosterone androstenedione nandrolone boldenone norandrostenediol clostebol norandrostenedione dehydrochlormethyl- norethandrolone testosterone oxandrolone dehydroepiandro- oxymesterone sterone (DHEA) oxymetholone dihydrotestosterone stanozolol (DHT) testosterone2 dromostanolone tetrahydrogestrinone (THG) epitrenbolone trenbolone fluoxymesterone and related compounds gestrinone mesterolone methandienone other anabolic agents methenolone clenbuterol (c) Substances Banned for Specific Sports: Rifle: alcohol pindolol atenolol propranolol metoprolol timolol nadolol and related compounds (d) Diuretics: acetazolamide hydrochlorothiazide bendroflumethiazide hydroflumethiazide benzhiazide methyclothiazide bumetanide metolazone chlorothiazide polythiazide chlorthalidone quinethazone ethacrynic acid spironolactone flumethiazide triamterene furosemide trichlormethiazide and related compounds (e) Street Drugs: heroin tetrahydrocannabinol marijuana3 (THC)3 (f) Peptide Hormones and Analogues: corticotrophin (ACTH) human chorionic gonadotrophin (hCG) leutenizing hormone (LH) growth hormone(HGH, somatotrophin) insulin like growth hormone (IGF-1) All the respective releasing factors of the above-mentioned substances also are banned: erythropoietin (EPO) sermorelin darbypoetin (g) Definitions of positive depends on the following: 1. for caffeine - if the concentration in urine exceeds 15 micrograms/ml. 2. for testosterone - if the administration of testosterone or use of any other manipulation has the result of increasing the ratio of the total concentration of testosterone to that of epitestosterone in the urine to greater than 6:1, unless there is evidence that this ratio is due to a physiological or pathological condition. 3. for marijuana and THC - if the concentration in the urine of THC metabolite exceeds 15 nanograms/ml.
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Alternative NamesImpotence caused by medications; Drug-induced erectile dysfunctionInformationVarious medications and recreational drugs can have an affect on sexual arousal and sexual performance. It should be noted that what causes impotence in one man may not affect another.If you think that a medication you are taking is having a negative effect on sexual performance, discuss the matter with your health care provider. NEVER stop taking any medication without first consulting your health care provider, because some medications can produce life-threatening reactions if they are not carefully and slowly stopped or switched appropriately.The following is a list of medications and non-prescription drugs that may cause impotence:Antidepressant and other psychiatric medications:Amitriptyline (Elavil)Amoxapine (Asendin)Buspirone (Buspar)Chlordiazepoxide (Librium)Chlorpromazine (Thorazine)Clomipramine (Anafranil)Clorazepate (Tranxene)Desipramine (Norpramin)Diazepam (Valium)Doxepin (Sinequan)Fluoxetine (Prozac)Fluphenazine (Prolixin)Imipramine (Tofranil)Isocarboxazid (Marplan)Lorazepam (Ativan)Meprobamate (Equanil)Mesoridazine (Serentil)Nortriptyline (Pamelor)Oxazepam (Serax)Phenelzine (Nardil)Phenytoin (Dilantin)Sertraline (Zoloft)Thioridazine (Mellaril)Thiothixene (Navane)Tranylcypromine (Parnate)Trifluoperazine (Stelazine)Antihistamine medications (certain classes of antihistamines are also used to treat heartburn):Cimetidine (Tagamet)Dimenhydrinate (Dramamine)Diphenhydramine (Benadryl)Hydroxyzine (Vistaril)Meclizine (Antivert)Nizatidine (Axid)Promethazine (Phenergan)Ranitidine (Zantac)High blood pressure medicines and diuretics ("water pills"):Atenolol (Tenormin)BethanidineBumetanide (Bumex)Captopril (Capoten)Chlorothiazide (Diuril)Chlorthalidone (Hygroton)Clonidine (Catapres)Enalapril (Vasotec)Furosemide (Lasix)Guanabenz (Wytensin)Guanethidine (Ismelin)Guanfacine (Tenex)Haloperidol (Haldol)Hydralazine (Apresoline)Hydrochlorothiazide (Esidrix)Labetalol (Normodyne)Methyldopa (Aldomet)Metoprolol (Lopressor)Minoxidil (Loniten)Nifedipine (Adalat, Procardia)Phenoxybenzamine (Dibenzyline)Phentolamine (Regitine)Prazosin (Minipress)Propranolol (Inderal)Reserpine (Serpasil)Spironolactone (Aldactone)Triamterene (Maxzide)Verapamil (Calan)Among the anti-hypertensive medications, thiazides are the most common cause of ED, followed by beta-blockers. Alpha-blockers are, in general, less likely to cause this problem.Parkinson's disease medications:Benztropine (Cogentin)Biperiden (Akineton)Bromocriptine (Parlodel)Levodopa (Sinemet)Procyclidine (Kemadrin)Trihexyphenidyl (Artane)Chemotherapy and hormonal medications:Antiandrogens (Casodex, Flutamide, Nilutamide)Busulfan (Myleran)Cyclophosphamide (Cytoxan)KetoconazoleLHRH agonists (Lupron, Zoladex)Other medications:Aminocaproic acid (Amicar)AtropineClofibrate (Atromid-S)Cyclobenzaprine (Flexeril)CyproteroneDigoxin (Lanoxin)Disopyramide (Norpace)EstrogenFinasteride (Propecia, Proscar, Avodart)Furazolidone (Furoxone)H2 Blockers (Tagamet, Zantac, Pepcid)Indomethacin (Indocin)Lipid lowering-agentsLicoriceMetoclopramide (Reglan)NSAIDs (Ibuprofen, etc.)Orphenadrine (Norflex)Prochlorperazine (Compazine)Pseudoephedrine (Sudafed)Opiate analgesics (painkillers)CodeineFentanyl (Innovar)Hydromorphone (Dilaudid)Meperidine (Demerol)MethadoneMorphineOxycodone (Oxycontin, Percodan)Recreational drugs:AlcoholAmphetaminesBarbituratesCocaineMarijuanaHeroinNicotineReferencesMcVary KT. Clinical practice. Erectile dysfunction.N Engl J Med. Dec 2007; 357(24): 2472-81.
DefinitionThiazide is an ingredient found in certain medications used to treat high blood pressure. Thiazide overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.Alternative NamesDiuretic antihypertensives overdosePoisonous IngredientThiazide is a type of drug called a diuretic. It prevents the body from reabsorbing sodium (salt) from part of the kidneys. Thiazide and related diuretics are used primarily to treat high blood pressure.Where FoundBendroflumethiazide (Naturetin)Benzthiazide (Exna)Chlorothiazide (Diuril, Diurigen)Chlorthalidone (Thalitone, Hygroton)Hydrochlorothiazide (Esidrix, HydroDiuril, Hydro-Par, Oretic)Hydroflumethiazide (Diucardin, Saluron)Indapamide (Lozol)Methyclothiazide (Enduron, Aquatensen)Metolazone (Zaroxolyn, Diulo)Polythiazide (Renese)Quinethazone (Hydromox)Trichlormethiazide (Metahydrin, Naqua, Diurese)Note: This list may not be all-inclusive.SymptomsBreathing - slowComaConfusionDizzinessDrowsinessFaintingFeverLow blood pressureMuscle crampsNauseaPhotosensitivity (skin is sensitive to sunlight)RashSeizuresUrination - frequentUrine - pale-coloredVision problems (items appear yellow)WeaknessYellow skinVomitingHome TreatmentSeek immediate medical help. Do NOT make a person throw up unless told to do so by poison control or a health care professional.Before Calling EmergencyDetermine the following information:Patient's age, weight, and conditionName of the product (ingredients and strengths, if known)Time it was swallowedAmount swallowedPoison Control, or a local emergency numberThe National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.Take the container with you to the hospital, if possible.See: Poison control center - emergency numberWhat to expect at the emergency roomThe health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:Activated charcoalBlood tests to determine body chemical levels and blood acid/base balanceEKG testMedicines to correct fluid and electrolyte imbalancesExpectations (prognosis)How well a patient does depends on the severity of the symptoms. Patients usually respond well to treatment. Serious symptoms and death are unlikely.ReferencesRichardson WH, Betten DP, Williams SR, Clark RF. Nitroprusside, ACE inhibitors, and other cardiovascular agents. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 61.
Many medicines and recreational medicines can affect a man's sexual arousal and sexual performance. What effects difficulties in one man may not harm another man. Talk to your health problem provider if you think that a drug is hurting your sexual performance. Never stop using any medicine without first speaking to your provider. Some medicines may lead to life-threatening problems if you do not take care when stopping or changing them. The following is a list of some medicines and drugs that may make n (ED) in men. There may be additional drugs other than those on this list that can make difficulties. Antidepressants and different psychiatric medicines: Amitriptyline (Elavil) Amoxapine (Asendin) Buspirone (Buspar) Chlordiazepoxide (Librium) Chlorpromazine (Thorazine) Clomipramine (Anafranil) Clorazepate (Tranxene) Desipramine (Norpramin) Diazepam (Valium) Doxepin (Sinequan) Fluoxetine (Prozac) Fluphenazine (Prolixin) Imipramine (Tofranil) Isocarboxazid (Marplan) Lorazepam (Ativan) Meprobamate (Equanil) Mesoridazine (Serentil) Nortriptyline (Pamelor) Oxazepam (Serax) Phenelzine (Nardil) Phenytoin (Dilantin) Sertraline (Zoloft) Thioridazine (Mellaril) Thiothixene (Navane) Tranylcypromine (Parnate) Trifluoperazine (Stelazine) Antihistamine medicines (certain classes of antihistamines are also used to treat heartburn): Cimetidine (Tagamet) Dimenhydrinate (Dramamine) Diphenhydramine (Benadryl) Hydroxyzine (Vistaril) Meclizine (Antivert) Nizatidine (Axid) Promethazine (Phenergan) Ranitidine (Zantac) High blood pressure medicines and diuretics (water pills): Atenolol (Tenormin) Bethanidine Bumetanide (Bumex) Captopril (Capoten) Chlorothiazide (Diuril) Chlorthalidone (Hygroton) Clonidine (Catapres) Enalapril (Vasotec) Furosemide (Lasix) Guanabenz (Wytensin) Guanethidine (Ismelin) Guanfacine (Tenex) Haloperidol (Haldol) Hydralazine (Apresoline) Hydrochlorothiazide (Esidrix) Labetalol (Normodyne) Methyldopa (Aldomet) Metoprolol (Lopressor) Nifedipine (Adalat, Procardia) Phenoxybenzamine (Dibenzyline) Phentolamine (Regitine) Prazosin (Minipress) Propranolol (Inderal) Reserpine (Serpasil) Spironolactone (Aldactone) Triamterene (Maxzide) Verapamil (Calan) Thiazides are the most common cause of erectile dysfunction with high blood pressure medicines. The following most popular cause is beta-blockers. Alpha-blockers tend to be less likely to cause this problem. Parkinson disease drugs: Benztropine (Cogentin) Biperiden (Akineton) Bromocriptine (Parlodel) Levodopa (Sinemet) Procyclidine (Kemadrin) Trihexyphenidyl (Artane) Chemotherapy and hormonal medicines: Antiandrogens (Casodex, Flutamide, Nilutamide) Busulfan (Mylan) Cyclophosphamide (Cytoxan) Ketoconazole LHRH agonists (Lupron, Zoladex) LHRH agonists (Firmagon) Other medicines: Aminocaproic acid (Amicar) Atropine Clofibrate (Atromid-S) Cyclobenzaprine (Flexeril) Cyproterone Digoxin (Lanoxin) Disopyramide (Norpace) Dutasteride (Avodart) Estrogen Finasteride (Propecia, Proscar) Furazolidone (Furoxone) H2 blockers (Tagamet, Zantac, Pepcid) Indomethacin (Indocin) Lipid-lowering agents Licorice Metoclopramide (Reglan) NSAIDs (ibuprofen, etc.) Orphenadrine (Norflex) Prochlorperazine (Compazine) Pseudoephedrine (Sudafed) Sumatriptan (Imitrex) Opiate analgesics (painkillers): Codeine Fentanyl (Innovar) Hydromorphone (Dilaudid) Meperidine (Demerol) Methadone Morphine Oxycodone (Oxycontin, Percodan) Recreational drugs: Alcohol Amphetamines Barbiturates Cocaine Marijuana Heroin Nicotine? For more Enquiry, you can call us 24*7 7687878787 and talk directly to the doctor
DescriptionMost people who have heart failure need to take medicines. These medicines treat your symptoms. Others may help prevent your heart failure from becoming worse and prolong survival.How to Take Your MedicinesYou will need to take most of your heart failure medicines every day, some just once per day, and others two or more times per day. It is very important that you take your drugs the way your health care provider told you to. This includes the time of day.NEVER just stop taking drugs for your heart, or any other drugs you may take for diabetes, high blood pressure, or any other medical conditions you may have without first talking to your health care provider.Your health care provider may also instruct you to either take certain medicines or take more medicine when your symptoms get worse or your weight increases from too much fluid in your body.Do not take any other drugs or herbs without asking your health care provider about them first. These include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis).Ace Inhibitors and ARBsAce inhibitors(angiotensin converting enzyme inhibitors) and ARBs (angiotensin II receptor antagonists) work by opening blood vessels and lowering blood pressure. This can reduce the work your heart has to do, help your heart muscle pump better, and keep your heart failure from getting worse. These medicines may also prevent or reduce changes to your heart muscle.Common side effects of these drugs include:Dry coughLightheadednessFatigueUpset stomachEdemaHeadacheDiarrheaWhen you take these medicines, your doctor will order blood tests to check how well your kidneys are working and to follow your potassium levels.Beta BlockersBeta blockers slow your heart rate and decrease the strength with which your heart muscle squeezes or contracts. Beta blockers help your heart failure from becoming worse and ultimately may help strengthen it.Common beta blockers used for heart failure include carvedilol (Coreg), bisoprolol (Zebeta), and metoprolol (Toprol).Do not abruptly stop taking these drugs. Doing so can increase the risk of angina and even a heart attack. Other side effects include lightheadedness, depression, fatigue, and memory loss.Water Pills or DiureticsDiuretics help your body get rid of extra fluid. Some also have other beneficial effects. They are often called "water pills." There are many brands of diuretics. Some are taken 1 time a day. Others are taken 2 times a day. The 3 common types are:Thiazides: chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), hydrochlorothiazide (Esidrix, HydroDiuril), and metolazone (Mykrox, Zaroxolyn)Loop diuretics: bumentanide (Bumex), furosemide (Lasix), and torasemide (Demadex)Potassium-sparing agents: amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium)When you take these medicines, your doctor will order blood tests to check how well your kidneys are working and to follow your potassium levels.Other Drugs for Heart FailureMany people with heart disease are asked to take either aspirin or clopidogrel (Plavix). These drugs help to prevent blood clots from forming in your arteries, lowering your risk of a stroke or heart attack.Coumadin (Warfarin) is recommended only for patients with heart failure who have a higher risk for blood clots. You will need to have extra blood tests to make sure your dose is correct and be careful about what you eat.See also: Taking warfarinOther drugs used less often to treat heart failure include:Digoxin helps the heart muscle pump stronger.Hydralazine and nitrates are two older drugs that help open up arteries and can help the heart muscle pump better. They are used mostly for patients who are unable to tolerate ACE inhibitors and angiotensin receptor blockers. They may also be used in patients of certain ethnic or racial groups.Calcium channel blockers are medicines that may be used to treat a type of heart failure called diastolic heart failure.Statins and other cholesterol-lowering drugs are used when needed.Antiarrhythmic medications are sometimes used in patients with heart failure who have abnormal heart rhythms. One example is Amiodarone.ReferencesJessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14;119(14):1977-2016. Epub 2009 Mar 26.Mann DL. Management of heart failure patients with reduced ejection fraction. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 28.Reviewed ByReview Date: 08/01/2011Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
There are about 7,000 English words that contain the letter Z. Here are some of the longer words:14-letter wordsacetazolamides, actualizations, advertizements, aerosolization, aestheticizing, aggrandizement, alkalinization, allegorization, anagrammatized, anagrammatizes, anathematizing, anglicizations, animalizations, apostrophizing, arabicizations, aromatizations, attitudinizing, authorizations, automatization, axiomatization, azidothymidine, bacterizations, balkanizations, bamboozlements, barbarizations, bastardization, benzanthracene, benzimidazoles, benzodiazepine, bipolarization, bituminization, bowdlerization, brutalizations, bureaucratized, bureaucratizes, capitalization, carbonizations, carburizations, cartelizations, catechizations, categorization, cauterizations, centralization, cephalizations, channelization, characterizing, chlorobenzenes, chlorothiazide, chlorpromazine, cicatrizations, civilizational, cocainizations, collateralized, collateralizes, collectivizing, commercialized, commercializes, communizations, complementizer, 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emotionalizing, envenomization, epigrammatized, epigrammatizer, epigrammatizes, epithelialized, epithelializes, epithelization, epizootiologic, eroticizations, essentializing, evangelization, factorizations, federalization, fertilizations, feudalizations, fictionalizing, fictionization, formalizations, fossilizations, fractionalized, fractionalizes, fraternization, gallicizations, galvanizations, gelatinization, generalization, geometrization, germanizations, gewurztraminer, ghettoizations, glamorizations, globalizations, gonadectomized, graphitization, gyrostabilizer, harmonizations, hellenizations, hepatectomized, heterozygosity, homogenization, homozygosities, hybridizations, hypercivilized, hyperimmunized, hyperimmunizes, hyperpolarized, hyperpolarizes, hypersensitize, hyposensitized, hyposensitizes, illegalization, immaterialized, immaterializes, immobilization, impersonalized, impersonalizes, indigenization, individualized, individualizes, industrialized, industrializes, initialization, insolubilizing, isoalloxazines, isocarboxazids, isomerizations, italicizations, keratinization, labializations, lateralization, legitimatizing, legitimization, lexicalization, liberalization, linearizations, literalization, localizability, luteinizations, lyophilization, lysogenization, magnetizations, martyrizations, mechanizations, melodramatized, melodramatizes, mercerizations, merchandizings, metallizations, metronidazoles, militarization, mineralization, misemphasizing, missionization, misutilization, modernizations, mongrelization, monopolization, monumentalized, monumentalizes, municipalizing, musicalization, mutualizations, naturalization, nephrectomized, nephrectomizes, neutralization, nonpolarizable, normalizations, occidentalized, occidentalizes, organizational, orthogonalized, orthogonalizes, ovariectomized, overcapitalize, overcentralize, overdramatized, overdramatizes, overemphasized, overemphasizes, overfertilized, overfertilizes, overgeneralize, 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stabilizations, sterilizations, stigmatization, structuralized, structuralizes, subcategorized, subcategorizes, subjectivizing, subsidizations, subspecialized, subspecializes, substantivized, substantivizes, subtilizations, sulfinpyrazone, summarizations, supercivilized, symbolizations, symmetrization, systemizations, technicalizing, technologizing, temporizations, tenderizations, territorialize, terrorizations, theatricalized, theatricalizes, thermalization, thiabendazoles, thymectomizing, traditionalize, tranquillizers, tranquillizing, transistorized, transistorizes, transparentize, trapezohedrons, traumatization, trivialization, ultracivilized, ultrahazardous, unacclimatized, unanesthetized, unappetizingly, uncomputerized, uncrystallized, underemphasize, underutilizing, universalizing, unrecognizable, unrecognizably, unromanticized, unstandardized, unsynchronized, unsystematized, vandalizations, ventriloquized, ventriloquizes, verbalizations, vernalizations, victimizations, visualizations, volatilization, vulcanizations, vulgarizations, weatherization, westernization, winterizations, zombifications, zoogeographers, zoogeographies15-letter wordsacclimatization, aerosolizations, aggrandizements, alkalinizations, allegorizations, alphabetization, anagrammatizing, analyzabilities, automatizations, axiomatizations, azidothymidines, bastardizations, benzanthracenes, benzodiazepines, bipolarizations, bituminizations, bowdlerizations, bureaucratizing, cannibalization, capitalizations, categorizations, catheterization, centralizations, channelizations, chlorothiazides, chlorpromazines, circularization, civilianization, coenzymatically, collateralizing, colonizationist, commercializing, complementizers, computerization, conceptualizers, conceptualizing, concretizations, contextualizing, conventionalize, conveyorization, criminalization, cryptozoologies, cryptozoologist, crystallization, decarburization, decasualization, decimalizations, decolonizations, decolorizations, decriminalizing, defeminizations, deglamorization, dehumanizations, deindustrialize, delocalizations, demagnetization, dematerializing, demobilizations, democratization, demonetizations, demoralizations, demythologizers, demythologizing, denationalizing, denazifications, departmentalize, depersonalizing, depolarizations, derivatizations, desacralization, desalinizations, desensitization, desexualization, despiritualized, despiritualizes, destabilization, desulfurization, detribalization, diagonalization, dichlorobenzene, dichotomization, digitalizations, dinitrobenzenes, disorganization, dolomitizations, envenomizations, epigrammatizers, epigrammatizing, epithelializing, epithelizations, epizootiologies, etherealization, evangelizations, extemporization, exteriorization, externalization, familiarization, federalizations, fictionizations, formularization, fractionalizing, fraternizations, gelatinizations, generalizations, geometrizations, gewurztraminers, governmentalize, graphitizations, gyrostabilizers, haphazardnesses, hazardousnesses, heterozygosises, homogenizations, horizontalities, hospitalization, hyperimmunizing, hyperpolarizing, hypersensitized, hypersensitizes, hypnotizability, hyposensitizing, hypostatization, hysterectomized, illegalizations, immaterializing, immobilizations, immortalization, impersonalizing, indigenizations, individualizing, industrializing, infantilization, initializations, intellectualize, interiorization, internalization, keratinizations, laryngectomized, lateralizations, legitimizations, lexicalizations, liberalizations, literalizations, lyophilizations, lysogenizations, marginalization, masculinization, materialization, mathematization, melodramatizing, militarizations, mineralizations, miniaturization, mischaracterize, missionizations, misutilizations, misvocalization, mongrelizations, monopolizations, monumentalizing, musicalizations, nationalization, naturalizations, nephrectomizing, neutralizations, noncomputerized, nonhospitalized, occidentalizing, oligomerization, orthogonalizing, overcapitalized, overcapitalizes, overcentralized, overcentralizes, overdramatizing, overemphasizing, overfertilizing, overgeneralized, overgeneralizes, overglamorizing, overhomogenized, overhomogenizes, overspecialized, overspecializes, overutilization, overzealousness, oxyphenbutazone, palatalizations, paleozoological, paleozoologists, parametrization, parasitizations, particularizing, pasteurizations, personalization, phenylbutazones, phosphatization, photoionization, photosensitized, photosensitizer, photosensitizes, photosynthesize, pinealectomized, pinealectomizes, plasticizations, platitudinizing, politicizations, polymerizations, popularizations, pressurizations, prioritizations, professionalize, proletarianized, proletarianizes, proselytization, protozoologists, provincializing, prussianization, psychoanalyzing, radicalizations, rationalization, reacclimatizing, reauthorization, recanalizations, recognizability, recolonizations, reconceptualize, recontextualize, recrystallizing, regionalization, regularizations, rehospitalizing, reindustrialize, rematerializing, remobilizations, remonetizations, remythologizing, renationalizing, reorganizations, repolarizations, reprivatization, republicanizing, resocialization, respiritualized, respiritualizes, resystematizing, revalorizations, revisualization, revitalizations, revolutionizers, revolutionizing, romanticization, schematizations, sclerotizations, secularizations, securitizations, sensationalized, sensationalizes, sensualizations, sentimentalized, sentimentalizes, solubilizations, specializations, splenectomizing, squeezabilities, standardization, stigmatizations, structuralizing, subcategorizing, suboptimization, suborganization, subspecializing, substantivizing, suburbanization, subvocalization, sulfinpyrazones, symmetrizations, synchronization, systematization, territorialized, territorializes, theatricalizing, thermalizations, totalitarianize, traditionalized, traditionalizes, transistorizing, transparentized, transparentizes, traumatizations, trifluoperazine, trivializations, uncategorizable, underemphasized, underemphasizes, underpublicized, vascularization, ventriloquizing, volatilizations, weatherizations, westernizations, zoogeographical16-letter wordsacclimatizations, adrenalectomized, alphabetizations, anthropomorphize, antiorganization, autoimmunization, cannibalizations, catheterizations, characterization, chlordiazepoxide, circularizations, civilianizations, collectivization, colonizationists, compartmentalize, computerizations, containerization, conventionalized, conventionalizes, conveyorizations, copolymerization, criminalizations, cryptozoologists, crystallizations, decarburizations, decasualizations, decentralization, deglamorizations, deindustrialized, deindustrializes, demagnetizations, demilitarization, demineralization, democratizations, denaturalization, denuclearization, departmentalized, departmentalizes, depoliticization, depolymerization, depressurization, desacralizations, desensitizations, desexualizations, despiritualizing, destabilizations, desulfurizations, detribalizations, diagonalizations, dichlorobenzenes, dichotomizations, diphthongization, disorganizations, editorialization, epizootiological, etherealizations, extemporizations, exteriorizations, externalizations, familiarizations, fictionalization, formularizations, generalizability, governmentalized, governmentalizes, heterozygosities, hospitalizations, hypersensitizing, hypophysectomize, hypostatizations, immortalizations, infantilizations, insolubilization, institutionalize, intellectualized, intellectualizer, intellectualizes, interiorizations, internalizations, internationalize, localizabilities, marginalizations, masculinizations, materializations, mathematizations, miniaturizations, mischaracterized, mischaracterizes, misvocalizations, municipalization, nationalizations, nonschizophrenic, oligomerizations, organizationally, overcapitalizing, overcentralizing, overgeneralizing, overhomogenizing, overspecializing, overutilizations, oxyphenbutazones, parameterization, parametrizations, personalizations, phosphatizations, photoionizations, photosensitizers, photosensitizing, photosynthesized, photosynthesizes, pictorialization, piezoelectricity, pinealectomizing, polarizabilities, politicalization, professionalized, professionalizes, proletarianizing, proselytizations, prussianizations, puzzleheadedness, rationalizations, reauthorizations, recapitalization, recentralization, reconceptualized, reconceptualizes, recontextualized, recontextualizes, regionalizations, reindustrialized, reindustrializes, remilitarization, reorganizational, reprivatizations, resocializations, respiritualizing, revisualizations, romanticizations, sensationalizing, sentimentalizing, spiritualization, standardizations, subjectivization, suboptimizations, suborganizations, suburbanizations, subvocalizations, superspecialized, sympathectomized, synchronizations, systematizations, technicalization, territorializing, thyroidectomized, totalitarianized, totalitarianizes, traditionalizing, transparentizing, trifluoperazines, uncommercialized, undercapitalized, underemphasizing, underutilization, unindustrialized, universalization, vascularizations17-letter wordsanagrammatization, anthropomorphized, anthropomorphizes, antiorganizations, antischizophrenia, antischizophrenic, autoimmunizations, bureaucratization, characterizations, chlordiazepoxides, collectivizations, commercialization, compartmentalized, compartmentalizes, conceptualization, constitutionalize, containerizations, conventionalizing, copolymerizations, decentralizations, decriminalization, deindustrializing, dematerialization, demilitarizations, demineralizations, demythologization, denationalization, denaturalizations, denuclearizations, departmentalizing, depersonalization, depoliticizations, depolymerizations, depressurizations, dimethylhydrazine, diphthongizations, editorializations, epithelialization, fictionalizations, fractionalization, governmentalizing, hyperimmunization, hyperpolarization, hypnotizabilities, hypophysectomized, hypophysectomizes, hyposensitization, impersonalization, individualization, industrialization, insolubilizations, institutionalized, institutionalizes, intellectualizers, intellectualizing, internationalized, internationalizes, melodramatization, microminiaturized, mischaracterizing, municipalizations, nonfraternization, nonindustrialized, orthogonalization, overcommercialize, overfertilization, overindustrialize, overzealousnesses, pancreatectomized, parameterizations, particularization, pentylenetetrazol, photosynthesizing, pictorializations, piezoelectrically, politicalizations, professionalizing, provincialization, recapitalizations, recentralizations, recognizabilities, reconceptualizing, recontextualizing, recrystallization, rehospitalization, reindustrializing, remilitarizations, renationalization, revascularization, schizophrenically, spiritualizations, structuralization, subcategorization, subjectivizations, supercivilization, technicalizations, theatricalization, totalitarianizing, transistorization, ultraminiaturized, underutilizations, universalizations, zoogeographically18-letter wordsanagrammatizations, anthropomorphizing, antischizophrenics, bureaucratizations, cholecystectomized, commercializations, compartmentalizing, conceptualizations, constitutionalized, constitutionalizes, decriminalizations, deinstitutionalize, dematerializations, demythologizations, denationalizations, depersonalizations, diethylcarbamazine, dimethylhydrazines, epithelializations, fractionalizations, generalizabilities, hyperimmunizations, hyperpolarizations, hypersensitization, hypophysectomizing, hyposensitizations, impersonalizations, individualizations, industrializations, institutionalizing, internationalizing, melodramatizations, nonfraternizations, orthogonalizations, overcapitalization, overcentralization, overcommercialized, overcommercializes, overfertilizations, overgeneralization, overindustrialized, overindustrializes, overspecialization, particularizations, pentylenetetrazols, photosensitization, piezoelectricities, proletarianization, provincializations, puzzleheadednesses, recrystallizations, rehospitalizations, renationalizations, revascularizations, sentimentalization, structuralizations, subcategorizations, supercivilizations, territorialization, theatricalizations, transistorizations19-letter wordsconstitutionalizing, conventionalization, countermobilization, deindustrialization, deinstitutionalized, deinstitutionalizes, departmentalization, diethylcarbamazines, hydrochlorothiazide, hypersensitizations, intellectualization, interorganizational, mischaracterization, overcapitalizations, overcentralizations, overcommercializing, overgeneralizations, overindustrializing, overintellectualize, overspecializations, paradichlorobenzene, photosensitizations, professionalization, proletarianizations, reconceptualization, reindustrialization, sentimentalizations, superspecialization, territorializations20-letter wordsanthropomorphization, compartmentalization, conventionalizations, countermobilizations, deindustrializations, deinstitutionalizing, departmentalizations, hydrochlorothiazides, institutionalization, intellectualizations, internationalization, microminiaturization, mischaracterizations, noninstitutionalized, overintellectualized, overintellectualizes, paradichlorobenzenes, parathyroidectomized, professionalizations, reconceptualizations, reindustrializations, superspecializations21-letter wordsanthropomorphizations, compartmentalizations, constitutionalization, institutionalizations, internationalizations, microminiaturizations, overcommercialization, overintellectualizing22-letter wordsconstitutionalizations, deinstitutionalization, overcommercializations, reinstitutionalization23-letter wordsdeinstitutionalizations, overintellectualization, reinstitutionalizations24-letter wordsoverintellectualizations
DefinitionHeart failure, also called congestive heart failure, is a condition in which the heart can no longer pump enough blood to the rest of the body.Alternative NamesCHF; Congestive heart failure; Left-sided heart failure; Right-sided heart failureCauses, incidence, and risk factorsHeart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly.The condition may affect the right side, the left side, or both sides of the heart.Right-sided heart failure means the right ventricle of the heart loses its pumping function.Left-sided heart failure means the heart's ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body.Heart failure is often classified as either systolic or diastolic.Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well.Diastolic heart failure means that your heart's pumping chamber does not fill up with blood.Both of these problems mean the heart is no longer able to pump enough blood out to the rest of your body, especially when you exercise or are active.As the heart's pumping action is lost, blood may back up in other areas of the body, producing congestion in the lungs, the liver, the gastrointestinal tract, and the arms and legs. As a result, there is a lack of oxygen and nutrition to organs, which damages them and reduces their ability to work properly.Perhaps the most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. For information on this condition and its risk factors, see: Coronary artery disease.Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies. There are many different types of cardiomyopathy. For information, see: CardiomyopathyOther heart problems that may cause heart failure are:Congenital heart diseaseHeart valve diseaseSome types of abnormal heart rhythms (arrhythmias)Diseases such as emphysema, severe anemia, hyperthyroidism, or hypothyroidism, may cause or contribute to heart failureSymptomsCommon symptoms are:Shortness of breath with activity, or after lying down for a whileCoughSwelling of feet and anklesSwelling of the abdomenWeight gainIrregular or rapid pulseSensation of feeling the heart beat (palpitations)Difficulty sleepingFatigue, weakness, faintnessLoss of appetite, indigestionOther symptoms may include:Decreased alertness or concentrationDecreased urine productionNausea and vomitingNeed to urinate at nightInfants may sweat during feeding (or other activity).Some patients with heart failure have no symptoms. In these people, the symptoms may develop only with these conditions:Abnormal heart rhythm (arrhythmias)AnemiaHyperthyroidismInfections with high feverKidney diseaseSigns and testsA physical examination may reveal the following:Fluid around the lungs (pleural effusion)Irregular heartbeatLeg swelling (edema)Neck veins that stick out (are distended)Swelling of the liverListening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds.The following tests may reveal heart swelling,decreased heart function, or lung congestion:Chest x-rayECGEchocardiogramCardiac stress testsHeart CT scanHeart catheterizationMRI of the heartNuclear heart scansThis disease may also alter the following test results:Blood chemistryBUNComplete blood countCreatinineCreatinine clearanceLiver function testsUric acid-blood testSodium - blood testUrinalysisSodium - urine testTreatmentIf you have heart failure, your doctor will monitor you closely. You will have follow up appointments at least every 3 to 6 months and tests to check your heart function. For example, an ultrasound of your heart (echocardiogram) will be done once in awhile to see how well your heart pumps blood with each beat.You will need to carefully monitor yourself and help manage your condition. One important way to do this is to track your weight on a daily basis. Weight gain can be a sign that you are retaining fluid and that your heart failure is worsening. Make sure you weigh yourself at the same time each day and on the same scale, with little to no clothes on.Other important measures include:Take your medications as directed. Carry a list of medications with you wherever you go.Limit salt intake.Don't smoke.Stay active. For example, walk or ride a stationary bicycle. Your doctor can provide a safe and effective exercise plan based on your degree of heart failure and how well you do on tests that check the strength and function of your heart. DO NOT exercise on days that your weight has gone up from fluid retention or you are not feeling well.Lose weight if you are overweight.Get enough rest, including after exercise, eating, or other activities. This allows your heart to rest as well. Keep your feet elevated to decrease swelling.Here are some tips to lower your salt and sodium intake:Look for foods that are labeled "low-sodium," "sodium-free," "no salt added," or "unsalted." Check the total sodium content on food labels. Be especially careful of canned, packaged, and frozen foods. A nutritionist can teach you how to understand these labels.Don't cook with salt or add salt to what you are eating. Try pepper, garlic, lemon, or other spices for flavor instead. Be careful of packaged spice blends as these often contain salt or salt products (like monosodium glutamate, MSG).Avoid foods that are naturally high in sodium, like anchovies, meats (particularly cured meats, bacon, hot dogs, sausage, bologna, ham, and salami), nuts, olives, pickles, sauerkraut, soy and Worcestershire sauces, tomato and other vegetable juices, and cheese.Take care when eating out. Stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauce, or cheese.Use oil and vinegar, rather than bottled dressings, on salads.Eat fresh fruit or sorbet when having dessert.Your doctor may consider prescribing the following medications:ACE inhibitors such as captopril, enalapril, lisinopril, and ramipril to open up blood vessels and decrease the work load of the heartDiuretics including hydrochlorothiazide, chlorthalidone, chlorothiazide, furosemide, torsemide, bumetanide, and spironolactone to help rid your body of fluid and salt (sodium)Digitalis glycosides to increase the ability of the heart muscle to contract properly and help treat some heart rhythm disturbancesAngiotensin receptor blockers (ARBs) such as losartan and candesartan to reduce the workload of the heart; this class of drug is especially important for those who cannot tolerate ACE inhibitorsBeta-blockers such as such as carvedilol and metoprolol, which are particularly useful for those with a history of coronary artery diseaseCertain medications may make heart failure worse and should be avoided. These include nonsteroidal anti-inflammatory drugs, thiazolidinediones, metformin, cilostazol, PDE-5 inhibitors (sildenafil, vardenafil), and many drugs that treat abnormal heart rhythms.Valve replacements or repair coronary bypass surgery (CABG), and angioplasty may help some people with heart failure.The following devices may be recommended for certain patients:A single or dual chamber pacemaker to help with slow heart rates or certain other heart signaling problemsA biventricular pacemaker to help the left and right side of your heart contract at the same time.An implantable cardioverter-defibrillator to correct or prevent severe arrhythmias (abnormal heart rhythms)Severe heart failure may require the following treatments:Intra-aortic balloon pump (IABP), a temporary device placed into the aortaLeft ventricular assist device (LVAD), which takes over the role of the heart by pumping blood from the heart into the aorta; it's most often used by those who are waiting for a heart transplant.Note: These devices can be life saving, but they are not permanent solutions. Patients who become dependent on circulatory support will need a heart transplant.Heart failure symptoms may be improved with biventricular pacemaker or cardiac resynchronization therapy. Ask your provider if you are a candidate for this type of treatment.Expectations (prognosis)Heart failure is a serious disorder. It is usually a chronic illness, which may get worse with infection or other physical stress.Many forms of heart failure can be controlled with medication, lifestyle changes, and treatment of any underlying disorder.ComplicationsIrregular heart rhythms (can be deadly)Pulmonary edemaTotal heart failure (circulatory collapse)Possible side effects of medications include:CoughDigitalis toxicityGastrointestinal upset (such as nausea, heartburn, diarrhea)HeadacheLight-headedness and faintingLow blood pressureLupusreactionMuscle crampsCalling your health care providerCall your health care provider if weakness, increased cough or sputum production, sudden weight gain or swelling, or other new or unexplained symptoms develop.Go to the emergency room or call the local emergency number (such as 911) if you experience severe crushing chest pain, fainting, or rapid and irregular heartbeat(particularly if other symptoms accompany a rapid and irregular heartbeat).PreventionFollow your health care provider's treatment recommendations and take all medications as directed.Keep your blood pressure , heart rate, and cholesterol under control as recommended by your doctor. This may involve exercise, a special diet, and medications.Other important treatment measures:Do not smoke.Do not drink alcohol.Reduce salt intake.Exercise as recommended by your health care provider.ReferencesHunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult. J Am Coll Cardiol. 2005;46:1-82.Mann DL. Management of heart failure patients with reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007: chap 25.Hess OM and Carroll JD. Clinical assessment of heart failure. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007: chap 23.Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14;119(14):1977-2016. Epub 2009 Mar 26.