NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which medication class is considered initial therapy in the treatment of chronic systolic HF for decreasing mortality?

  1. Loop diuretics

  2. ARNI, ACE or ARB

  3. SGLT2 inhibitors

  4. Hydralazine and nitrates

The correct answer is: ARNI, ACE or ARB

Initial therapy in the treatment of chronic systolic HF is focused on decreasing mortality, so medications from the ARNI, ACE or ARB class would be most effective. Loop diuretics are used to reduce fluid build-up and relieve symptoms, but they do not have an impact on mortality. SGLT2 inhibitors may be used in addition to ARNI, ACE or ARB, but they are not the initial therapy for decreasing mortality. Hydralazine and nitrates are typically used in conjunction with ARNI, ACE or ARB in patients who cannot tolerate these medications or do not respond to them, making them less suitable as initial therapy for decreasing mortality.