Whereas pure beta blocking drugs have benefit in the treatment of CHF and dilated cardiomyopathies they should be used with caution in frail elderly patients because of their potential to cause confusion and hallucinations. Carvedilol, with properties of both beta and alpha blockade, and anti-oxidant effect , may have merit in the further treatment of patients with NYHA class II and III CHF who have been stabilized on a low sodium diet, diuretics, ACE inhibitors and digoxin, since an improvement in survival has been found on those patients taking this drug. The FDA now approves this drug for use in CHF, but experience using this drug in the elderly is limited. At this time, the primary care physician should use this drug only in close consultation with a cardiologist.

Commonly Used Drugs in the Management of CHF