Why should calcium channel blockers (CCBs) and NSAIDs be avoided in patients with congestive heart failure (CHF)?

Calcium channel blockers (CCBs) and nonsteroidal anti-inflammatory drugs (NSAIDs) are generally avoided in patients with congestive heart failure (CHF) due to the potential adverse effects related to fluid retention. CCBs can lead to fluid buildup because they may cause peripheral edema by impairing the contractility of the heart and increasing the workload on the heart. Additionally, these medications can alter renal function, leading to further fluid retention, which is particularly problematic in CHF where the body already struggles with fluid management.

NSAIDs are known to inhibit the production of prostaglandins, which play a role in maintaining renal blood flow and promoting diuresis. When used in patients with existing heart failure, NSAIDs can lead to sodium and water retention, exacerbating the fluid overload state that these patients often experience. This retention can result in worsening heart failure symptoms and put additional strain on the failing heart.

In summary, option B correctly identifies that CCBs lead to fluid buildup, which is a significant concern in the management of patients with CHF, as fluid overload can directly worsen their condition and lead to severe complications.