Congestive cardiac failure is characterized by decreased pumping ability of the heart and thereby reduced cardiac output. The ventricles are not completely emptied resulting in increased venous pressure in the pulmonary and systemic circulation. The drugs used in CCF include diuretics, vasodilators and cardiac glycosides. Diuretics reduce preload and venous pressure, improve cardiac performance and relieve edema. Vasodilators reduce preload and after load or both resulting in a reduction in the workload on the heart. ACE inhibitors, sodium nitroprusside, hydralazine, organic nitrates and prazosin are the vasodilators used. Digoxin is the most commonly used cardiac glycoside. Cardiac glycosides increase the force of the contraction of the heart. The stroke volume increases and thereby the cardiac output. Digoxin improves cardiac performance in the dilated, failing heart. When patients are not controlled by diuretics and vasodilators, digoxin is used.