Congestive heart failure (CHF) (MN551 Unit 5 DP)

Congestive heart failure (CHF) (MN551 Unit 5 DP)
Things to think about when choosing a drug
Researchers have found that chronic heart failure is one of the leading reasons of other illnesses and deaths around the world. Patients with heart failure can get relief from their symptoms with diuretics, which have been used as the first-line treatment for this disease. Loop diuretics, thiazide diuretics, and potassium-sparing diuretics are the three types of diuretics.

When deciding which diuretic to give to a certain patient, several things are taken into account, since the different classes work in different ways and at different places of action. Before prescribing a certain diuretic, a doctor must first think about the amount of electrolytes in a patient. The potassium level is the most important element to look at because it tells if the patient should also be given a diuretic that doesn’t get rid of potassium.

Second, you need to think about how your liver and kidneys work. These drugs depend a lot on how the liver and kidneys break them down and get rid of them. (Ellison & Felker, 2017). So, in order to get this treatment, you need to have a healthy liver and kidneys. In cases of liver or kidney failure, the amounts are adjusted to keep the drug from being too toxic. Renal instability makes the pathophysiology of congestive heart failure worse by turning on RAAS even more, which makes the body hold on to more fluid. (Ellison & Felker, 2017).

In this case, I would tell the person to take a loop diuretic. Studies show that loop diuretics are the best way to treat the signs of HF. I would give 40 mg OD of Lasix.

Getting the patient to understand how it works

I would use simple, easy-to-understand words to explain how Lasix works to the patient. I would tell the patient that Lasix helps the body get rid of the extra water that is causing edema and swelling by making more salt leave the body. It does this by stopping the loop of Henle from taking in sodium chloride (Graffagnino et al., 2020).This has therapeutic benefits, like making you pee more, which lowers swelling and blood pressure.

How the medicine is changed by less blood flow to the kidneys

When taking loop diuretics, renal circulation is an important thing to think about. If the patient gets kidney failure, the way the drug works will be different. Furosemide is mostly gotten rid of from the body through the kidneys. If the blood flow to the kidneys goes down, the amount of furosemide that gets into the kidney tubules also goes down a lot. (Hedge, 2020). Also, because the kidneys’ ability to get rid of waste would be affected, sodium and water would not be gotten rid of as well. This would make the signs of congestive heart failure and kidney disease worse.

What changes would be made to the care

Due to less drug getting into the renal tubules, a bigger dose of the drug would be needed to get the effect that was wanted. Hedge (2020) says that loop diuretics have a ceiling below which they don’t do much and above which they do a lot. There is also evidence that when there is less blood flow to the kidneys, furosemide stays in the body longer. torsemide and bumetanide, on the other hand, have shorter half-lives than furosemide and are cleared from the body more quickly when kidney blood flow is low. (Hedge, 2020). So, I would change the treatment to 2 mg BD of bumetanide.

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