The drug treatment plan for heart failure
Heart failure is a medical disease in which the heart muscles can’t pump enough blood to the organs on the outside of the body. During the phase of heart failure, different organs are affected, which causes different symptoms like shortness of breath, leg swelling, and a cough that won’t go away. When a patient goes to see a doctor, the doctor takes a good history of the patient, does a physical check, and does tests. When heart failure is found to be the problem, the patient’s care can begin. The use of drug regimens to help the patient is part of taking care of the patient. This paper will look at a piece that describes the different drug regimens used to treat heart failure, why they are used, and how they work.
The Renin-Angiotensin-Aldosterone System is the subject of a set of drugs.
In heart failure, the heart isn’t able to pump enough blood and nutrients to the kidneys. This turns on the RAAS system, which is a set of compensatory processes. Angiotensin II, which is made by the RAAS system, narrows blood vessels and causes aldosterone to be released, which makes sodium and water stay in the body. This makes fluid retention in heart failure worse. (Zipps et al., 2016). Angiotensin-converting Enzyme inhibitors (ACIs) are one type of treatment that targets the RAAS system (Colafella, Bovée, & Danser, 2019). The other type is ACE inhibitors. The drugs stop the angiotensin-converting enzyme from turning angiotensin I into angiotensin II, which stops the symptoms of angiotensin I from happening. Enalapril and captopril are two examples of ACIs. (Colafella et al., 2019). Angiotensin Receptor Blockers are the second type of treatment for heart failure that works on RAAS. (ARBs). ARBS work by stopping the receptors for angiotensin, which stops angiotensin from doing what it’s supposed to do. (Colafella et al., 2019). Telmisartan, Candesartan, and Losartan are all examples of ARBs.
A drug treatment plan for pulmonary hypertension
When the heart fails to pump blood out of its chambers and to the rest of the body’s systems, blood flows back into the pulmonary system. This causes pulmonary hypertension, which can be treated in two ways. Also, when the heart fails, the baroreflex is less sensitive, which causes too much nervous activity and high blood pressure. The first group is called beta-blockers. They block the affects of the molecule epinephrine in the sympathetic system, which lowers pulmonary hypertension. (Dai et al., 2018). Nebivolol, bisoprolol, carvedilol, and metoprolol are all types of beta-blockers. The second group is vasodilator drugs, which cause blood vessels to widen and relax. This lowers the stiffness of the blood vessels in the body’s edges, which lowers blood pressure. Nitroglycerin and sodium nitroprusside are vasodilators. They work by making nitrogen oxide, which is a strong vasodilator.(Dai et al., 2018).
Targeting hypertrophy, fibrosis, and contractile failure with a set of drugs
When the heart keeps working too hard to get blood and nutrients to organs in the body’s periphery, the heart goes through hypertrophy, fibrosis, and may have cardiac failure. The drugs that were used in these cases are called Phosphodiesterase V inhibitors. Sildenafil is the most popular drug in this group that is used to treat heart failure. It has been linked to better functioning of the right atrial and ventricle and lower pressure in the pulmonary artery. This makes it important for treating heart failure. (Yang et al., 2016)
A drug program that focuses on heart rate
When someone has heart failure, their cardiac output drops by a lot. To make up for this, their heart beats faster to get enough blood to their other systems, which increases their heart rate (Mentz & O’connor, 2016). The goal of Calcium Channel Blockers (CCBs), a group of drugs, is to slow down the heart rate. Ivabradine is a popular CCB used to treat heart failure. It works directly on the sinus node to slow the heart rate without having any bad effects on the blood flow. Mentz and O’Connor (2016) found that people with heart failure who used the routine had better vascular stiffness, ventricular elasticity, and diastolic function, all of which led to a better state of health.
Pharmacological strategy targeting natriuretic peptide
When the heart has to work too hard to get blood to organs in the body’s periphery, there is a lot of ventricular stretching, which causes natriuretic peptides to be released (Mentz & O’connor, 2016). Natriuretic peptides are very important for dilatation, natriuresis, and the relaxation of the heart muscle. Vasodilation lowers high blood pressure, natriuresis gets rid of sodium and water to lower fluid overload, and myocardial relaxation increases heart output. Neprilysin is a protease inhibitor that breaks down biologically active natriuretic peptides. This means that the peptides no longer offer the benefits they did before. Valsartan is a drug that is often used as a neprilysin inhibitor.
The drugs that are used to treat fluid overload
It is common for people with heart failure to have too much fluid in their bodies because aldosterone keeps water and salt in their bodies. It’s important to use diuretics to relieve the signs and symptoms of fluid accumulation. Mentz and O’connor (2016) say that some of the signs are leg swelling and lung edema, and that some of the symptoms are trouble breathing and chest pain. Loop diuretics like furosemide are often used to get rid of too much fluid in the body. The diuretic effect of furosemide reduces pulmonary edema while the anti-vasoconstriction effect relieves pulmonary hypertension. Because they work better in the body, injectable loop diuretics are better than oral diuretics.
Changes in how the body works are taken into account when recommending treatment for heart failure.
When choosing the best treatment, pathophysiologic changes are taken into account. First, the patient’s signs, such as too much fluid in the body and a faster heart rate. Mentz and O’connor (2016) say that the signs help the doctor decide which drugs will work best. For example, a doctor would have to prescribe diuretics if there were signs of too much fluid in the body, like swollen legs and lung edema. On the other hand, if the heart rate is high, it would be a sign that the person needs to be checked for cardiac enlargement and fibrosis and given a treatment plan that focuses on heart rate, like Ivabradine, which is a calcium channel blocker. The second thing that needs to be taken into account is the pathophysiology of the patient. This is because it can help determine the best treatment plan for the patient. For example, beta-blockers are not the first choice of treatment for a diabetic patient who is showing signs of heart failure. This is because beta-blockers slow down the response of endocrine organs to hypoglycemia and bronchoconstriction, which makes the underlying medical situation worse. In this case, this is especially true for advanced cases of diabetes. Also, the doctor should ask if the patient has ever been sensitive to any drugs. If so, the drug they want to give the patient may be the cause and do more harm than good. Lastly, you must think about the changes in pathophysiology that were caused by the risk factors that led to heart failure. For example, if a patient is overweight, which increases the risk of high blood pressure and heart failure, the patient must also take anti-arrhythmia drugs because being overweight increases the risk of cardiac rhythms.
Heart failure is a medical situation in which the heart can’t pump enough blood to the rest of the body to meet the organs’ needs for oxygen and nutrients. When a person has heart failure, they may feel tired easily, have shortness of breath, swollen legs, and a cough that won’t go away. (Jagadeesh, Balakumar & Maung, 2015). After a patient has been diagnosed with heart failure, different drug treatments can be given to improve his or her health. Each pharmacological program has its own reasons for using it, or its intended effect, and its own way of working, which varies from class to class. Angiotensin-converting enzyme inhibitors, such as enalapril, and angiotensin receptor blockers, such as losartan, are two types of drugs that are used to treat heart failure. Some, like Nitroglycerin, relax the blood vessels. Others, like furosemide, which is a loop diuretic (Jagadeesh et al., 2015), are diuretics.Also, when prescribing these pharmacological regimens, the doctor needs to think about the pathophysiologic changes that will happen. Some other things to think about are the patient’s symptoms. For example, if the patient has signs of fluid buildup, diuretics may be needed. Preexisting conditions, such as diabetes, mean that some treatments, like beta-blockers, can’t be used because they will make the underlying medical condition worse. (Jgadeesh et al., 2015). Pathophysiologically, it’s important for doctors to think about the causes of heart failure and how the person reacts to any drugs used to treat heart failure.
Advances in the pathophysiology and treatment of heart failure with preserved ejection fraction. (n.d.). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391977/
Dai, Z., Zhu, M. M., Peng, Y., Machireddy, N., Evans, C. E., Machado, R., … & Zhao, Y. Y. (2018). Therapeutic targeting of vascular remodeling and right heart failure in pulmonary arterial hypertension with a HIF-2α inhibitor. American journal of respiratory and critical care medicine, 198(11), 1423-1434.
Colafella, K. M. M., Bovée, D. M., & Danser, A. J. (2019). The renin-angiotensin-aldosterone system and its therapeutic targets. Experimental eye research, 186, 107680.
Jagadeesh, G., Balakumar, P., & Maung-U, K. (Eds.). (2015). Pathophysiology and pharmacotherapy of cardiovascular disease. Springer.
Mentz, R. J., & O’connor, C. M. (2016). Pathophysiology and clinical evaluation of acute heart failure. Nature Reviews Cardiology, 13(1), 28-35.
Yang, J., Savvatis, K., Kang, J. S., Fan, P., Zhong, H., Schwartz, K., … & Adamkewicz, J. (2016). Targeting LOXL2 for cardiac interstitial fibrosis and heart failure treatment. Nature communications, 7(1), 1-15.
Zipes, D. P., Libby, P., Bonow, R. O., Mann, D. L., & Tomaselli, G. F. (2018). Braunwald’s Heart Disease E-Book: A Textbook of Cardiovascular Medicine. Elsevier Health Sciences.
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