Drugs for treating heart failure
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Drugs for treating heart failure. A. Introduction. Heart failure (HF) is due to the inability of the ventricles to pump sufficient blood thru-out the body. There are a number of causes of heart failure:. diabetes. from:http://www.nhlbi.nih.gov/health/dci/images/heart_coronary_artery.gif.

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A introduction
A. Introduction

  • Heart failure (HF) is due to the inability of the ventricles to pump sufficient blood thru-out the body.




From http www nhlbi nih gov health dci images heart coronary artery gif
from:http://www.nhlbi.nih.gov/health/dci/images/heart_coronary_artery.giffrom:http://www.nhlbi.nih.gov/health/dci/images/heart_coronary_artery.gif

  • coronary artery disease


  • chronic HTfrom:http://www.nhlbi.nih.gov/health/dci/images/heart_coronary_artery.gif


  • MIfrom:http://www.nhlbi.nih.gov/health/dci/images/heart_coronary_artery.gif






B pathophysiology of heart failure
B. Pathophysiology of heart failure treating/removing the underlying causes in order to improve the quality of life and/or extend life expectancy.

  • Two important factors which affect cardiac output, and therefore affect how heart failure is treated, are preload and afterload


1 preload
1. Preload treating/removing the underlying causes in order to improve the quality of life and/or extend life expectancy.

  • Immediately before the chambers of the heart contract they are filled to their maximum capacity with blood.




2 afterload
2. Afterload they will contract

  • For the left ventricle to pump blood out of the heart, it must overcome a fairly substantial pressure in the aorta.





3 left heart failure aka chf
3. Left heart failure aka CHF or on both sides.

  • If heart failure is on the left side (more common), excess blood accumulates in the left ventricle.





4 right heart failure
4. Right heart failure breath, especially when a patient is prone

  • Here, blood “backs up” into peripheral veins.



5 cardiac output
5. Cardiac Output (peripheral edema) and engorgement of organs such as liver

  • Cardiac output (the amount of blood pumped by the heart per minute) is significantly decreased during heart failure.




C drug class mechanisms of action in treating heart failure
C. Drug class mechanisms of action in treating heart failure

  • There are a number of different mechanisms of action when considering how to treat heart failure:








1a cardiac glycoside therapy of heart failure
1a. Cardiac glycoside therapy of heart failure characteristic of the natriuretic peptides.

  • The cardiac glycosides are derived from the foxglove plants, Digitalis purpurea and

    Digitalis lanata











  • Elevated Ca is inhibition of the 2+ results in an increase in the force of heart contraction









1b phosphodiesterase inhibitor therapy of heart failure
1b. Phosphodiesterase inhibitor therapy of heart failure believed, by some physicians, to show evidence of digoxin (aka digitalis) toxicity, in the way he created yellow-green halos around the stars.

  • Phosphodiesterase inhibitors are used for short-term control of acute/advanced heart failure that is unresponsive to the “more conventional” ( i.e. diuretics and ACE inhibitors) treatments.



  • An increase in muscle which prevents the hydrolysis of cAMP. cAMP leads to an increase in Ca2+.




  • Phosphodiesterase inhibitors include: produce potentially serious adverse effects (ventricular arrhythmias, severe hypotension, thrombocytopenia)

  • inamrinone (Inocor): IV, peak effect in 10 min.

  • milrinone (Primacor): IV, peak effect in 2 min.


2 beta adrenergic blocker therapy of heart failure
2. Beta adrenergic blocker therapy of heart failure produce potentially serious adverse effects (ventricular arrhythmias, severe hypotension, thrombocytopenia)

  • Selective beta blockers target beta1 receptors in the heart and kidneys. They are used in combination with other drugs to slow the progression of heart failure and to prolong patient survival.








3 vasodilator therapy of heart failure
3. Vasodilator therapy of heart failure failure are:

  • Vasodilators generally play a minor role in the drug therapy of heart failure.









4 diuretic therapy of heart failure
4. Diuretic therapy of heart failure tachycardia.

  • Diuretics are one of the “more conventional” treatments for heart failure.













5 ace inhibitor acei therapy of hf
5. ACE inhibitor (ACEI) therapy of HF failure include:

  • ACE inhibitors have become the preferred drugs for the treatment of heart failure.






6 natriuretic peptide therapy of hf
6. Natriuretic peptide therapy of HF treatment of heart failure include:

  • Natriuretic peptide was approved in 2001 for the treatment of heart failure.








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