The Clinical Pharmacology of Heart Failure Flashcards
What are the strengths of diuretic therapy in the treatment of congestive heart failure?
- Reduce symptoms of tiredness/fatigue and improve exercise capacity
What are the disadvantages of diuretic therapy in the treatment of congestive heart failure?
- Dehydration
- Hypotension
- Hypokalaemia, hyponatraemia
- Gout
- Impaired glucose tolerance, diabetes
What are the strengths of ACE inhibitors in the treatment of heart failure
- reduces morbidity
- reduces mortality
What are the weaknesses of ACE inhibitors in the treatment of heart failure
- cough
- angioedema
- renal impairment
- renal failure
- hyperkalaemia
Explain the role of renal and hepatic dysfunction in adverse drug reactions and drug
interactions
can cause renal toxicity
What are the hormonal and physiological responses to heart failure and the potential
sites for therapeutic intervention.
- Cardiac output falls
- The body registers this as a loss in circulatory volume
- Vasoconstrictor system activation (Sympathetic systems)
- Salt and water retaining system activation (RAAS)
FRANK STARLING LAW
if the muscle of a healthy heart is stretched it will contract with greater force and pump out more blood.
- In the failing or damaged heart this relationship is lost
- As circulatory volume increases the heart dilates, the force of contraction weakens and cardiac output drops further
THE FINAL RESULT
- A failing heart that can not pump out sufficient blood to supply the needs of the body
- Progressive retention of salt and water which results in peripheral and pulmonary oedema
- Progressive vasoconstriction, myocyte death and fibrosis
What are the strengths of beta-blockade in the treatment of heart failure?
- reduce morbidity
- reduce mortality
What are the weaknesses of beta-blockade in the treatment of heart failure?
- Deteriorating symptoms of heart failure (such as symptoms of fluid overload and fatigue
- Hypotension
- Bradycardia
